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In this episode of the Conquering Your Fibromyalgia podcast, Dr. Michael Lenz delves into the complex relationship between hormones and chronic pain conditions such as fibromyalgia, migraines, dysmenorrhea, and others. The focus is on Premenstrual Dysphoric Disorder (PMDD), exploring the impact of estrogen and progesterone fluctuations on pain perception and symptom management. Key studies are discussed to highlight the relationship between menstrual cycles and fibromyalgia symptoms. The episode also covers the genetic, neurobiological, and environmental factors contributing to PMDD, as well as treatment options ranging from SSRIs and hormonal treatments to lifestyle changes and cognitive behavioral therapy. The intricate link between ADHD in women and mood disorders like PMDD and depression is also examined.

00:00 Introduction to Hormones and Chronic Pain
00:56 Understanding Hormonal Fluctuations
02:26 Clinical Studies on Hormones and Pain
03:48 The Role of Estrogen and Progesterone
04:42 Historical Perspective on Premenstrual Disorders
06:28 Diagnosing PMDD: Symptoms and Criteria
07:39 Causes and Brain Sensitivity in PMDD
09:35 Genetic and Neurobiological Factors
10:45 Serotonin and Allopregnanolone in PMDD
12:06 Stress, Inflammation, and PMDD
13:33 Treatment Options: SSRIs and Hormonal Therapies
16:26 Advanced Treatments and Surgical Options
21:06 ADHD and Hormone-Related Mood Disorders
27:43 Managing PMDD: Lifestyle and Non-Pharmacological Approaches
31:12 Conclusion and Final Thoughts

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When I started this podcast—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. You’re not alone. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 28+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace personal medical advice.*