From PMDD to Perimenopause: An Evolving Journey with Sarah Malone (Part 2)

Navigating the changes that come with peri-menopause and Premenstrual Dysphoric Disorder (PMDD) can feel like a tough challenge filled with confusion and uncertainty. Many women face overwhelming symptoms and often wonder about treatment options. I recently embarked on my own journey to understand PMDD and peri-menopause, ultimately leading me to Hormone Replacement Therapy (HRT). What I discovered might surprise you, it turned out to be easier than I had expected.

The Call, the Quiz, and the Question Marks

So this morning, I got the call.

You know the one — the results from my blood test.

And what I thought was going to be a proper, sit-down, serious chat with a doctor… turned out to be a very quick call with what I think was a nurse practitioner. She went over things very briefly and basically said, “Yep, we’re happy to prescribe HRT.”

Just like that.

Apparently, they’d assessed me based on a quiz. A generic one. The kind that asks: “Are you having hot flashes?” “Are you forgetful?” “Do you lack drive?” And based on a 1–3 scale, I scored 27 — not wildly high, but high enough to raise their eyebrows.

And from that… boom. Menopause diagnosis. Not perimenopause — nope, they went straight in with “you’re in menopause.”

I tried to explain that my cycles are every 21–23 days — not 28 — so I’ll probably get four periods in three months, not one or two. That didn't seem to register, peri-menopause seemed like it wasn't a word they used when it came to women's health...

I told them I’d had a brilliant consult with Jane Prangbourne, a menopause specialist, who’d confirmed it was definitely perimenopause, and that I was navigating this alongside PMDD, which can obviously complicate the whole bloody thing.

Jane wrote a full letter with her recommendations, including that I take progesterone vaginally rather than orally, so that it goes directly to where it’s needed. But the nurse said they couldn’t issue that without approval from their pharmacy team. They’d need that letter first.

No timeframes.

No follow-up care plan.

No explanation.

I had to ask right at the end of the call about my actual blood test results, because she never brought them up.

Apparently, they all came back “normal,” which I knew was likely because they tested me on day two of my cycle, when my hormone levels are naturally calmer.

Also, hormone blood ranges are so wide that they’re basically useless unless something is wildly wrong. Thyroid? “Normal.” Liver? “Fine.” Blood pressure and weight? Already recorded.

But here’s what wasn’t asked: “How are you actually feeling?”

No talk of PMDD.

No curiosity about my emotional or energetic state.

No preparation for what to expect.

And honestly? That left me feeling… weird. Like I should be grateful for how easy it all was - and I am - but also, I felt invisible. Like a tick-box on a spreadsheet.

In the back of my mind, I started to spiral a little:

• What happens if this makes my PMDD worse?

• What if I don’t feel great on it?

• What if I do feel amazing, and then I feel guilty for not doing this sooner?

  
  

There’s this strange inner conflict where part of me is whispering, “You’re doing the right thing,” and another part is shouting, “Are you really going to put a synthetic, man-made chemical into your body after everything you’ve resisted?”

I know it’s fear.

I know it’s programming.

I know I’m worthy of support.

But that old part of me — the one who has trialled every natural remedy under the sun, the one who’s been burned by meds before, the one who fought so hard to manage PMDD HOLISTICALLY - she’s scared.

Because it took me years to find stability.

To track.

To understand.

To own it.

And now I feel like I’m stepping into another unknown… again.

And I don’t know what this is going to do.

Will I feel more myself than I’ve ever felt? Or will I spiral into Werewolf Week (this is my pet name for PMDD), and how long will it last? Will this bring balance - or more chaos?

No one knows.

So here I am, documenting it all - because this isn’t just a medical journey.

It’s emotional.

It’s spiritual.

It’s messy.

It’s mine.

(Here’s the raw video I recorded straight after the call — honest, messy, and exactly what I needed to say at that moment.)

Stay tuned for the next update, where I’ll probably be sitting in my dressing gown googling “What the f*** is progesterone doing to my life?” with a cuppa in one hand and a heat pack on my womb. Next entry: “Starting HRT: Will I Become a Glowing Goddess or Just Sweaty and Confused?”