PMDD and breastfeeding with Lucy Webber IBCLC

The brilliant Lucy Webber IBCLC returns to talk to me today, and this time about a subject that is personal to her  - PMDD (Premenstrual Dysphoric Disorder). Lucy shares her personal experiences with PMDD, the importance of recognizing its symptoms, and the need for proper support. We talk about the challenges families face with the impact of returning menstrual cycles on lactation, especially when coupled with the severe symptoms of PMDD. We also explore the intersection of PMDD with perimenopause, and how to approach getting help from your GP.

My new picture book on how breastfeeding journeys end, The Story of Jessie’s Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children’s Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.

You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com 

Resources mentioned - 

Management of Premenstrual Syndrome - 2017 - BJOG: An International Journal of Obstetrics & Gynaecology

 https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14260 

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

This transcript is AI generated.

[00:00:00] Emma Pickett: I am Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself Makes Milk. That was my superpower at the time because I was breastfeeding my own two children, and now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end, and I'm big on making sure parents get support at the end too.

Join me for conversations on how breastfeeding is amazing and also sometimes really, really hard. We'll look honestly and openly at that process of making milk, and of course, breastfeeding and chest feeding are a lot more than just making milk. Thank you very much for joining me for today's episode. I am thrilled today to be joined by Lucy Webber.

That's Lucy Webber, IBCLC. Um, I first spoke to Lucy about 70 episodes ago on this podcast when we talked about the fourth trimester. I know when people present Saturday Night Live, they get given a jacket when they've been on five times. So I'm gonna get the jackets commissioned. So when you do come on the podcast for your fifth time, I will, uh, give you a special award.

I'm so grateful for you coming on again. Last time we talked about the fourth trimester because your book about breastfeeding in the fourth trimester hadn't been out super long when we first spoke. And I think that book really is essential reading for all for new and expectant parents. In fact, I'm literally doing an antenatal session after this and I'm going to give them a copy 'cause I give people a copy of that book.

Um, so important, I think the messages that you, you share in that book and your Instagram, your social media are absolute essentials for anybody who's working in this space. Your work is all about who you are, which is authentic and real, and honest, and empathic and knowledgeable. And you tell the truth and you do it beautifully.

And, um, you're one of my very favorite British IBCLCs. Mm-hmm. So thank you very much for joining me. Um, today we're gonna be talking about a topic which may not connect with everybody. So obviously the last topic, the fourth trimester, everyone goes, oh yeah, yeah. We all do the fourth trimester. But some people might look at the title of this episode and think.

What's that? Is that a typo? Is there an extra D there? Did she mean PMDD? So this is an episode which I hope will be impactful in a different way because if someone is being affected by this, they can feel really isolated and misunderstood. And people who work with them or know them may not understand either.

So even if only one person feels more supported by this episode, or one person supporting someone else feels more knowledgeable, I think that is a win in my mind. Thank you so much for your time today. How does it, how's it going with the book? You're two years now into the book being published. How have those two years been for you?

That's a big question. It's a big 

[00:02:46] Lucy Webber: question. It's any way you want. Yeah. It's a big question. Thank you. Oh, that's lovely. Yeah. Um, it's lovely to hear that you're giving it out to people. That really does mean a lot. 'cause it's really hard when you. When you put out a book, when you put stuff out on social media, you can delete it.

If you suddenly think, oh, I'm uncomfortable with that, or I haven't phrased that correctly, or, you know, actually I don't, I don't want that message to, to be like that. And you can't do that with a book. Um, once it's out, it's out. And so you've gotta be pretty confident in it. And I'm generally very underconfident in most things.

So to have it out there, and I know it's making a difference to people is, is gorgeous. And it's never going to be a mainstream book because it doesn't talk about how to make our babies independent and make them sleep through the night and put them in a routine. And that's, you know, often what we're told is what needs to happen, right?

So it's never gonna be a mainstream book, and I'm comfortable with that. But for the people that do find it, generally, they are finding it extremely helpful and enjoying it. And that's worn just gorgeous, that I love it. So I'm, I've really enjoyed it being out there. Once I got over the initial terror. Of putting it out there.

[00:03:56] Emma Pickett: Yeah. I relate to the terror thing. Yeah. Um, yeah. You say you can't take it back and then when you, when new stuff comes out or you think differently about things, you think, well, the old stuff's still in that, in that book. I can't go around to everyone's houses and take it all back. Um, yeah, no, I, I, I do think that the best people have imposter syndrome as well, which maybe you have a slight touch.

Oh, just a touch on what you, just based on what you're saying, it's interesting what you're saying about the messages in that book not being mainstream because routines and sleeping through the night are mainstream. I genuinely think there has been a shift Yes. In the last 10 years or so. Yes. I would say since I first started doing this, I very, very rarely meet somebody now who says, I'm following this book by a woman whose surname begins with F and I'm going to get them on a routine.

And that's the way it needs to be for me and my family. Um, I very rarely meet those people now. Mm-hmm. Um, whereas I used to meet them once a week. Yes. Um, people who, from a sort of professional background who would say. And then this baby needs to fit in with my routine and they've got to be sleeping 12 hours.

[00:04:57] Lucy Webber: Yeah. 

[00:04:57] Emma Pickett: I think it's partly because of the work of you and people like Lindsay Hway. And actually one of the benefits of social media is that more and more people are coming across the core group of qualified people who actually talk about biology and what's normal. Yeah. Um, and realize that actually the people who are talking about the non biologically normal stuff.

'cause they don't have an evidence base. They can't keep spitting it out day after day because you peter out when you're not talking. Yeah. Reality and truth. And if you haven't got anything to back up what you're saying, you can't keep going post after post, after post. So I don't think social media is giving those people loud voices and amplifying that message.

So I think, um, am I, am I wishfully thinking here? What do you feel? No, 

[00:05:39] Lucy Webber: I do think there's been a change. I sometimes wonder if it's just that their algorithm, I guess to some extent means that the people who want to find people like us find us. And the people who don't don't and they go down the other, the other route.

I dunno. So maybe it's just that they know that they're not going to get what they want, I suppose through, but I, yeah, generally I think there has been, has been a shift to a much more understanding of, of the fact that children. Have needs and their needs need to be met. And that's not just a physical need, but it's an emotional need and a, you know, mental health and connection.

And, you know, it's really not that long ago where people were talking about babies having vaccinations, didn't hurt them. You know, 'cause they didn't feel pain because they were a baby. And that wasn't really that long ago. And that, you know, we, I think most people are now aware that that's kind of not the case.

So yeah, I do think there is a shift. I hope it will continue. 

[00:06:35] Emma Pickett: Okay. Let's talk about periods. Mm. Let's talk about periods. So before we talk about PMDD and what that is and what that means, I, let's talk about periods and lactation more generally because I'm willing to bet you and I have similar conversations with people when they get in touch, when they're asking questions about their, their cycle and breastfeeding.

What are some of the common conversations that you are having with people? 

[00:06:57] Lucy Webber: Uh, it's the sort of two extremes, isn't it? It's the, I've got my period back at six weeks. Is that normal? What's gonna happen? Is it all going wrong? And the other extreme of my period will not come back. What can I do to get it back?

