Benefits of Hormonal Birth Control for PMDD

If you have premenstrual dysphoric disorder (PMDD), you may want to consider looking into hormonal birth control to help combat the side effects. Although selective serotonin reuptake inhibitors (SSRIs) are considered the first line of treatment for PMDD, many women don't want to take them and would prefer to combine their need for contraception with their need for relief from PMDD.

Understanding PMDD

While mild premenstrual syndrome (PMS), affects around 75% of women, PMDD is a severe and comparatively rare form of PMS. With PMS, you may experience a wide range of physical and/or emotional symptoms about seven to ten days before your monthly menstrual cycle begins.

The more severe PMDD is a condition that adversely affects the psychological well-being, social interactions, and relationships of about 3% to 8% of women of reproductive age. Its primary features are anger, irritability, and anxiety. Hormonal birth control methods, including extended-cycle pills, have been shown to offer some relief and may work as a treatment for PMS as well as PMDD.

Hormonal Contraception and PMDD

Hormonal contraception, like the Pill, is a very popular contraceptive choice for many women, yet women using this type of birth control may not be aware of its non-contraceptive benefits. Various hormonal contraceptives have shown some ability to diminish PMDD symptoms, as well as provide some PMS relief.

You may react differently to certain contraceptive methods; therefore, this information is intended to be a general overview. Also, keep in mind that the chief reason to use hormonal birth control is for contraception (to prevent an unintended pregnancy).

Treatment Options

If you and your doctor are considering the non-contraceptive benefits of birth control for treating your PMDD, there are a number of hormonal methods to consider, most especially combination birth control pills.

In randomized controlled trials, the combination pills that have proven most effective in treating PMDD are those which use a combination of ethinyl estradiol and drospirenone. These include such commonly prescribed brands as Yaz, Ocella, and Beyaz

Only Yaz is approved by the U.S. Food and Drug Administration (FDA) to treat the symptoms of PMDD. According to research, Yaz decreases premenstrual mood deterioration while improving all self-reported symptoms, functioning, and quality of life measures.

Other prescription birth control methods have also been shown to be effective in treating PMDD as well as PMS:

  • Combination birth control pills that contain levonorgestrel and ethinyl estradiol have also been shown to help PMDD symptoms when taken continuously without the placebo.
  • Because extended-cycle pills can reduce your number of periods to 4 times a year (Seasonique) or suppress menstruation altogether (Amythest) for the year, these pills can offer some PMDD and PMS relief.
  • Women on cyclic hormonal contraception (21-day active pills/7-day placebo) may experience premenstrual symptoms as well as pelvic pain, headaches, breast tenderness, and bloating during the hormone-free interval. Extending the usual 21-day cycle of contraceptive pills has been shown to reduce pelvic pain and headaches while improving overall mood.
  • Because you have fewer periods when using them, extended use of the contraceptive patch and the contraceptive ring may provide similar benefits as the extended-cycle pills. Note: The Ortho Evra contraceptive patch has been discontinued in the United States. A generic form, Xulane, is available.
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  1. Office on Women's Health. Premenstrual syndrome. Updated March 16, 2018.

  2. Office on Women's Health. Premenstrual dysphoric disorder (PMDD). Updated March 16, 2018.

  3. Rapkin AJ, Korotkaya Y, Taylor KC. Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectivesOpen Access J Contracept. 2019;10:27–39. doi:10.2147/OAJC.S183193

  4. Freeman EW, Halbreich U, Grubb GS, et al. An overview of four studies of a continuous oral contraceptive (levonorgestrel 90 mcg/<ethinyl estradiol 20 mcg) on premenstrual dysphoric disorder and premenstrual syndromeContraception. May 2012;85(5):437-45. doi:10.1016/j.contraception.2011.09.010

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