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Simon Davis

10/16/14 11:10AM

Filed to: INTERVIEWS

In 1994, a South Florida man who goes by the name Gelding was surgically castrated. In 2011, he had his penis removed as well. He's a "nullo": A cisgender man who removes his external genitalia completely as a form of body modification, and he recently agreed to answer our questions—from "why?" to "what do balls taste like?"

Gelding is a nudist and describes himself as a submissive bear. Apart from his desire to use a pseudonym, he let it all hang out (so to speak) when I reached out to him and graciously answered every question I had.

Is nullo your preferred term to describe yourself and others like you who are castrated and have removed their penis?

Yes, the reason that we use that it is not transgender. It's simply nullification of what you've got. A friend of mine Mack in San Francisco likes to use the term "mascunull", because I remain as masculine as they come with fur and so forth. But I no longer have the parts.

What are some misconceptions people have about nullos?

A few men don't know their own physiology to the point where they think if they lose their balls they can't come any more. And that's false. If you look at the physiology you see that the fluids are made by the seminal vesicles and the prostate. Very little of the fluid and the content is produced in the testes. I still unload.

But the active ingredient for impregnating someone isn't there.

Right.

Do you get a lot of people who think you're trying to become a woman?

Absolutely. And it's mostly the medical profession who sees the sexes as either male or female. And anyone who wants to alter any part of that is in some way suffering from gender dysphoria. They don't like themselves for some reason and they want to change gender. And that's absolutely false.

It's not a dysphoria. I see it in the positive way of working toward something, rather than away from something. Many of the guys instead of putting a negative feel on it see it as a positive. Being castrated is a positive to them. Rather than removing something that they dislike, they are moving in the direction that they want. I went through a long set of psychological evaluation sessions with a psychologist here in town, because that was necessary in order to have the penis removed.

You've previously discussed your 1994 castration. However, I didn't find anything on your penis removal in 2011. Can you talk about that?

I knew I was uncomfortable in having frankly large male parts. I would quite often sit on my own balls because they were loose unless I wore something tight and held them in I would sit on them and squash them. That got me into trouble playing soccer in college when they forced us to wear these hard plastic cups. What happened was I fell on a guy's upright knee with the weight of another player behind me, so two of us fell on the knee. The knee happened to hit the middle of the plastic cup and imploded and tore me up. I was severely injured.

The doctor saved everything but over a period of time the nerves gave me some problems and I had aches in my testicles all the time. When I was in the military service they tried doing a varicose vein removal but that didn't help, it just made matters worse. They thought I was suffering from varicose veins. So after leaving the service I had them removed. And that removed that little problem but I still had the nerve sensations in the penis which woke me up at night. So I could get erect, but it was painful.

So I talked with my urologist and he said the only treatment for that was to make it numb, which is very dangerous because if you make something like that numb then you don't know if it's infected for some reason. Or remove it, but to do that he needs to cover his ass and asked for a psychological evaluation. And my own doctor is a professor at Nova Southeastern University here in. She is the most brilliant doctor I've ever met. So, I asked her about this problem and she was very forthright and said "well, we'll have to treat you". She didn't consider it something that was wrong with me, she said "we have to investigate." I went to see a psychiatrist and he spent a good 90 minutes with me and said "yes, I have just the person that can work with you." So the psychologist did a battery of personality tests and said "you're perfectly fine, your only problem is that you've got these physical problems which work on your nerves." And I said "yeah." And he said "it also works with your personality" because I'm a gay submissive and I always have been and it wasn't working right. So in order to to fix it I worked toward a goal of having things removed. And that was it. I'm working in a positive way to solve my own personal problem.

But was castration something you were contemplating prior to the injury?

Yes. For whatever reason I was always embarrassed by the size of what I had. It didn't fit my personality.

Do you remember when you the fantasy to remove your testicles first occurred?