I'm, you know, a year and a half down the line and I want to have another baby and I just can't get my period back. So this kind of, uh, very, very normal spectrum of periods coming back throughout the time that you're breastfeeding or not coming back and the worry about which is the norm and the fact that all of it can be absolutely the norm.

So I dunno whether you are of the thought around this sort of six week weird bleed that can happen that sometimes looks like a period coming back and then nothing kind of happens again after that. That's something that I come across quite often. People going, oh, I got my period back at six weeks, but then it, it didn't come back again.

I think there is something around the six week mark that, you know, I have no evidence to back that up, but it seems like there's something around six weeks that some people will have a bit of a bleed, but actually isn't a period coming back. I dunno whether you've noticed that. Yeah, 

[00:07:57] Emma Pickett: I mean, I haven't met people whose cycle is starting regularly.

You know, at two months, three months, and how that doesn't seem to fit with everything else. You know, people who are exclusively breastfeeding and, and responsibly feeding and co-sleeping and their periods coming back. And then when they read literature about, you know, using breastfeeding as a contraceptive method, it seems so confusing that they don't fit in that group.

And, and often people think, what does that mean? My milk supply's Yes. Going, is that the end of my breastfeeding journey? Is that the end of it? And um, and another common conversation is when people have their first period, they may notice that their milk supply takes a little bit of a dip that first time, first c fracture 

[00:08:35] Lucy Webber: babies, um, yeah.

And going, oh no, it's all, it's all, you know, going to pot. And, um, this is gonna be the end. And, and of course the hormonal fluctuations with that meaning emotions as well for a lot of people, meaning that then that feels even harder. Um, so yeah, definitely the worry about is it, is it all going wrong because I've got my period back is a big one.

[00:08:56] Emma Pickett: Yeah. And, and if the first cycle hits your supply particularly hard, it doesn't necessarily mean that's gonna carry on for every cycle. Some, some people will not be affected the next time. Um, but some people will be, some people will feel there is a little bit of a dip and, and you see online conversations about taking kind of calcium and magnesium supplements.

Mm-hmm. I don't think we fully understand why that works, but that's some people that seems to help a bit. Yeah. And then also, as you say, conversations around worrying about fertility and worrying that their period doesn't come back at two years or, you know, what does that mean? And, and, and the myths around that people saying, oh, it doesn't matter.

Your period doesn't come back, you're still fertile. Yes. Keep trying, keep trying. Yes. And that irritates 

[00:09:35] Lucy Webber: me more than anything I know. You can catch the first egg, uh, sort of situation. And actually for a lot of people, especially in that first six months, if they get period, their period back, they're not ovulating necessarily.

That's not to say you should definitely use it as a form of contraception. Um, that's a whole thing, isn't it? But, um, you know, if you, if. Don't want to get pregnant, then don't rely on it necessarily. But for most people, even if they do get their period back at 3, 4, 5 months, they're possibly probably not ovulating for the first cycle or two anyway.

So it isn't as simple as, well, you could get pregnant even before your period comes back. In theory, possibly, yes. But actually it's really, really rare. I know the internet says it's not rare and there's always, you know, well my cousin's dog's neighbor's friend did it and uh, you know, but actually how many people we actually come across that have got pregnant before they've had a period while they're breastfeeding is minute.

[00:10:26] Emma Pickett: Yeah. Yeah. And it's far more likely that you will ovulate. And even that ovulation won't be enough to be fertile because it'll be a sub mature egg, and your, your cycle won't be long enough. And I think people just need to really drill down and understand their cycles rather than, oh, there's that one person in a group who didn't, you know, didn't have to have a period and got pregnant.

Um, yeah, and I, I know I always refer to Carol Smith, Smith with a y her, her articles on breastfeeding and sensitivity. Fabulous. Super, super useful. So, I mean, I, I mentioned about the calcium and magnesium supplements. If people are worried that their babies are fussy, and this is gonna sound, it's really hard to kind of unpick what's our perception and what's the reality.

But I do think there's also a factor where people are not feeling great themselves because their periods come back and then that changes how they interpret their baby's behavior. That changes how they feel around their baby. And, and we get this kind of dyad kind of bouncing off each other. Mm-hmm.

Mm-hmm. So, I'm not sure that fussiness is always a direct result of something having changed in the milk or the milk tasting different. I think sometimes it's our. Perception. Is that, is that fair? Yeah, I 

[00:11:30] Lucy Webber: think so. I think yeah. And often a mixture of the two, isn't it? They may be that little bit more fussy, but just that tiny bit more fussy, but that feels like massively more fussy because you are just touched out or, or just everything is too much.

And um, especially if you are, if got nipple sensitivity or if you've got a version around your period, then yeah, you really, feeding that baby is, can be foul. Um, and so, you know, and that's awful if you're feeling like that. 'cause then you feel the guilt around it and all sorts of things. So then every feed feels like, oh, they're feeding so much.

Whereas actually a week later you might be feeding even more often, but barely notice. 

[00:12:07] Emma Pickett: Yeah, I'm glad you mentioned diversion. I think there's a really strong relationship between aversion and our cycle, and I'm sure, we'll, we'll talk about that a bit more in more detail in a minute. But, um, I have one guest on one of my podcast e episode episodes called Reiki, who really noticed that relationship.

And quite often I get people contacting me going, oh, I think I need to start weaning. Um, I'm just gonna give it a few days and be back in touch. And then I notice they get back in touch. The time later. Yeah. Time a month later. Mm-hmm. Literally, I've, I've had that a couple of times and people go, actually, I, you know, I'm fine actually.

I, I always thought I was fine, but maybe I'm not fine. And then they're fine again. And, um, sometimes if you notice that pattern, it makes such a difference. Uh, so many things with lactation, if you realize what's normal, it can feel better, even if it's not easier. And, and with older nestlings, you can talk to them about, you know, today's a day when mommy's not feeling great, so we're gonna have a little bit less milky and there's shorter milky.

And um, and then obviously there's that nipple sensitivity that comes from hormonal changes as well. And the nipple actually. Being painful, not because of latching, but because of the hormones. So our bodies do annoying things sometimes. They do wonderful things and annoying things. I want to tell you about my brand new book called The Story of Jesse's Milky.

It's a picture book for two to six year olds, and I wanted to write a book that was about weaning, but also not about weaning, because breastfeeding journeys end in all sorts of different ways. So Jesse's story is presented as having three possible endings. In one ending, his mom is pregnant and Jesse's going to share his milk with a new baby.

In the second, his mom is getting really tired and it's time for some mother led weaning. And in the third, we see a self weaning journey as Jesse's attachment to breastfeeding gradually fades. There are beautiful illustrations by the very talented Jojo Ford, and the feedback from parents so far has been so lovely and touching and I'm really excited to share the book with you.

If you're interested in my other books for Older Children, I have the Breast book, which is a guide for nine to 14 year olds, and it's a puberty book that puts the emphasis on breasts, which I think is very much needed. And I also have two books about supporting breastfeeding beyond six months and supporting the transition from breastfeeding for a 10% discount on the last two.

Go to Jessica Kingsley Press. That's uk.jkp.com and use the code. Mm PE 10 Makes milk picket Emma 10. Let's talk about PMDD. So, I mean, as a society we joke a lot about PMS and PMT and um, we probably joke about it more than we talk about it seriously. In terms of sort of popular culture, what is PMDD?

