Episode 181

Understanding PMS and PMDD: Managing Premenstrual Disorders with Professor Jayashri Kulkarni

In this episode of The Good GP, Karin Sekhon speaks with Professor Jayashri Kulkarni, a renowned psychiatrist, about premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Professor Kulkarni explains the distinctions between PMS and PMDD, emphasising that PMS is more prevalent and generally involves physical symptoms like bloating and headaches, while PMDD affects a smaller percentage of women and includes severe psychological symptoms such as major depression, anxiety, and brain fog. She talks about the genetic and environmental factors contributing to PMDD, highlighting a specific gene complex that may be activated by trauma.


Discussing the primary pharmacological treatments for PMDD, Professor Kulkarni advises starting with hormonal treatments like the combined oral contraceptive pill; she recommends the pill "Zoely" for its balanced hormone levels. She also elaborates on the use of SSRIs like sertraline for additional support and gives a stepped approach to treatment, including the possible need for hormone replacement therapy (HRT) or menstrual suppression in complex cases.


They also touched on the potential role of complementary therapies and the importance of holistic care, involving psychological support and lifestyle modifications. Professor Kulkarni provides guidance on when GPs should consider referring patients to specialists and emphasises the collaborative role of GPs in managing PMDD effectively.


If you want to learn more about this topic, consider the HER Centre Australia's online short course on Women's Mental Health: https://www.monash.edu/medicine/translational/psychiatry/short-courses/womens-mental-health


The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network


If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com

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Tim Koh

Dr. Tim Koh is a General Practitioner and practice owner based in Perth, Australia, with over 20 years of experience. Throughout his career, Tim has been continuously involved in GP education and teaching GP registrars. As the host of The Good GP podcast, Tim provides expert insights and practical advice for GPs and other health professionals. Passionate about evidence-based medicine and teaching in general practice, Tim addresses a wide range of topics relevant to primary care, keeping listeners informed about the latest issues affecting the field.
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Krystyna de Lange

Dr Krystyna de Lange is co-host of The Good GP and dedicated General Practitioner with nine years of experience in primary care in Australia. Passionate about the full spectrum of medicine, she thrives on the opportunity to support her patients’ diverse health needs. She has a specific interest in the areas of Aboriginal and Torres Strait Islander health, womens health and chronic disease management.

Since joining The Good GP podcast team in 2019, her goal has been to empower fellow practitioners with the latest insights, best practices, and valuable discussions on essential health topics. With her approachable style and deep commitment to community health, she fosters an engaging environment that encourages learning and collaboration.
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Sean Stevens

Dr Sean Stevens, a seasoned General Practitioner with 27 years of experience, is a pioneer in medical education and podcasting. As one of the founding voices of The Good GP Podcast since 2016, he has personally contributed to over 60 episodes of their 170+ episode catalogue, sharing invaluable insights with the medical community. Recognised as Australian GP Supervisor of the Year, Sean combines his passion for education with a commitment to embracing new technologies. He is dedicated to empowering fellow GPs and promoting quality care in general practice.