I had a baby face in high school, there was one of these bullies and he said "you have a man's equipment but you're still a boy" and he squeezed my balls in the shower. He was on the football team, I was on the soccer team showering together and he said "you shouldn't have such big equipment" so he squeezed my balls and at that point it was just a fantasy for me. So how about getting rid of them for some reason?

When did it go from fantasy to aspiration?

It became a fetish thing where I would do sort of more self destructive things with them like putting rubber bands around them and needles through the balls and whatnot. It's a progression which a lot of guys go through. It's something that works on them and they say "Well, how about if we just have them off? Then I won't be bothered by this constant urge to hurt them". And this is where a psychologist gets into the dysphoria. It's very difficult to distinguish whether it's a dislike for something or instead you're working towards something else. I always thought when I was on the beach—I was also on the swim team—and we had Speedos, it was difficult to pack everything in frankly. I would be embarrassed and everybody was looking and here I am and I've got the biggest package and I'm not the biggest guy and I got a whole lot of looks from everybody.

I had a big dick, it got damaged and I was a bottom. I didn't want to use it, I got pushed into using it, I had to take all sorts of medications and was tired of being somebody else's tool.

Broadly speaking, how can someone know that being a nullo is something they actually want to go through with as opposed to something they fantasize about?

That's something really for a psychologist to answer, but in talking to all the guys that I've been talking with, they try to come up with all sorts of different rationalizations to justify it. In my case, my medical situation really didn't justify it because I was just uncomfortable with what I had. It wasn't medically necessary. But I felt that I would be much more comfortable having the issues of having the sensation but not being able to use it well. It was something like a guy having a useless appendage and it's something he has to carry around, and it becomes baggage after a while.

If someone starts/botches the process on their own, what would you recommend they do? Should people use a cover story to avoid getting in trouble?

No. Go to the emergency room. Today, they have been exposed to a lot more of the literature out there than they were 20 years ago. They're not going to be institutionalized. I mean years ago they used to institutionalize guys that were gay.

How would you say the breakdown is between gay and straight men for nullos?

I would have to say it's mostly gays. I don't know of a straight guy who became a nullo.

You had said in a previous interview that for castrations it's about a two to one for gay to straight men that decide to do it.

I've heard of a couple of straight guys who decided that they were making too many babies so they had their balls off so they could take testosterone and continue. I know quite a few bodybuilders both gay and straight whose testes have shrunk because of the steroids they are taking which are bad for their health. So they got castrated and now they're on medically injected testosterone which is good for them. It's not as harmful as oral steroids are or some of the other shit that they're pumping into themselves.

How would you recommend people do their penectomy and castration?

In the last couple of years, my friend Mack from San Francisco ran into Dr. Crane from Brownstein & Crane and he met him, and I don't know how the two of them had the discussion, and then I had a phone interview with Dr. Crane and I explained my situation with him and now Dr. Crane is no longer doing just transgender type of procedures but [also] genital modifications.

So in a way, you educated him.

The protocol that the doctors use for transgender people is called the Harry Benjamin protocol. So for example Dr. Reed in Miami, before you go to his clinic you have to take female hormones for six months and show some development of breasts and whatnot, some feminine characteristics before he will deal with you. And why do that when you simply want to get the genitals removed?

If anything, wouldn't additional testosterone be what you'd need after castration?

Men who get castrated, they do get depressed if they don't start fairly right away on testosterone. Because the falling hormone causes hot flashes first of all, and then the loss of libido. You lose all interest in sex and everything else.

Are there any changes that occur to the body as a result?

Body changes are minimal really. If you lose your balls, you won't lose all your hair.

What about voice? Is that a myth?

Voice doesn't change, no. The larynx is a hard tissue, and the voice box and everything else is a hard tissue. But the timbre of your voice is a factor of the larynx. I sang in the college choir, I know about these things.