'cause I bet a lot of people aren't familiar with it. Yeah, 

[00:14:53] Lucy Webber: so a huge amount of people get PMS and it is the butt of the joke, isn't it? It's often, oh, you're a bit moody, or you're getting your period and, you know, and it's, it's not kind of okay, and there's a whole big patriarchal nonsense around that, that we could deep dive into, but we better not, um, quite a huge amount, amount of people.

It's something like 70% plus we'll get some physical or emotional symptoms around the few days before their period and their period. But for people who get PMDD, which is, um, premenstrual dysphoric disorder, it's, it's much, much smaller. There's not enough research into this, as there often isn't with women's health.

And certainly with breastfeeding, the numbers vary and it's between like one and 8%. People will get PMDD. It is like PMS on steroids. It is like, it's horrific. It's a horrible, horrible, it's not just, oh, bit more irritable, little bit teary. It is impacting your functioning in all areas of your life, in your relationship, in your home life, in your work life, in your, you know, everything.

It is. It is awful. And for anybody that struggles with it like I do, which is the reason I'm here, I really feel so bad for them because it is not understood by most people and it is minimized. And certainly in the healthcare system it can be a little bit, yeah, just that. Oh well it's just PMS. You just have to deal with it.

It's just normal. And with breastfeeding as well. Breastfeeding can be a bit of a scapegoat for stuff, can't it? Oh, well, it's because you're breastfeeding, that kind of thing, so, um, but I'm sure, we'll, yeah, we'll come on to that a bit more, but yeah. PMDD is a significant difficulty in functioning in your life.

Premenstrually, it can be. Just, you know, only a few days before your period, or it can be that whole latter part of your cycle. So from sort of after ovulating onwards for, you know, a couple of weeks-ish. Um, and it is awful. 

[00:16:45] Emma Pickett: I mean, 8%, I mean, that's an enormous, that's high. That's a high figure. I mean, that's sort of like significant rates.

Mm-hmm. You don't care. Many people, we talk, we talk about babies of tongue tie. That's a a lot of people Yeah. Struggling and potentially for half of their lives. That's intense. Seriously intense. And there 

[00:17:00] Lucy Webber: is, there is some research around it. They took into account the cycles over your lifetime and they took out an average of.

Now what's interesting is they took out two pregnancies and postnatal periods, so cycle list times. And they put 22 months for that, which. I guess maybe they've worked out the averages, but it's interesting that two pregnancies and postnatal periods, they thought that we would have just 22 months of cycle this time, but nevermind about that.

Um, but that's what they've worked it on, and that apparently is 481 cycles of your lifetime and that equates to eight years of symptoms of PMDD in your life. So eight whole years struggling with PMDD. If you are a ser 

[00:17:44] Emma Pickett: that's a long time. Yeah. I know you've very kindly come on today to talk about your personal experience, which I really appreciate.

'cause that's not something that we, we always do with our I-B-C-L-C hat on. Mm-hmm. Hats on. But I think it's really valuable for people to hear you today, because obviously you've got the, the BRE breastfeeding experience and expertise and your experience of this as well. When did it first become o obvious to you that you were struggling more than most people and how old were you?

[00:18:08] Lucy Webber: Oh, I mean, uh, probably even as a teenager, it was apparent. You know, even more so then it was just you were put down to you're just a teenager or you're just, you know, uh, and especially sort of in the nineties, even more so, oh, you've got PMT ha ha ha kind of thing. Looking back, now that we've got our NHS apps, uh, and we can look back at consultations we've had with gps, I can see conversations, um, about my premenstrual concerns back into, I think it was 2006 or before.

So I have been going to them and going, help me, help me. Please, could you help me for a really, really long time? But it's definitely before that, I mean, that was when it was reaching absolute boiling point for me to go and sort of ask for help and, and going outside of my self-help measures and thinking I needed to seek external support at that point.

Um, so a very long time, and it can impact, you know, it can, it can hit at any point really. It's more likely in certain people, so it is more likely. If you've had trauma, so childhood trauma or traumatic events. And that does make me wonder about people who've had birth trauma, which is not an insignificant number of people actually, is it?

I think back to my first birth, which on paper was fine. Um, fine, apart from being 36 weeks and five days. So a touch premature. But aside from that quick labor, pop this baby out in three hours. Not a problem. No, no difficulties. Vaginal birth, absolutely fine. To me, even as a midwife at that time, that labor was so fast and so intense that I absolutely would class that as traumatic for me at the time, it was traumatic, even though on paper it was fine.

So I don't think this is a case of, oh, you've had forceps and cesarean and bleeding and NICU and all sorts. I don't think it has to be like that to be a traumatic birth necessarily. Trauma for someone is gonna be very different for someone else. So, but I, I do wonder about if we know that people, if, if trauma is a, is a risk factor for PMDD, then yeah.

Is there people that are potentially going to be developing that after having had their baby where they may not have had it before? 

[00:20:20] Emma Pickett: So that would obviously over be overlapping with the breastfeeding experience Yeah. If they're for the first time having it postnatally. Absolutely. Um, can I just ask you a bit about your symptoms?

Yes. What, if you were kind of watching yourself with a drone, what do you, how do you look different from, from normal? Am I allowed to say normal? 

[00:20:38] Lucy Webber: Yeah. Yeah. From a, from my day to day life, it's like I'm a totally different person. I'm a totally different person. I have to plan my work around my cycles because I can barely work when I am in that, especially that few days before I get my period.

I can barely work. Because partly just an inability to cope. My brain is completely foggy. I can't think of words. I mean, obviously that's all worsening with perimenopause generally. That's a whole nother thing, isn't it? Um, I, I can't think straight. I can't cope. I'm incredibly tearful. And when you are in a job that you are emotionally giving yourself over to somebody else, you have to be quite fully invested in that.

And I really genuinely feel that if I can't give myself over to somebody completely in that time we're meeting, then I shouldn't be doing it. So I will have to schedule my work around my cycles, which is crazy, isn't it? I don't think many people do that. My family all are, well, the, the, the older ones, certainly not my 9-year-old necessarily, but the older ones in the house are aware and support me beautifully actually.

They're gorgeous. Thank you to them. But they're aware that I just need to be treated very differently. I need to go and hide a lot. I need to be as understimulated as possible. I need to be quiet. I need to do as little as I can. They, they know that the house needs to be as tidy as it can be. Because if I, I, if there's mess anywhere, I just get a bit like I just can't, you know, if there's stuff in my eye line, I can't, I can't cope with it.

So mainly emotional, physically, actually these days I'm barely affected. I don't get any, uh, sort of breast pain or stomach cramps necessarily or anything massively significant at all. The physical symptoms I would class as within the realms of normal. It's mainly emotional, I suppose. Yeah, there is, there is fatigue and brain fog.

Brain fog. Would we call that emotional or physical? I dunno. That's an interesting one, isn't it? Um, but yeah, it. It's just an, an inability to cope in all areas. I can't go to the supermarket. I couldn't take a list to the supermarket and just try and do some normal shopping. I would end up standing in front of the bread going, I can't remember what bread we buy.

I don't know. Should I be getting different bread? This is on offer. I, I, you know, sort of decision paralysis. Just a, a, you know, just like I, I need to leave. I've just got to leave the supermarket. And the shame that comes with that, the guilt and the shame that comes with not being able to function in your day-to-day life is enormous 'cause it's so misunderstood.

