Content warning: Discussion of suicidal ideation.
Themes 💕Hormonal literacy | Mental health | Neurodivergent self-advocacy | Medical gaslighting | Access inequality | Post-surgical recovery | PMDD symptom improvement
“When I try to raise awareness — what IAPMD does — their mission is awareness and education.
And I think that’s really where any woman or uterus owner should begin: with knowing.
I know that’s hard — it’s executive function all over the place — but truly, information is everything.
I’ll never forget reading The New Menopause; in it, she says ‘Information is your foot in the door.’
And we just — we have to be able to get that foot in the door.
Whether you do that through peer support or whatever means you can, that’s one of the only ways right now to really start the conversation.
It’s unfortunate, and so tragically unfair.
But just know that there’s always a conversation that can be had.
We just have to — unfortunately — sometimes be the ones to start it, which is such b******t.
But still, there’s always a way to begin.”
Kim Pitts
If this conversation helps you feel seen, please share or comment below. Your story could help someone else survive their PMDD too.
Kim and I have been planning to discuss PMDD and our resulting hysterectomies for a while now, and we finally figured out the timezones between her location of Oregon, US and mine in Wellington, Aotearoa New Zealand.
Links to all the resources and further reading we discussed are at the end of this post.
Our chat is available in multiple formats for accessibility:
* Video with subtitles/closed captions available
* Podcast/audio only
* Transcription
* Plain timestamped summary table*
* Substack-formatted timestamped summary*
* Generated by ChatGPT as an executive functioning tool on my part. Sorry, Kim! I know you gave AI the finger during our chat!
🩸 PMDD, Hysterectomy & Neurodivergent Menopause
A Conversation with Kim Pitts
⏱️ 00:00 – 02:00 | Introductions
Sam (Aotearoa NZ) and Kim (US) open the chat.Both are neurodivergent women who chose surgical menopause (hysterectomy) to stop PMDD symptoms and save their mental health.This is peer support, not medical advice.
🩺 02:00 – 04:00 | Surgery Stories
Kim shares how her US doctor fought for her right to a hysterectomy despite insurance barriers.Sam reflects on recovery, her four laparoscopic scars, and the strange post-op moment of thinking, “Where’s the baby? Oh wait — no more uterus!”
💊 06:00 – 10:00 | Progesterone Intolerance
Sam explains how progesterone caused bloating, digestive pain, and depression.Kim agrees—progesterone can be lifesaving or intolerable depending on the body.They unpack the delicate HRT balancing act and how mental health depends on getting the right dose and delivery.
🧠 10:00 – 13:00 | Medical Gatekeeping
Sam details the challenge of navigating public vs. private healthcare, using index cards to remember key points at appointments.They talk about executive dysfunction, prescription chaos, and how neurodivergence complicates healthcare admin.
💬 13:00 – 17:00 | What Is PMDD?
Kim defines Premenstrual Dysphoric Disorder (PMDD) — a neuroendocrine disorder where hormonal fluctuations trigger severe mood symptoms.Often mistaken for PMS, it requires careful tracking, but that’s hard for ADHD and autistic women.
📝 17:00 – 22:00 | Hormones, Neurodivergence & Tracking
They discuss multiple hormone sensitivity theory, links between ADHD/autism and PMDD, and why symptom tracking is often impossible.Kim used old text messages as evidence to identify her cycles.
⚖️ 22:00 – 27:00 | Self-Advocacy & Self-Gaslighting
Sam shares how she doubted her own symptoms right up to surgery.Both reflect on medical gaslighting, the exhaustion of self-advocacy, and the relief of being believed.Finding the right doctor = survival.
⚠️ 25:00 – 33:00 | Suicidality & Survival
Content warning: Discussion of suicidal ideation.They discuss how PMDD, autism, and ADHD overlap with high suicide rates for midlife women (ages 44-58).They stress the need for hormonal treatment first, not just SSRIs, and for open peer conversation.
🫀 36:00 – 40:00 | Hysterectomy Research & HRT Myths
Kim explains how outdated studies scared women — early hysterectomy patients weren’t given HRT, so they suffered bone and heart issues.Modern practice should include immediate hormone replacement for safety and quality of life.
💸 43:00 – 46:00 | Funding Barriers
Kim shares how she accessed surgery through a hospital financial-assistance program in the US.The approval felt like “relief and disbelief.”They dream aloud of a nonprofit fund to help others afford lifesaving PMDD surgeries.
🔄 47:00 – 52:00 | Before Surgery: Life in Cycles
Sam recalls living between inertia, shutdown, and rage, with shrinking windows of good days.After constant bleeding and progesterone crashes, surgery brought instant hormonal stability and mental clarity.
🩺 52:00 – End | Takeaways & Solidarity
* Blood tests are a snapshot, not the full story.
* Lived experience matters more than lab numbers.
* Peer advocacy can bridge dangerous medical gaps.
* Both women close with gratitude — for surviving, for community, and for being heard.
Resources and Further Reading
* International Association for Premenstrual Disorders (IAPMD)website
* PMDD Symptom trackerfromIAPMD website (above)
* The New Menopause - Navigating Your Path Through Hormonal Change with Purpose, Power and the Facts book by Dr Mary Claire Haver
* Your Periods, ADHD & the Multiple Hormone Sensitivity TheoryDr Nighat Arif video
* MENO-D A rating scale to detect depression in menopause by Professor Jayashari Kulkarni
* Progesterone intoleranceDr Loiuse Newson article
Please take good care of yourself.
Want to support me? The best way to support my advocacy and peer support work at Divergent Menopause is to become a paid subscriber. Thank you again for your support! It means the world to me. 💕
P.S.: That was intense, so here’s a photo of Harry! I have invested my paid subscriber contributions on some equipment to make my desk more ergonomically accessible post-hysterectomy. Huge thanks to my paid subscribers for making this possible!
