Wednesday, 17 May 2017

The NAPS Conference.(National Association of PMS). A Summary.

The National Association of Premenstrual Syndromes Annual conference.

Last week I was lucky enough to be able to attend the conference. I say lucky as its normally only professional medical personnel whom are invited. As far as I know only myself and one other sufferer have ever been granted access, and so it was both a privilege and an honour.

I was representing the Gia Allemand Foundation in the hope of further collaboration and the sharing of any relevant  information which maybe shared with our own clinical advisory board.

There were several senior consultants in attendance.

Mr Nick Panay, Chairman of NAPS and Consultant Gynaecologist.
Dr Michael Craig,  Gynaecologist and senior lecturer in reproductive psychiatry.
Dr Louise Newson. Clinician and Menopause expert.
Dr Carrie Sadler. Clinician and trustee for NAPS, as well as research roles in PMS.
Dr Hannah Short. Clinician and Trustee for NAPS and assistant in Gynaecology.

After Mr Panay's welcome, DR Louise Newson gave a talk on HRT and the role which it now plays in our society. As there have been a huge amount of  negative media reports, Louise was able to explain the different types of HRT available and what they mean for our health both emotionally and physically.

As many women suffer enormously during their reproductive lives she was able to dispel the myths of HRT being carcinogenic and also the benefits of some being able to allow the continuation of a fulfilling sex life. She also highlighted the fact that natural hormonal intervention can protect us from heart and vascular diseases, as well as protect our bone density and emotional stability.

DR Michael Craig's talk was absolutely fascinating as he was able to share the latest brain imaging slides and talked extensively about how males and females empathise in an entirely different way.
Indeed the response in the Amygdala was visually different on the scan, and cerebral blood flow in mental rotational tasks was less active in the males.
He also explained how in autistic humans there were much higher testosterone levels, although at present we don't yet know why. The crossing of cortisol into the placenta and into amniotic fluid also seems to have some relevance here too.

In terms of reproductive depression traits, so PMDD and PND, the binding of oestrogen to serotonin receptors was also compromised, which also increased the risk of both Alzheimer's disease, and dementia. This lack of efficiency in binding is also critical in both epilepsy and migraine with aura, and so therefore may also be attributed to that.

Its important to say the Dr Craig found a 50 percent co-morbidity rate with core pre-menstrual disorders, which surprised me enormously. I had expected the number to be lower as a Pre-menstrual exacerbation, but it was indeed clarified by Dr Nick Panay when I questioned him further during coffee break. In other words there is often an underlying mental health disorder, whether it be major depressive disorder or even bipolar,which then activates extensively during the late luteal phase..

Mr Panay's talk was obviously greatly anticipated and it has to be said that he is also the nicest, kindest doctor you could ever wish to meet. He is full of compassion for all suffering women and utterly dedicated to his work. He is also anxious to collaborate with the Gia Allemand Foundation and swap dialogue with Professors in the States. This can only mean more research and more understanding for the long term.

Firstly he spoke about the importance of charting the symptoms in order to gain further clarity and the knowledge that PMDD/PMS is organic in origin. So therefore, it has a cellular cause with multiple aetiology and is a biological disorder. He spoke about the recent findings in cellular response and gene variants published by the Institute of health in North Carolina. He also told of the complexity in the sequences of cells and how they respond to oestrogen and progesterone. The struggle is real.

The complementary therapies for PMS which show the most promising results are,

Strict diet and exercise intervention.
Vitamin B6- 10-50 mgs daily.
Calcium, of which the evidence is consistent.
Isoflavones,  particularly when there is migraine with aura.
Agnus Cactus, BUT it must be of exceptionally high quality.
St Johns Wort which also showed a significant change in symptoms.

Once however, the symptoms move into PMDD criteria,
Antidepressants for the short term,
Hormonal therapy for the long term, particularly if suicidal tendencies are present.
The contraceptive birth control which had shown the most significant results was YAZ which has a license for PMDD because it contains the lowest amount of synthetic progestins.

GNHR Analogues, both Zoladex and synarel were both more effective than tibilone but Mr Panay highlighted the need for regular bone scans and the need for a multidisciplinary approach. Last but not least, was the hysterectomy and removal of ovaries which of course is the most effective. If the sufferer doesn't respond well to hysterectomy, she must be scanned for Ovarian Remnant syndrome and even recommenced on the GNRH analogue.

During Dr Carrie Sadler and Dr Hannah Shorts question time I expressed my concern that so many women were having a severe and catastrophic response to both Depo injection and the Mirena coil, (myself included). Dr Sadler explained that again, it was the intolerance to progestin which would cause this. Personally I would like to have had a warning of some kind before using Depo, however its highly probable that anyone using Depo wouldn't realise the severity of the long term effects, and would at least have it once regardless.
 I also expressed my concerns about using synthetics particularly on young pubescent girls who have yet to establish a cycle, but are often given birth control pills as a response to painful periods.

Sadly there is no such categorisation of prescribing synthetic hormones and regard to mental health.
This is all the more worrying as now there is a self administered contraceptive injection available which anyone can use at home.

On the whole the conference was informative, interesting and confirmation of the huge amount of research that is going on behind the scenes for all suffering women. I am delighted that I was able to attend and bring you this information and hope to be invited again. In the meantime it is important to mention that the Gia Allemands Foundation also has a conference in October. Register now at to learn more and view it on live stream.

Take care of you.