[00:23:23] Emma Pickett: Yeah. Um, gosh, I'm thinking when you're working as a, if you're working as a midwife, doing shifts all the time. Mm-hmm. I just don't know how anybody would cope and we don't have a working world where we can say, oh, these are the few days off a month where I'm going to need to step back. No, indeed. Um, I mean, I guess as you, as you're now self-employed, you're able to, and lucky to be able to do that, teaching responsibilities and, and appointments and things around it, but there must be people out there who are really struggling to hold down work at all.

Yeah, 

[00:23:50] Lucy Webber: it definitely is part of the, the one of the reasons that I'm, you know, now working in a self-employed way, one of many reasons, but also that, uh, I, looking back, I remember having a, a meeting with my manager years ago. It was probably early two thousands where we were talking about my sickness absences, and we noticed that I was off sick more frequently around, you know, the time of my periods.

So it, it really was, you know, impact just that I, I, I just can't do it. I just cannot do it. And not, I hadn't noticed that cycle of, of what was happening until then. 

[00:24:25] Emma Pickett: So the, the initials that word dysphoric mm means something's going pear shaped, something's wrong, something's abnormal. I don't really understand the science of what that word means.

I know I use it in terms of, you know, d merr Mm. And dysphoric milk ejection reflex, but mm-hmm. That suggests it is more about a mental issue, but it, but from what you're saying there is also people do also have more severe physical symptoms. Is it true if someone's got, the more, you know, if someone's got endometriosis, they're more likely to struggle from it.

Have we seen any other physical connections? Um, 

[00:24:57] Lucy Webber: I dunno about the endometriosis one, as I said with, with all of this, I mean there's that lovely, you know, fact isn't there from I think Amy Brown who, who showed us that actually the study into endometriosis impact on partners actually received more funding than the endometriosis research, which, you know, says it all.

So, um, there is not going to be a piece of research probably into PMDD and endometriosis, but it wouldn't surprise me at all if people who have that have more, a more likely trauma. As I said, people who I was gonna say it's connected to trauma from Yeah. Pain and trauma. People with family history. There, there's got to be something genetic.

'cause it, it runs through families. We know that, that if you are, you know, siblings, parents, whatever are, uh, have it, you're more likely to have it. Generally if you have anxiety and depression, you are more likely to neurodivergent people, people with gender dysphoria more likely to have it. So there, there are, uh, you know, people who, who are more at risk, I suppose.

And then, yeah, the, the physical side of things, I mean, it isn't just sore breasts and, and cramps. It can be joint pain, exhaustion, night sweats, um, you know, and so many of these things that link with breastfeeding that we, you know, that if you went to somebody and said, oh, I'm getting, you know, kind of night sweats, they might go, well, that's normal for breastfeeding.

And it know can be normal for breastfeeding. But also in that instance that is also a red flag for something going on, you know, hormonally. So 

[00:26:25] Emma Pickett: you mentioned that you would, you eventually were seeking some professional help back in the sort of early two thousands, but you had been doing some self-help.

What Self-help stuff is good for you and does make a difference for you. 

[00:26:39] Lucy Webber: I've, I've tried a bit of everything really. So we know that smokers are more likely to have PMDD and I was smoking then smoking was cool in the nineties. Um, uh, and I was smoking then. And so whether that was having a worse impact, I don't, almost certainly was.

So stopping smoking, obesity again, obesity is a, is something that is, um, is a risk factor and my weight has fluctuated over the years. Recently I've lost a, you know, a fair chunk of weight, not for appearance reasons, 'cause I do not buy into that at all, but for health reasons as I hit perimenopause. And I really can't say my PMDD is any better for losing weight at all, but that's, the studies show that it, it is likely to be better.

Sadly, that didn't work for me. I tried things like. You know, getting out, doing moderate, mild to moderate exercise. So walking or going to the gym, more sleep, less sleep, CBT sort of, you know, cognitive behavioral therapy. What other things generally just, you know, movies and chocolate indulging the, I just need to sit and do what my body's telling me, which is to sit here and cry and watch a sad film and eat chocolate.

Um, you know, I've tried all those sorts of things and then when I went to the gp, usually they will suggest things like, um, oral contraceptives. That's a real mixed bag. So the, the theory behind PMDD and what causes it is that it's to do with hormones. Again, we don't actually know fully, we don't know. For some people combined oral contraceptives work well for other people.

It's awful and it makes things worse and they just don't feel well the entire month then. And obviously that for some people they do find that the pill does have an impact on their milk supply. That's something that would need to be thought about very carefully, risks and benefits, et cetera, for that individual person.

[00:28:37] Emma Pickett: I'm just thinking about the science of what might be going on. I mean, elevated estrogen and progesterone presumably is a factor. Yeah. So if you're giving someone the contraceptive pill mm-hmm. And boosting their estrogen and progesterone levels just a smidge, you might stop someone bleeding, but their estrogen, progesterone levels aren't gonna be changing and in a positive direction.

And as you say, you could end up tipping someone into symptoms the whole time, potentially. Yeah, exactly. Do people with PMDD have more, more of a struggle during pregnancy with things like brain fog and emotional stuff? Im just wondering if 

[00:29:07] Lucy Webber: Yeah. Yeah, I don't know. You didn't find that yourself necessarily?

No. Well, I mean, yeah, generally pregnancy, I wasn't very good at pregnancy. I, I would sort of class myself as somebody who is just generally very sensitive to any hormonal fluctuations. So pretty much from day six, day seven, post conceiving. 'cause every time I have conceived, three times I have been trying to actively trying to conceive.

And my first took a couple of years to conceive. So I was really monitoring every single aspect of my fertility at that point. And from very, very early on I had Tums like, you know, I was hyper, hyper hypersensitive to those hormonal changes. Very, very, very sick. And I do wonder if people who have PMDD are more likely to have hyperemesis.

I really do wonder, it'd be a fascinating piece of research to do anything sort of, so puberty. Early pregnancy, weaning, weaning blues for me absolutely kick my butt. They just wreck me. 

[00:30:12] Emma Pickett: I was gonna ask you about that because I have definitely noticed people who've, who describe themselves as having PMTA hit harder by weaning blues.

Yeah. So that would make, yeah, that's my very unprofessional connection. Having spoken to hundreds of people over the last few years, I've definitely noticed that pattern to the extent where I'm actually asking people, how do you feel during your cycle? Would you describe yourself as getting PT? Yes. Same.

Yeah. So that, that makes, that makes perfect sense. Um, you talked about going to the doctor and the answer is often hormonal contraception. Mm-hmm. Is there anything else? 

[00:30:42] Lucy Webber: Yeah. They often offer an SSRI, so an antidepressant, something like, um, sertraline often or citalopram. That can be taken full time as a, an antidepressant normally would be, but there also is a way of doing it just in the second half of your cycle, which threw me initially I thought, gosh, this, oh wow, I didn't even know that was an option.

This doctor knows nothing. What are they talking about? You know, went away and investigated it and went, oh no, it is actually a thing. It's in the, the sort of Royal College of Obstetricians and gynecologists sort of green top paper, you know, where they talk about it. You can just take it during that last part of your cycle, um, and then come off it when you get your periods.