One thing I noticed while reading testimonials is that many people seem to try their hand at castration and penectomy but then go to the doctor only if it goes wrong. How much of this would you say is due to the medical profession's reluctance to remove healthy body parts and how much is due to people's general fear of discussing this type of thing with their doctor or therapist?

You know about the Hippocratic oath right? "First do no harm". They have to be convinced that what they are doing is in fact an improvement on your health. Which is why the surgeon is requesting a psychological evaluation. And the psychologist comes back and says "yeah, he's going to be uncomfortable where he is, he's going to be more improved, better mood, better this, better that" and so forth. So from a totality point of view, it's going to get better after he gets modified.

And let me tell you my mood has improved dramatically since going nullo. I don't miss the baggage. I don't miss the fact that I get into sex with a guy, he expects me to perform in some ways, now he doesn't have that expectation. In fact, quite a few guys find it very arousing that they don't have to have that distraction.

Are there other benefits?

Another thing is, guys who are aroused by my situation are very aroused. I've got some guys who are pursuing me a lot. And they just like this idea, because there's nothing there to be in the way. Face to face fucking is very pleasurable. And when they're doing that I actually wet their stomachs with my fluids. And this one guy, he likes to go down on me. He's a bi guy and he said he does this with his girlfriend so he goes down there and starts licking me. And he just loves that idea. He loves the idea that I have a hairy chest and what is to him a very tiny vagina that he can't fuck but he can lick and he can enjoy being the male role. I've even got a straight guy here in town who likes to fuck me because I don't have any male genitals and he doesn't feel threatened by that.

Are there any downsides?

One of the most obvious cons is I have to sit to pee, or I have to use one of these female urination devices. It's an odd funnel shaped device that you can use if there's only a men's urinal. Also, some times I get urinary tract infections. There's a shorter path to the bladder through what I've got now. So I've got to be very careful and keep it clean. I can't get guy fingering me down there because it's the inside of the urethra so it's sensitive.

Do you ever get "phantom dick" syndrome when you are reaching for it out of habit?

A lot of the nerves are bundled on the base of the penis where most of the sensation comes from. It's not along the length of penis but on the base of the penis is where most of the sensations are. And I wake up in the morning with a feeling that I have a big dick that's erect.

In your experience, what percentage of castrations are done by non-medical professionals? How about penectomies? What are the safety risks for each? Would you say one is more difficult than the other for a layman?

I would above three quarters [by non-medical professionals]. And that number is lower than say twenty years ago. There are not as many today.

Which are not as many?

The amateur cutters. There are a lot of wannabes that are successful that manage to stay below the radar of the authorities because they run into trouble because of their lack of skill. Because if you mess up there are problems there. But if you're very careful in choosing the men you work with so that you have very low risk involved, which is age (you don't do old men), you don't do very overweight men, you don't do men who smoke, who don't take drugs and anything else. If you take these fairly low-risk guys and you do it well, then there won't be any problems. Once these guys get castrated, most of them simply become very private and they don't brag about things. They sort of withdraw from pursuing anything else because they've reached their goal.

So is the the percentage of amateur cutters lower today due to more people with medical training performing castrations?

Yes. They are finding that there is a living in this if they do it among other things.

How about with penectomies? I would imagine (and hope!) there's fewer amateurs performing these.

Almost all of them are done by medical professionals. That's tricky, yeah. More tricky. It's sort of major surgery and it's been done by some amateurs. They're fairly good with their surgical techniques. I was actually at one and the guy did a fairly good job but it took a long time and it was a very involved, very slow process. I've heard of only three or four done by cutters in the past and they have left active participation in this.

When you do a penectomy you have to re-route the urethra, yes?

Yes, what I did with this is I knew where I was going with this in 1999 and I contacted my urologist in Hollywood [Florida], an old guy who was just about to retire and I talked to him very carefully and said "in the future I'm going to want the penis removed". And he said "OK, we can do a urethral relocation in the base of the penis".

So how do things like ejaculation and urination work when you've rerouted the urethra and no longer use the penis for them?

