“catastrophic” PMDD and BC experiences

hi friends <3

recently diagnosed with lean-type PCOS and my treatment options are pretty limited. i have never taken BC in my life (never needed to for its initial purpose as i am a lesbian lol)

i am asking specifically for experiences with BC (pills or mirena IUD) from those with catastrophic PMDD. i understand PMDD to be a spectrum, and it seems that i’m one of the unlucky few that has the “unalive” risk version of this. my worry is that i will become a danger to myself if my mood symptoms worsen by even 1%

my gynecologist is really concerned about my irregular periods (60 days apart) and endometrial buildup. cyclic progesterone is off the table for now because in her professional experience, it tends to trigger more intense mood symptoms than a combined pill or IUD

i really feel like i’ve hit a wall. i’ve heard of many people having improvements with PMDD symptoms with hormonal treatment but i genuinely cannot risk it getting worse. i would not survive this