And it does seem to work for some people. So it isn't even necessarily a full-time thing That worried me personally, because having been on an SSRI got quite strong side effects when starting them and thought, I don't wanna do that every month. That sounds pretty awful. So didn't opt for for that option and went onto it full time instead.

I think generally the more I talk about being dysregulated a lot, generally if you are more dysregulated in everyday life, your PMT, your PMS, your PMDD, whatever it is, is then gonna be harder. So if generally your life is, you are well-regulated, your, you've got help, you are not overloaded, your mental load is as balanced as it can be and you are sharing that load, then you're gonna manage a bit better when you get to that part of your cycle.

If you are running on empty generally anyway in the better parts of the month and then you hit PMDD, it's just gonna explode. You know? So it's, that was always a suggestion of, you know, where, where, what is your life like in the good parts of your cycle? Are you feeling like actually all is well and you are coping or are you not coping in that time as well?

And not just because of the al side of things. What else in your life can change sometimes with, with. Breastfeeding and with babies and with toddlers and things, we can't, we can't change sleep, we can't change that. They're night waking and night feeding. So what else can we change? Can we change getting some time for ourselves to go to the gym or watch Grey Anatomy reruns or um, catch up on some sleep at the weekend or whatever because we, we are not necessarily gonna be able to get that baby waking less or that toddler needing you less, but we might be able to change some other things to help you cope more and what can you change?

Yeah. But that's really hard to evaluate your own life and figure out what you can give and what you can delegate. 'cause as the default parent when you're breastfeeding, it all often falls to us, especially when we're off work in that maternity leave bit. We take, we take, we take a lot on board. So it's no wonder people are just finding it too much.

[00:33:26] Emma Pickett: Yeah. And people perceiving that maternity leave is a break. Yeah. And therefore you should be doing the housework, et cetera. So if someone does have a partner, their partner really needs to understand mm-hmm. Just how out of control this can get and how massively, it must be quite scary. It must be quite frightening to not feel, I mean, you just described not knowing what bread to buy, but actually that sounds quite frightening.

It's horrible not being able to shop in a supermarket and, and feeling that level of, of overwhelm. And 

[00:33:51] Lucy Webber: that's me on my own in the supermarket as a, you know, an, an adult just functioning, you know, and not having to look after a 2-year-old and a baby. You know, that when I had a 2-year-old and a baby and I, and, and the 2-year-old was toilet training and the baby was, you know, a bit of a, a sad baby who needed breastfeeding a lot and, and had some stuff going on, you know, that was, that was wild.

That was really, really, really hard. Yeah. 

[00:34:18] Emma Pickett: Did you find that breastfeeding, the beginning of breastfeeding was any easier when you didn't, didn't have your cycle? Did, did symptoms go? What was that like for you? 

[00:34:26] Lucy Webber: Yes, but so I didn't have the fluctuations of, so the, the, the positive with PMDD for me is that once it's done, once I get to day one, day two of my period, it lifts, it's like the clouds have cleared from the sky and the sun comes out and everyone goes, oh, she's back.

Okay, that's all right. We can all just carry on with our lives. It's all okay. So that is a positive 'cause then that, for that couple of weeks, I know that I can, uh, my imposter syndrome is better. I can do speaking gigs, I can cope with this. I can go out and see this person. I can manage on less sleep.

Gorgeous. But I didn't get that during. Early breastfeeding and when I didn't have my cycles because I was struggling with the hormones generally day in, day out. And I think that was a big part of why I had postnatal depression and postnatal anxiety, mainly anxiety with my third. So it was like, I almost had PMDD all the time, but actually it was postnatal depression and anxiety.

[00:35:34] Emma Pickett: Yeah. So there's never that kind of cloud lifting. It just feels like there's a cloud there all the time. Yeah. 

[00:35:39] Lucy Webber: But for a lot of people, if they don't have postnatal depression or anxiety and they're not having their cycles, absolutely. They say it has been just wonderful, just gorgeous to go through my pregnancy and go through however long without periods.

It's been a real relief for them. Absolute huge relief for them. And they are gutted when their periods come back. 

[00:36:00] Emma Pickett: Yeah. I mean, I, I know the answer to this question already, but I'm guessing there's no research that. Looks into whether PMDD is linked to postnatal depression or postnatal anxiety? 

[00:36:08] Lucy Webber: There definitely is a link, yeah, absolutely.

You are more likely to have, so we know you are more likely to have PMDD if you've had postnatal depression, anxiety. We dunno if it's the other way round as well, but I wouldn't be surprised at all. I wouldn't be surprised if it's, especially if there's, if it's, if it is hormonally linked, then yeah, I think it, it really will be more likely.

[00:36:32] Emma Pickett: So when your cycles return and you're breastfeeding, what does the world look like when you're looking after a little person and you know that those days are coming? Is there anything you, is there anything that you, you did, I mean, you talked about trying to get time to sleep in at the weekends or getting a bit of extra support.

What, what practically made a difference for you in those weeks? 

[00:36:52] Lucy Webber: Yeah, I mean, you, you have to, if you've got a partner, you have to lean on your partner a lot. And I think that takes a massive strain on your relationship and it depends entirely on. How that relationship is, how understanding they can be of what you're saying.

People are very, very different, aren't they? And, and some people will go, look, this is what's happening for me. I need you to step up. And others will go, no, it's okay. I can just keep going. Just keep going. And you really need to be able to lean on your trusted person, whoever that is, whether that's your partner or your mom or your friend or whoever.

You need to be able to lean on them because actually you can't keep going, uh, through those few days. And for some people it's longer than a few days. It can be a couple of weeks, which is awful when you get two weeks on, two weeks off, um, really, really hard. So, yeah, and knowing that it's coming, I mean, tricky when your cycles are irregular 'cause you dunno when it's coming, so you can't plan as much.

Um, leaning on other people taking it depends. It, I guess it depends on what you need. For me, I needed to do something every day. Because it was easier actually being out with babies and toddlers and going to groups than being at home with them and having them feed more. Um, you know, when you're home, they're just on you, on you, on you, on you, on you.

When you're out. Then you might get, you know, a journey in a car or a push chair where they're not on you and you get a bit of fresh air and you are walking or whatever. Um, if I didn't have something planned in every day, I found that much harder. But for somebody else, that would be totally different.

They might just need to completely retreat and now I don't plan things in, you know, but I did need to when I had the babies. Did 

[00:38:21] Emma Pickett: you ever take sort of. Natural supplements. I dunno if you're a Herley person. I'm not. So I'm always curious when people are, yeah. Is there anything that people take? I mean, you hear people taking, you know, evening primrose oil and mm-hmm.

St. John's wha and things for various women's issues in ver commas. But some of those wouldn't be compatible with, with antidepressants, I'm guessing. And, and is, did anything like that ever help you? 

[00:38:45] Lucy Webber: I tried some Agnes Castus a few years ago, which did seem to really help, but I dunno whether it was, and then, and then things got a bit better and then I, as you do, stopped taking it 'cause I was like, oh, it's fine.

Um, and then I've started taking it again fairly recently just to see whether it will kind of help and it hasn't kind of done anything yet, but other things sort of Herbie, things that people have come across. Vitamin B six, magnesium always cropping up, isn't it? And Calcium, Agnes Castus. But again, the, the sort of diet modifications, things like complex carbs and, you know, lots of protein cutting back on sugar.