With ejaculation, just before you reach the peak, all the fluid is there at the base of the penis, and right before orgasm happens it's the urethra that acts like a rail gun and expels the semen. So when you don't use the penis, there's no force behind it. It just flows out.

What happens to the body parts after removal?

Quite a few [cutters] collect them. They preserve them, they put them in jars. One guy embedded his in plastic and now it's an ornament somewhere. This typically happens when you're in a master/slave dominant/submissive relationship and the submissive gives up his balls to his partner for keepsake. And then you get into this S&M thing where the dominant partner controls and regulates the libido of the submissive. Especially if the submissive is on say androgel where the turnaround time from full sexiness to limp dick is about on the order of a week. The reaction time for the transdermal is very fast. Whereas the injections wear off after two to three weeks. The half life of the testosterone I'm taking is eight days.

You mentioned consumption of body parts in another interview. Is that for real?

It is for real, yes. Some guys do that. Think about the Testy Festy, where they go there and every year there they have concentration of people who are into eating sheep and bull nuts and rocky mountain oysters. I know a few cutters that don't charge anything for their work, the only charge they have is that they get the nuts afterwards.

Is this something that you've tasted?

Yes, as a matter of fact they do taste a little like chicken. Actually I would have to say they taste as much like chicken as they do roast pork. But it all depends on how you cook them. If you cook them in salted butter then they might be saltier than they might otherwise be.

How do you like them cooked?

I went to a cutter's place and he was having an event where he cut a number of guys and I was assisting him there. And what I did is I cooked them up in some butter with some mushrooms. Quite good with a nice red merlot wine.

Cheers to that, Gelding.

(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49813935)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814012)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49813944)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814013)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814396)

Request an appointment

Symptoms &

causes

Diagnosis &

treatment

On this page

Diagnosis

Treatment

Self care

Alternative medicine

Preparing for your appointment

Diagnosis

There are no unique physical findings or lab tests to positively diagnose premenstrual syndrome. Your doctor may attribute a particular symptom to PMS if it's part of your predictable premenstrual pattern.

To help establish a premenstrual pattern, your doctor may have you record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also be sure to mark the days your period starts and ends.

Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

Treatment

For many women, lifestyle changes can help relieve premenstrual syndrome (PMS) symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.

The success of medications in relieving symptoms varies among women. Commonly prescribed medications for premenstrual syndrome include:

Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD). These medications are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.

Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.

Hormonal contraceptives. These prescription medications stop ovulation, which may bring relief from PMS symptoms.

Request an appointment

More Information

Combination birth control pills

Minipill (progestin-only birth control pill)

Self care

You can sometimes manage or reduce the symptoms of premenstrual syndrome by making changes in the way you eat, exercise and approach daily life. Try these tips:

Modify your diet

Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.

Limit salt and salty foods to reduce bloating and fluid retention.

Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.

Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, a daily calcium supplement may help.

Avoid caffeine and alcohol.

Incorporate exercise into your regular routine

Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.

Reduce stress

Get plenty of sleep.

Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).

Try yoga or massage to relax and relieve stress.

Record your symptoms for a few months

Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.

Alternative medicine

Here's what's known about the effectiveness of complementary remedies used to soothe the symptoms of premenstrual syndrome:

Vitamin supplements. Calcium, magnesium, vitamin E and vitamin B-6 have all been reported to soothe symptoms, but evidence is limited or lacking.

Herbal remedies. Some women report relief of premenstrual syndrome (PMS) symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John's wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms.

Herbal remedies also aren't regulated by the Food and Drug Administration, so there's no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interact with other medications you're taking. St. John's wort, for example, reduces the effectiveness of birth control pills.

Acupuncture. A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.

Preparing for your appointment

You're likely to start by seeing your family doctor or primary care provider. However, in some cases when you call to set up an appointment, you may be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).

Here's some information to help you prepare for your appointment and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance to prepare.

Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins or supplements you're taking.

Consider questions to ask your doctor and write them down. Bring along notepaper and a pen to jot down information as your doctor addresses your questions.

For premenstrual syndrome, some basic questions to ask your doctor include:

Is there anything I can do to minimize PMS symptoms?

Will my PMS symptoms eventually go away on their own?

Could the symptoms that I'm experiencing indicate a more serious medical condition?

Do you recommend treatment for PMS symptoms? What treatments are available?

Is there a generic alternative to the medicine you're prescribing?

Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

Don't hesitate to ask any other questions that occur to you during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

How severe are your symptoms?

On what days during your menstrual cycle are your symptoms at their worst?

Do you have symptom-free days during your menstrual cycle?

Can you anticipate when your symptoms are coming on?

Does anything seem to make your symptoms better or worse?

Do your symptoms interfere with your daily activities?

Have you recently felt down, depressed or hopeless?

Have you or has anyone in your family been diagnosed with a psychiatric disorder?

What treatments have you tried so far? How have they worked?

https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814442)

Whoops!

(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814635)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814039)

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(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814015)

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Request an appointment

Symptoms &

causes

Diagnosis &

treatment

On this page

Diagnosis

Treatment

Self care

Alternative medicine

Preparing for your appointment

Diagnosis

There are no unique physical findings or lab tests to positively diagnose premenstrual syndrome. Your doctor may attribute a particular symptom to PMS if it's part of your predictable premenstrual pattern.

To help establish a premenstrual pattern, your doctor may have you record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also be sure to mark the days your period starts and ends.

Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

Treatment

For many women, lifestyle changes can help relieve premenstrual syndrome (PMS) symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.

The success of medications in relieving symptoms varies among women. Commonly prescribed medications for premenstrual syndrome include:

Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD). These medications are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.

Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.

Hormonal contraceptives. These prescription medications stop ovulation, which may bring relief from PMS symptoms.

Request an appointment

More Information

Combination birth control pills

Minipill (progestin-only birth control pill)

Self care

You can sometimes manage or reduce the symptoms of premenstrual syndrome by making changes in the way you eat, exercise and approach daily life. Try these tips:

Modify your diet

Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.

Limit salt and salty foods to reduce bloating and fluid retention.

Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.

Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, a daily calcium supplement may help.

Avoid caffeine and alcohol.

Incorporate exercise into your regular routine

Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.

Reduce stress

Get plenty of sleep.

Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).

Try yoga or massage to relax and relieve stress.

Record your symptoms for a few months

Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.

Alternative medicine

Here's what's known about the effectiveness of complementary remedies used to soothe the symptoms of premenstrual syndrome:

Vitamin supplements. Calcium, magnesium, vitamin E and vitamin B-6 have all been reported to soothe symptoms, but evidence is limited or lacking.

Herbal remedies. Some women report relief of premenstrual syndrome (PMS) symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John's wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms.

Herbal remedies also aren't regulated by the Food and Drug Administration, so there's no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interact with other medications you're taking. St. John's wort, for example, reduces the effectiveness of birth control pills.

Acupuncture. A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.

Preparing for your appointment

You're likely to start by seeing your family doctor or primary care provider. However, in some cases when you call to set up an appointment, you may be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).

Here's some information to help you prepare for your appointment and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance to prepare.

Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins or supplements you're taking.

Consider questions to ask your doctor and write them down. Bring along notepaper and a pen to jot down information as your doctor addresses your questions.

For premenstrual syndrome, some basic questions to ask your doctor include:

Is there anything I can do to minimize PMS symptoms?

Will my PMS symptoms eventually go away on their own?

Could the symptoms that I'm experiencing indicate a more serious medical condition?

Do you recommend treatment for PMS symptoms? What treatments are available?

Is there a generic alternative to the medicine you're prescribing?

Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

Don't hesitate to ask any other questions that occur to you during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

How severe are your symptoms?

