Episode Details

Ever feel like you become a completely different person the week before your period? Maybe you're suddenly overwhelmed with anxiety, rage, irritability, insomnia, or intrusive thoughts, and then your period arrives and it's like a switch flips. If you've ever wondered whether it's "just PMS" or something more, you're not alone. 

In this episode, Dr. Lucky Sekhon and Dr. Alicia Robbins sit down with reproductive psychiatrist Dr. Sarah Oreck to unpack the complex relationship between hormones and mental health. Together, they discuss between PMS and PMDD, and the role of estrogen, progesterone, serotonin, dopamine, and GABA in mood regulation. The conversation also dives into PMDD treatment options, including SSRIs, birth control pills, lifestyle interventions, supplements, and the viral Pepcid-and-Allegra trend that's taken social media by storm. Beyond the menstrual cycle, they explore how hormones affect mental health during pregnancy, postpartum, and perimenopause, including postpartum depression, anxiety, intrusive thoughts, and the newest FDA-approved treatment for postpartum depression. 

IF YOU’RE TEXTING YOUR FRIENDS LIKE... 

You: 

Why do I feel completely fine one week and then want to quit my job the next??? 

Also You: 

Is this PMS... or is this something more serious? 

3AM You: 

Wait... do hormones actually affect serotonin and anxiety or is that just something people say??? 

IF YOUR GOOGLE SEARCH HISTORY LOOKS LIKE THIS… 

• What is PMDD? 
• What's the difference between PMS and PMDD? 
• Why am I so emotional before my period? 
• Can hormones affect anxiety and depression? 
• Should I test my hormone levels for PMDD? 
• Can birth control help PMDD? 
• Do SSRIs work for PMDD? 
• Does Pepcid help PMDD? 
• What is Zurzuvae? 
• Can perimenopause cause anxiety and insomnia? 
• What is reproductive psychiatry? 

YOU’VE COME TO THE RIGHT PLACE! 

In today’s chat we cover: 

[08:00] Meet reproductive psychiatrist Dr. Sarah Oreck & the mission behind Mavida Health 

[11:00] Why specialized women's mental healthcare is so difficult to access 

[12:00] PMS vs. PMDD: what's the difference? 

[13:00] Premenstrual exacerbation vs. true PMDD 

[13:30] Why PMDD can feel life-altering 

[14:00] Hormone testing myths & why lab results often don't explain symptoms 

[14:30] Progesterone sensitivity and the latest PMDD theories 

[15:00] Why PMDD symptoms can worsen during perimenopause 

[16:00] Cycle tracking, spreadsheets & identifying hormonal patterns 

[17:00] Estrogen, progesterone & their effects on the brain 

[17:30] Serotonin, dopamine, GABA & mood regulation 

[18:00] PCOS, depression, anxiety & the mental health connection 

[19:00] How PMDD is actually diagnosed 

[21:00] The most effective lifestyle interventions for PMDD 

[21:30] Alcohol, caffeine, nutrition, exercise & symptom management 

[22:00] Calcium, magnesium, chasteberry & supplement evidence 

[22:30] Why PMDD diagnosis is still largely clinical 

[23:30] SSRIs for PMDD: how they work & when they're appropriate 

[24:00] Continuous vs. luteal-phase SSRI treatment 

[25:00] Birth control pills and PMDD: who benefits and who doesn't 

[26:00] Why there's no single "best" birth control pill 

[27:00]