You know, trying all these things and, and from the groups I'm in, it seems like other people, the combination of what's right for them is really, really different. There's a, a large amount of people taking antihistamines on their difficult days. Wow, okay. Interesting. 'cause there's a theory that it's to do with histamine sensitivity.

I've never tried it. I am tempted to try it. I think I've, to some extent, there's a bit of me going, Hmm, can it do any harm? But actually we know if you take a lot of antihistamines, there's a higher dementia risk actually. So it, it is something to, you know, and I, I would never advise it to anybody. I can give, in our role as IB CLCs, we can give them information, can't we?

And we can say, look, here's what research we have, here's what research we don't have. It's over to you what you do or what you don't do. And it's really difficult in my role when I do speak to people and they are struggling with this stuff. 'cause I always wanna go, here's what I know as an individual and you have to be a bit.

Careful about what works for me and what, and, and kind of sharing that information or not. So I just talk about what I, what I know. I, I think sometimes, actually no, I do, I do talk about my own experiences. 'cause for some people it is helpful, um, because it's nice for them to hear that they are not alone.

'cause it's really isolating, really, really isolating. Yeah. 

[00:40:43] Emma Pickett: I mean, you, you touched on this before, but I think what often happens if this is someone, what someone's experienced postnatally is that breastfeeding gets the blame. Mm-hmm. That this is about breastfeeding hormones, especially if it's starting maybe for the first time in someone's life, in this phase of their life, they think this, the, what's the big variable?

It must be the fact that I'm still breastfeeding. Absolutely. And, and I regularly get people told by, you know, family members or health professionals, why don't you stop breastfeeding and see if things get easier? Mm-hmm. But I can't imagine that parenting a little person who still needs to climb all over you, who still needs that emotional contact and then you've taken away your magic tool.

Yeah, exactly. You've taken away the thing that gives you the oxytocin lift. Yeah. Which might help a little bit on the really tough days, but only once you've got through the wean oxy surge in your blood. Yeah. Yeah. I mean, the oxytocin surge is something I'm wondering whether that might counteract some of the impacts.

Yeah. But yeah, the idea that ending breastfeeding regulates your hormones. No, I mean, that could be the last thing that necessarily helps somebody. And as you say, going through the weaning blues, which can be, you know, two or three months of really difficult time. Yes. Tell, tell me a bit more about your weaning blues experience.

What, what, what happened with you? 

[00:41:51] Lucy Webber: I mean, I, I had three different endings to my breastfeeding journeys, which has been really useful as an I-B-C-L-C actually, because my first, we stopped at in the 19 now, so somewhere at seven-ish months, something like that, I went back to work as a midwife and, uh, I couldn't pump because I had a rubbish pump and a rubbish flange size and things would be very different now.

And, um, the baby started night waking a lot, and so I of course thought, oh my goodness, it's all going wrong. I now know that actually all this was very normal and I could have made adjustments, but we decided to stop. I was like, I can't manage this and work, so I'm going to stop breastfeeding and put them onto formula.

And I remember just sitting at work just sobbing and sobbing. And I thought I was missing my baby. Well, I was missing my baby. Of course, I was missing my baby, but they were just all going, oh, are you missing your baby? Oh, it's hard being back to work, isn't it? And I, and I, at the time, I had no idea, even as a midwife that that weaning blues were a thing.

But I can remember sitting just having to go off to the staff room and just crying so many times because I was just so really struggling. And I don't remember when it lifted and because I didn't even know what it was. But I certainly remember that happening, even in just handover, just getting a handover, just sitting there, trying to write notes about what was going on for people, and just tears dribbling down my face, just feeling awful.

And that was an abrupt stop. Okay. It was very abrupt. 

[00:43:16] Emma Pickett: Okay. So abrupt plus a history of PMDD. Mm-hmm. That is a powerful combination. Yeah. 

[00:43:21] Lucy Webber: Massively. And then the second was about 13, 14 months when she stopped. She never really was particularly bothered by breastfeeding. She was one of these that don't offer, don't refuse worked for.

Um, the very, very, very few that it worked for. I suddenly thought, I think I'm just offering, um, I wonder if you're bothered. And I stopped offering and I don't think she ever asked again. I just, she was just like, me, fine. I'm really not up for it. She never really was particularly fussed by breastfeeding.

And I don't know really how, I can't remember a distinct period. 'cause actually with a toddler and a, and a, well two toddlers at that point, you know, 1-year-old and a 3-year-old basically. And working, I just wasn't in a happy place anyway. I was just not a well. Person. So I was running a lot, I was doing a lot of exercise running.

Um, and then I went back to work and I dislocated my knee, um, out dancing to meatloaf and I mean, yeah, dislocated my knee and was then off work for six months with my leg in full plaster. So I was looking after a 3-year-old and a 1-year-old with my leg in plaster. And so I dunno whether it was weaning blues, whether it was depression, whether it was life, whether, you know, it was just all a big mess.

A lot of that is all blocked out now. So I can imagine the weaning blues probably had a big impact, but I can't directly remember it. My son though, my third one, he's now nine. He fed until he was somewhere between three and three and a half. Not entirely sure. When, because from three onwards things just gradually, slowly dropped off.

I'm not sure when our last feed was. Um, I don't remember it. I don't, it, it, yeah. Join the club. High five. I'm the same. I have no idea where my last feed was when my talked to, no clue. No clue at all. But it was somewhere three and a quarter, three and a half, somewhere between there. Um, but I do know, because I'd posted on social media that I, uh, was having a rubbish time and that I'd had to get the kids out the house.

We went blackberry picking, so if we were Blackberry picking it probably would've been August, September time. So, and he was three in the July. So maybe it was just over three. So I, and I, I know that I was needing to get out and get a little fresh air, but that went on for months. I, and I knew what it was.

And even though we'd had a very gradual slow, mutually desired stop, it still completely shook me and I really struggled with it. Yeah. Yeah. 

[00:45:54] Emma Pickett: So. You've talked about sort of sense of depression and sadness. Mm-hmm. Some people talk about kind of anger flashes. Yes. Or, or how would you describe any of the symptoms?

[00:46:05] Lucy Webber: Things like, I mean, irritability is one that people often talk about with PMT, isn't it? They, they go, oh, she's a bit snappy. She must have PMT. And actually it's, it, yeah, irritability is like that, but it's, it's, it's irritability on the biggest scale. Even, you know, the sight of something, the noise of something that, that everything just makes you just wanna just kick some walls and.

I wouldn't say it's anger from my point because I hold it all down, but if I let it out, which is probably much more healthy, it absolutely would be anger, but I would class it as kind of irritability. So yeah, absolutely. Anger, irritability, just labile mood, you know, feeling tearful, just absolutely suicidal, actually, you know, suicidal ideation and even plans is, is really significant in people with PMDD.

Huge. It's a big thing. Um, and often there needs to be safety netting around that. Like what is the, what is the plan? Because if you're going through harder times generally in your life, then your PMDD kicks in. You have need to have people in your life who are looking out for you actually and going, right, how are we gonna keep you safe?

