Posted 1/30/2023 12:32 PM (GMT -5)
Welcome to the forum!
I also get terrible nerve pain at times alongside menstruation and sometimes ovulation as well. Periods are very good at highlighting where in our bodies we're having trouble, even with things unrelated to menstruation, because they cause so many types of inflammatory processes to increase. The research done on anything related to cycling hormones and menstruation is shamefully scant. A few ideas:
Do you have endometriosis, ovarian cysts, or fibroids? (Endometriosis and ovarian cysts can be difficult to detect on the imaging you mentioned.) A mass or growth of any type of tissue could be pressing on your sciatic nerve, and could grow larger at certain times in your cycle. When I get ovarian cysts on my right ovary, they sometimes cause me terrible pain at the base of my spine, sometimes from ovulation until the following period allows the cyst to resolve (or partially resolve). When I get ovarian cysts on my left ovary, they press on the genitofemoral nerve, causing searing pain in my pelvis and pubic bone, extending down the leg into the angle, even causing it to spasm. Endometriosis causes me pudendal nerve pain (including sensations of a UTI) as my uterine tissue swells before my period, as well as various pangs elsewhere in my abdomen. Good times!
If you have any of these issues, or really any severe cycle-related issues, then it's worth doing what you can to keep your HPA axis (the interactions of the hypothalamus, pituitary gland, and adrenal system) balanced. Your hunch that balancing your thyroid might help makes sense, too, since all the hormonal systems interact and impact each other. Which other hormones were tested, and what have the results been? How are you at the basics - sleep, stress, movement, diet, stimulants, etc.? If you don't get quality sleep regularly, don't genuinely manage your stress, ingest caffeine and sugar regularly, etc. then inflammation of any kind will be higher, and your hormones will all be in flux as they try to make up for deficiencies and excesses.
Are you doing anything structurally that could be an issue (and then the added inflammation of menstruation makes it worse)? I'm sure you've looked into all of your ergonomics to see if anything could be irritating your sciatic nerve, but just in case: desk chair, general work set-up, mattress, wherever you lounge, car, dining table, all of your shoes? Have you been checked out by a physical therapist, chiropractor, pelvic floor specialist, or craniosacral therapist? Have you ever been pregnant (which can change the shape of the pelvis and re-align the abdomen)? Tick-borne infections certainly can make our nerves extra excitable.
Have you looked into issues with histamine or mast cell activation? Here's an article about how estrogen interacts with mast cells, causing people all kids of of nervous system-related issues (most people think of migraines in this context, another example of nerves gone haywire, triggered by periods): https://www.larabriden.com/the-curious-link-between-estrogen-and-histamine-intolerance/
Is your period uneventful aside from the sciatica? Are you experiencing any other symptoms, or do you feel basically fine aside from this?
Sorry for the nine thousand questions here, just trying to get more of a sense of what's going on. Hormone systems can be frightfully complex, and disruption in them looks different for everyone, but anything that helps to balance your hormonal cycling better might ease the inflammation you're dealing with, while you work on treating any underlying infections and your thyroid. There are lots of supplements that could help the hormonal stuff, but what would help depends on which hormones are out of whack.
For straight-up symptom relief, I would suggest CBD or full-spectrum cannabis (depending on what's legal where you live). My dad suffered terribly with sciatica for years, and the only thing that touched the pain was cannabis derivatives. This did get expensive, though, unfortunately. (His was caused by ergonomics and obesity, so a new sofa and losing 100 pounds cured him.) But I have not found anything that addresses nerve pain as well as CBD does.
Your doctor's conviction that EBV "needs to clear" before your can treat Lyme is not typical, as far as I know. The LLMDs I have seen have thought of my extremely high EBV titers as an afterthought when the protocols I did for tick-borne infections didn't yield much in the way of results. (When treating infections doesn't help, then LLMDs tend to look at the other things that keep people from improving - gut dysbiosis, candida, mold toxicity, long-term damage, heavy metals, chronic viruses, etc.) 90% of people have a history of EBV, and lots of people with Lyme have extremely high EBV titers when tested. Lyme and EBV are also thought to be cross-reactive on antibody tests. So what I'm saying is that most people would be treating their tick-borne infections and not waiting on an EBV test to say one thing or another, because some perfectly healthy people have very high EBV titers. Which symptoms does your doctor think are from EBV? I'm curious why your doctor believes you can't treat Lyme until you address EBV, and what you are doing to address EBV, and how your doctor thinks you will determine when EBV is under control.
My auxiliary point here is that you should delve into the Buhner protocol (or whatever you choose) if that feels right to you. Herbal medicine is great because herbs all do more than one thing for your body, so many herbs are antibacterial and antiviral and anti-inflammatory and immunomodulatory and all sort of things your system might benefit from whether it's fighting EBV or Lyme or one of the many co-infections ticks tend to contribute.
A few resources that could help with herbal treatment ideas, especially if you are interested in self-treating or want to have talking points for your next LLMD visit:
rawlsmd.com
treatlyme.net
Healing Lyme by Stephen Buhner
Good luck!