It may be getting warmer out, but gals…Winter is HERE!

It’s no big secret that I’m a Game of Thrones fanatic.  Like I LOVE it.  No, I don’t cosplay as Mother of Dragons.  But it reminds me of my first medical practice after leaving the Navy.  Beheadings, poisonings, intrigue.   Good times, good times.

Do you know what I think about while watching it?  How all that political crap was happening—and the women STILL having to have periods, babies and go through menopause.  Yikes.  It’s like that favorite quote of mine:  Ginger Rogers did everything Fred Astaire did but backwards and in heels.  Can you imagine having dragon triplets back in Westeros????? I. Can’t. Even.

So as a kudos to the ladies seeking to get their hands on the Iron Throne, I’d like to feature each one and consider what freakin’ gyn problems they had to withstand while getting married off to sadists, or suffocating their now-zombie husband, or falling in love with a eunuch.  I thought it a fine time to highlight some common gynecologic complaints—so common, even the women by the Wall would experience them!

Get ready my lovelies for the GYN CLINIC OF WESTEROS!  We are now OPEN for patient care. I take no responsibility for changing the outcome of the race to the Iron Throne if I was around back then 😉

Episode 1: Cersei “PMS” Lannister

Cersei Lannister—the current occupant of the Iron Throne, Cersei is no stranger to killing…a LOT of people. I can’t help thinking she’s suffering from a horrendous case of PMDD (premensutral dysphoric disorder)—PMDD (a more heinous cousin to PMS).  PMDD causes severe irritability, depression, or anxiety in the week or two before your period starts.  Maybe that’s when she blew up Margery and the entire kingdom.  Symptoms usually go away two to three days after your period starts.  PMDD affects up to 5% of women of childbearing age.1 Many women with PMDD may also have anxiety or depression.

PMDD is no joke!  These women are truly suffering.  Researchers do not know for sure what causes PMDD or PMS. Hormonal changes throughout the menstrual cycle may play a role. A brain chemical called serotonin may also play a role in PMDD. Serotonin levels change throughout the menstrual cycle. Some women may be more sensitive to these changes.

Symptoms of PMDD include:

  • Lasting irritability or anger that may affect other people
  • Feelings of sadness or despair, or even thoughts of suicide
  • Feelings of tension or anxiety
  • Panic attacks
  • Mood swings or crying often
  • Lack of interest in daily activities and relationships
  • Trouble thinking or focusing
  • Tiredness or low energy
  • Food cravings or binge eating
  • Trouble sleeping
  • Feeling out of control
  • Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

What can dear Cersei do?  She might keep the iron throne if she could get her condition under control.

  • Antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs change serotonin levels in the brain. The Food and Drug Administration (FDA) approved three SSRIs to treat PMDD:4
  • Birth control pills. Keeps the hormones even throughout the month which may allay the symptoms.
  • Over-the-counter pain relievers may help relieve physical symptoms, such as cramps, joint pain, headaches, backaches, and breast tenderness. These include:
  • Stress management, such as relaxation techniques and spending time on activities you enjoy.  Come on, Cersei—head to a King’s Landing yoga studio to get your RELAX on.

Making healthy changes, such as eating a healthy combination of foods across the food groups, cutting back on salty and sugary foods, and getting more physical activity, may also help relieve some PMDD symptoms. But PMDD can be serious enough that some women should go to a doctor or nurse to discuss treatment options. And, if you are thinking of hurting yourself or others, call 911 right away.

Cersei drinks a LOT of wine on the show, and while there are some health benefits to women who drink moderately, she might find she’s self-medicating her anxiety/depression.  She needs to head tout de suite to the Maester to have him whip her up a little concoction to help. PMDD is treatable, Cersei!

Can you even imagine having a period back then???   There was no Diva cup, pads or ‘pons (and Cersei is a perfect Diva cup user) .Ugh with a capital UGH.  Makes you kind of see Cersei in a whole new light, am I right?