On what days during your menstrual cycle are your symptoms at their worst?

Do you have symptom-free days during your menstrual cycle?

Can you anticipate when your symptoms are coming on?

Does anything seem to make your symptoms better or worse?

Do your symptoms interfere with your daily activities?

Have you recently felt down, depressed or hopeless?

Have you or has anyone in your family been diagnosed with a psychiatric disorder?

What treatments have you tried so far? How have they worked?

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Please confirm you believe this wholeheartedly and will comply with updated instructions. TYIA.

(http://www.autoadmit.com/thread.php?thread_id=5856572&forum_id=2).#49814449)

Request an appointment

Symptoms &

causes

Diagnosis &

treatment

On this page

Diagnosis

Treatment

Self care

Alternative medicine

Preparing for your appointment

Diagnosis

There are no unique physical findings or lab tests to positively diagnose premenstrual syndrome. Your doctor may attribute a particular symptom to PMS if it's part of your predictable premenstrual pattern.

To help establish a premenstrual pattern, your doctor may have you record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also be sure to mark the days your period starts and ends.

Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

Treatment

For many women, lifestyle changes can help relieve premenstrual syndrome (PMS) symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome.

The success of medications in relieving symptoms varies among women. Commonly prescribed medications for premenstrual syndrome include:

Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD). These medications are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.

Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.

Hormonal contraceptives. These prescription medications stop ovulation, which may bring relief from PMS symptoms.

Request an appointment

More Information

Combination birth control pills

Minipill (progestin-only birth control pill)

Self care

You can sometimes manage or reduce the symptoms of premenstrual syndrome by making changes in the way you eat, exercise and approach daily life. Try these tips:

Modify your diet

Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.

Limit salt and salty foods to reduce bloating and fluid retention.

Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.

Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, a daily calcium supplement may help.

Avoid caffeine and alcohol.

Incorporate exercise into your regular routine

Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.

Reduce stress

Get plenty of sleep.

Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).

Try yoga or massage to relax and relieve stress.

Record your symptoms for a few months

Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.

Alternative medicine

Here's what's known about the effectiveness of complementary remedies used to soothe the symptoms of premenstrual syndrome:

Vitamin supplements. Calcium, magnesium, vitamin E and vitamin B-6 have all been reported to soothe symptoms, but evidence is limited or lacking.

Herbal remedies. Some women report relief of premenstrual syndrome (PMS) symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John's wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms.

Herbal remedies also aren't regulated by the Food and Drug Administration, so there's no record of product safety or effectiveness. Talk with your doctor before taking any herbal products, as they may have side effects or interact with other medications you're taking. St. John's wort, for example, reduces the effectiveness of birth control pills.

Acupuncture. A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.

Preparing for your appointment

You're likely to start by seeing your family doctor or primary care provider. However, in some cases when you call to set up an appointment, you may be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).

Here's some information to help you prepare for your appointment and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance to prepare.

Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins or supplements you're taking.

Consider questions to ask your doctor and write them down. Bring along notepaper and a pen to jot down information as your doctor addresses your questions.

For premenstrual syndrome, some basic questions to ask your doctor include:

Is there anything I can do to minimize PMS symptoms?

Will my PMS symptoms eventually go away on their own?

Could the symptoms that I'm experiencing indicate a more serious medical condition?

Do you recommend treatment for PMS symptoms? What treatments are available?

Is there a generic alternative to the medicine you're prescribing?

Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

Don't hesitate to ask any other questions that occur to you during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

How severe are your symptoms?

On what days during your menstrual cycle are your symptoms at their worst?

Do you have symptom-free days during your menstrual cycle?

Can you anticipate when your symptoms are coming on?

Does anything seem to make your symptoms better or worse?

Do your symptoms interfere with your daily activities?

Have you recently felt down, depressed or hopeless?

Have you or has anyone in your family been diagnosed with a psychiatric disorder?

What treatments have you tried so far? How have they worked?

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