Not necessarily keep you, well keep you as well as possible, but keep you safe. What's the, what's the plan? What's holding you down here? What's keeping you connected and grounded? So suicidal thoughts and, and even plans for some people. And the guilt and the shame that then add into that. And that is such a big theme with breastfeeding generally.

And parenting generally, isn't it? This whole, but they're not sleeping and so it must be me or I'm doing it wrong. Or I read the book that said they should be going three hours between feeds by now, or that they should only be feeding morning and nighttime. That whole guilt that we carry around about parenting and breastfeeding is massive, isn't it?

And then when you throw in, and now I'm not even to function, able to function as a human being for several days. I mean, how do you even manage with that? It's, it's rubbish 

[00:48:04] Emma Pickett: And a world that doesn't get it. Like a world that doesn't understand PMDD doesn't understand women's cycles, generally, doesn't understand breastfeeding, doesn't understand mm-hmm.

Weaning blues. Yeah. I mean that all adds up to this horrible feeling of isolation and, and just confusion. Yeah. And as you say. If you don't understand it, what's wrong with me? Why is, why am I having this experience? Yeah. 

[00:48:23] Lucy Webber: And that people thinking you should just be getting on with it. You should. Well you should just get on with it.

It's just because it's part of your life. You should just accept it, get on with it and cope. You should just be able to cope and you literally can't cope. Except in that first two weeks from my period onward, I think, oh, come on. You're being ridiculous. Of course you can cope with it. And then the second half my cycle comes and I go, oh yeah, no, I really, I really can't.

And it's, and the acceptance of knowing it's not your fault. That radical acceptance of this is not my fault, this is my body doing what it's doing. I'm doing the things I can do is, is huge. But then when all those little messages in your head are going, you are not worthy of help, you are worthless, you are, you know, and rejection sensitivity.

If someone beeps you at a traffic light, 'cause you haven't moved quickly enough, normally I'd be like, you beeping me for. Three days before my period, I would've to pull over and cry, which is pathetic because I'm so upset that I've bothered someone else in my car. You know, it's just like I'm a totally, totally different, different person.

It's, yeah, it, it's, it's huge. And I, for anybody that is going through it, I, I feel so, so bad for them and I, I wouldn't wish it on my enemy. I would not wish it on my enemy. 

[00:49:36] Emma Pickett: I'm just thinking about perimenopause layer on top of all this. Oh gosh. I mean, in a way that probably wasn't happening 30 years ago.

We, we've got a lot more moms who are having children later in life, and lots of my clients are in their forties and thinking, why is it so hard to parent? Definitely this 2-year-old, this 3-year-old, why does breastfeeding feel much harder and less sleep? Less sleep feels much harder than perhaps it should.

Perimenopause is so poorly understood, and then again, just gets breastfeeding and perimenopause blend together. Mm-hmm. And people don't understand what's what symptom. Um, you've, you've touched on being perimenopause yourself. Mm-hmm. How, how has that changed your experiences with PMVD? It's 

[00:50:13] Lucy Webber: difficult because of irregular cycles, so I could, it's harder to plan life and know what's, what's kind of going on.

And of course you've got the apps where you can, you know, they can kind of try and predict for you. But when even the app's going, I don't really know what's going on. You're like, okay, well if you don't know, then I, I'm probably not gonna know. And I try not to rely on apps too much anyway 'cause they're good and bad.

Right. And that it links with breastfeeding too. It is difficult. We know, I mean, at least we are now slightly better with understanding perimenopause than we were even five, 10 years ago. You know, previously it was, uh. It was, you know, menopause or nothing and it was, you were in your fifties or nothing.

And now I think a lot more people are recognizing that even early forties, these changes are starting to happen potentially. You know, it's great for me that I have physical symptoms of perimenopause. The fact that my hair is coming out in clumps and I'm having visible hot flushes and sweating buckets in the night makes me feel like I'm not going crazy.

It is an actual thing because if it was only, or just mood based, I would be thinking, oh, it's a stall in my head then. So I'm grateful. It's ridiculous, isn't it? I'm grateful that I've got physical symptoms to be able to prove that this is happening. Um, but we're definitely a lot more aware of perimenopause now and yeah, lots more people having babies and feeding into toddlerhood and so therefore that combination of stuff, we are all coming together in this perfect storm.

Um, and all very misunderstood areas. So the, where you get the help from. Oh, it's it. If you've got a GP that gets it, then you're golden. You know? Um, but if you don't and they're not one who understands it or wants to understand it or perhaps doesn't understand breastfeeding or you know, then, then it can be really difficult.

Because if you go and see them and they just go, oh, you've just gotta get on with it or stop breastfeeding, then well, where'd you go from there? It's impossible. 

[00:52:10] Emma Pickett: Yeah. I'm guessing that HRT is an option for some people. Yeah, but I mean, I don't understand enough about HRT really and what's happening. But if oral contraception doesn't take away someone's PMDD symptoms, yeah.

Would HRT always make a difference? So 

[00:52:26] Lucy Webber: sometimes some people, for who it is really, really significant, will actually have their ovaries removed. When they have been down the line, they will medically induce menopause because that is the preferred option for them. I mean, it's, you know, preferred makes it sound like it's a, just a, you know, walk in the park.

Let's just pop my ovaries out. You know, it's a significant, massive, massive life change. Um, you know, people having it in their twenties and their thirties where their PMDD is so severe that they've had to make this incredibly difficult choice and put themselves into perimenopause. Uh, into menopause.

Those people will often have HRT to then balance things out. So. HRT seems to have mixed impact on people generally, and a mixed reaction with PMDD. Some people they're like, oh, this is absolute bliss. I wish I'd done this sooner. Others are going, Nope, this is much worse. I just dunno what to do. And of course, they're going round around in circles of, well, just try this different one.

Or maybe you need the patch rather than the pill, or, you know, it's, it's, uh, trying all these different things and kind of going back and going, help me, help me. Um, and some people finding the right combo and others just not. 

[00:53:34] Emma Pickett: Yeah. You mentioned that you are in a support group. Is that mm-hmm. That social media based.

[00:53:39] Lucy Webber: It's really interesting actually. 'cause the first two weeks of my cycle, I always mute the groups. I'm like, I don't need the fuck, I don't need to follow these. Why am I following all these groups? And then it gets to the second half of my cycle. I'm like, where are those groups? I need to try something. And they're all, uh, yeah, there's, there's Facebook groups.

Um, I mean, they're very different, aren't they? Facebook groups. Some of them are very right. You need to put some water out under the moon. And then when you've, you know, and then you can drink the water and have the thing under your pillow. Others will be like, right, there's this drug, this drug, this drug, this drug.

We're gonna do this. And then there's some that are in the middle. And I think you just, there's lots of groups. You have to find the right one that feels the right fit for you, because everybody's different. What one person wants is not gonna be the same as somebody else. And that's okay. 

[00:54:22] Emma Pickett: And are people talking about breastfeeding and parenting in those groups too?

[00:54:27] Lucy Webber: I mean, as you can imagine, less, um. Less than, than you would expect because parenting Yes, definitely. But breastfeeding doesn't come up as much, and that's just generally because obviously our breastfeeding rates aren't fabulous. Um, we don't have very many people breastfeeding really, um, compared to what they might be.

Um, and because of under-diagnosis or under recognition of what's going on when you are breastfeeding or when you've just had a baby misdiagnosis, you know, or well, maybe it's because you're breastfeeding or maybe it's because you've got postnatal depression and not recognizing what it is or even, you know, postnatal thyroid issues, which are actually, you know, not un mean.

They're, they're not rare are they postnatal thyroid issues. I think then people perhaps are, are, are, they're looking for a physical cause or something when actually it's their PMDD and then they're not recognizing it until later down the line. So no, they're not, they're not necessarily bringing it up in the groups.

They do talk about it. And I think if, if someone put a post up and said, this is my situation, I think people would absolutely jump on it and go, Hey, here's, here's what happened to me in that time. 

[00:55:33] Emma Pickett: I'm guessing there are some people who have been advised to when breastfeeding Definitely. And have done that.

Yes. And don't necessarily want to hear a message that that perhaps wasn't as something they needed to do. No, because that hurts. Um, that's, yeah. The same way people find out they didn't need to stop because of medication. That's the sort of, yeah. You can be a, have a lifelong grief from that. And I wonder how many people 

[00:55:51] Lucy Webber: have had depression from stopping, not a hormonal depression, but a depression from stopping breastfeeding before they wanted to, before they were ready because of that message that actually then has impacted on their PMDD, you know, this just massive mix up and cycle of things all coming together.

It's, it's really hard. 

[00:56:10] Emma Pickett: So if someone's listening to this and they're thinking. Okay. Maybe you've been talking about me. Mm-hmm. And I thought I just had a sensitivity around life cycle beginning. I thought I had PMT, but actually, or just I'm not coping very well with it. Yeah. But actually maybe my symptoms are so extreme, they're affecting my life.

To the extent that you are describing. Mm-hmm. Maybe I do need to think about this in a different way. Yeah. Is it a conversation with a GP to start off? I mean, is there a diagnosis that happens? Is it 

[00:56:40] Lucy Webber: There is a diagnosis, yeah, but there are no diagnostic tests, so they can't take bloods or do a scan, for example, to say, yes, this is what you've got.

It's based on, it's an assessment criteria based on sort of reporting of symptoms. So keep a symptom diary and there are apps that you can do it in if you want to, but you can literally go old school and write it in a book. Just write down how you are feeling, what's going on for you physically, mentally, emotionally.

Are you working? Are you coping? Are you eating differently? Eating changes, you know, even lack of appetite or eating too much. Sleeping too much, not sleeping enough. I know that's one's difficult when you've got small children. Um, 'cause sleep's gonna be a little bit all over the shop anyway, but you know, write down your symptoms and then go and speak to a GP.

And I don't want to GP bash, but sometimes it is a mixed uh, response, isn't it? Some are will get it. So if you feel like you go to the GP and you don't necessarily gel, then it's okay to ask to speak to somebody else and go back and have an appointment with somebody different. That absolutely is okay to do.

[00:57:44] Emma Pickett: Yeah. Yeah. And when you first call the practice, say who in the practice Yeah. Is the g is the menopause female hormone person. Yes. And that's the person I'd like to talk to please. And you have the, you have the right to make that request for sure. Absolute. Absolutely. And in a breastfeeding context, I'd also say if you're making notes, talk, you know, try and see if you can describe feelings of aversion.

Are, you know, a bedtime's more frustrating at certain times than others. You know, there are some times when your child's not going to sleep and you are filled with rage. Oh gosh. It's cool. And then other times when it's like, actually I quite fancy, I'm gonna lie down. It's fine by me. They take love that, love that snuggly feed at the end of the day.

Yeah. Or I can, I'm happy if they leap up and want to play a bit more. No problem. And other times it just absolutely is the last thing you can cope with. Mm-hmm. Um, so trying to, to record how you're feeling about some of those things that are normal patterns and I guess if, if you are fine for two weeks of the month, that's not breastfeeding.

Exactly. If that makes sense. It can't, it can't be that breastfeeding's the variable. And I 

[00:58:38] Lucy Webber: suppose you may not be fine necessarily in those. Two weeks. You know, you might still find that life's very hard, but does it get significantly harder? You know, it's not that those first two weeks you're skipping around, life's golden and you're coping beautifully, but you may be coping significantly better.

'cause I think, you know, we are, we do live in a society where when we are breastfeeding, when we are parenting young children and toddlers and, you know, various things, I think, uh, uh, it often is a very, very hard time. It shouldn't be 'cause we should be supported, but we're, we are not. We know that. And so we are struggling with coping with that.

And, and so it may not be that you are absolutely fine in that time, but are you struggling more in that part before your period? 

[00:59:19] Emma Pickett: Yeah, that's important to mention. No one's finding this easy at the moment in most places. But if you're seeing that regular dip at a certain time in the month and it's a pattern you're noticing.

That's a clue. And you can take that information to someone when you're having a conversation that can therefore suggest it looks unlikely. That breastfeeding's the factor here. 

[00:59:38] Lucy Webber: And I, and I think if somebody is saying to you, it's the breastfeeding, I think, uh, you need, that's, that should be ringing alarm bells for you because that suggests that they perhaps don't know enough about breastfeeding or about what's going on to necessarily be able to support you in this.

And perhaps that's having a different conversation with somebody else. Anybody that starts saying it's the breastfeeding, we have to take the breastfeeding into account. Absolutely. But it's not a, well, it's the breastfeeding just stop. If that is ever told to anybody, then immediately it's like, okay, that's a big red flag.

We need to think again. 

[01:00:11] Emma Pickett: Yeah. And that includes partners and friends and family saying that too. Yes. Yeah. Because as you say, the stopping could be a very, very difficult time in someone's life. And that, and it doesn't necessarily get easier after even that difficult time. No. And, and they just, they might not 

[01:00:24] Lucy Webber: want to and therefore it's not the answer.

You know, if they don't want to stop breastfeeding then, then that's not the answer, is it? Um, yeah, absolutely. But, you know, family and friends not understanding, uh, is a, is a really big problem. 

[01:00:37] Emma Pickett: Thank you so much for your time today, Lucy. I'm really grateful. Uh, are there any resources that you'd recommend?

Um, obviously it sounds like with the groups, people just have to kind of find something that's right for them. Um, so are we just going on Facebook and searching PMDD support? Yeah, 

[01:00:51] Lucy Webber: absolutely. And the sort of, um, the Royal College of Obstetrician Gynecologists Green top paper in the UK has got a, a big long list of all the different, and it does include things like.

You know, high dose vitamins and various things and it looks at the sort of, you know, trialing those and various things. So it's not just a medication based paper that is, can be quite useful, but it is knowing that it can take a bit of time and trialing and that there may not be an answer, it may be, uh, self-help measures massively.

[01:01:25] Emma Pickett: Okay. Well I'm hoping that your perimenopause continues in a positive direction. Me too. And your symptoms continue to get easier and I'm gonna be seeing you very soon in Birmingham. Yeah. So, um, I look forward to that. And thank you so much for your time today. You're very welcome.

Thank you for joining me today. You can find me on Instagram at Emma Pickett Ibclc and on Twitter at Makes milk. It would be lovely if you subscribed because that helps other people to know I exist and leaving a review would be great. As well, get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast.

This podcast is produced by the lovely Emily Crosby Media.