How Premenstrual Dysphoric Disorder (PMDD) Is Treated

Premenstrual dysphoric disorder (PMDD) can be addressed with both pharmacological and lifestyle-based treatment methods. Healthcare providers treating PMDD will have varying treatment recommendations, highly dependent on which symptoms are most distressing to an individual and which act as the greatest barrier to function.

The specific treatments used ultimately depends on the judgment of the individual seeking medical care. Each person has different comfort levels with each treatment. It's recommended to research each method and speak with your healthcare provider to find the best options for you.

Home Remedies and Lifestyle

While there is little scientific evidence proving the effectiveness of herbal remedies in alleviating the symptoms of PMDD, they are an option some choose. These can be used for individual symptoms of PMDD, rather than treating the diagnosis as a whole. Herbal remedies such as chasteberry claim to reduce breast pain due to its reported ability to reduce prolactin in the body.

Some women use St. John’s wort as a natural mood stabilizer to ease symptoms of emotional unrest. There are also claims of Ginkgo Biloba helping reducing insomnia, bloating, and fatigue. These herbal remedies can also be found at your local pharmacy, but should not be used without research on their purpose and usage instructions.

Home remedies which some women opt for as a PMDD treatment include aromatherapy with oils such as lavender, clary sage, and chamomile.

Vitamins such as vitamin E and vitamin B6 have been known to assist with mood irregularities and hormonal imbalances. Calcium and magnesium also assist with mood regulation along with relieving muscle tension to lessen cramps and body aches.

Getting adequate sleep and having good sleep hygiene is also important for managing both stress and hormone levels. It may help alleviate cramping, bloating, nausea, and fatigue to stay away from foods with an excess of salt or sugar, as this can worsen gastrointestinal-related symptoms.

Over-the-Counter Therapies

Over-the-counter pain relievers may be a recommended treatment if the pain is the most debilitating symptom of PMDD. Over-the-counter medications include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin. These can be taken without a healthcare provider’s prescription and bought at any local pharmacy. However, if they are ineffective or you find yourself needing too many pills to manage your symptoms, it is recommended to speak with a healthcare provider regarding dosage or potential alternative treatment options.

If oral contraceptives are not effective at treating PMDD, a healthcare provider may recommend other mediums of hormone therapy to assist in balancing levels within the body. Estrogen patches or implants may be indicated to inhibit the ovulation cycles in those women with low levels of estrogen. Gonadotropin-releasing hormone agonists can also assist with suppressing the hormonal cycle if no other prescriptions options have been successful at managing the symptoms of PMDD.

If any of these are options you are considering to treat PMDD, it is important to ask your healthcare provider about side effects and interactions with any other prescription medications you may be taking.

Prescriptions

The most common prescription treatments for PMDD are antidepressants to help manage and control mood swings at a more balanced level. Antidepressants most commonly used are selective serotonin reuptake inhibitors (SSRIs), which assist the body in absorbing higher levels of a neurotransmitter called serotonin. Serotonin is a naturally occurring chemical in the brain which makes us feel happy and content.

This neurotransmitter also assists in providing a sense of reward and motivation, while aiding in many other hormone-related functions such as sleep regulation, appetite control, learning, and cognition. Common SSRIs include Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Lexapro), and Citalopram (Celexa).

Since the internal functions of an individual with PMDD are not the same as those of a person with a depressive disorder, use of SSRIs typically resolve mood-related symptoms quicker in women with PMDD. This means daily, regular use of an SSRI may not be indicated for women with PMDD.

Additional prescriptions to treat PMDD are oral contraceptives, or birth control pills. These assist with balancing and regulating hormone levels throughout the body. Depending on the type of birth control pill, included hormones may be estrogen, progesterone, and/or testosterone.

With any medical treatments or medical diagnosis, oversight from a licensed and trained healthcare provider is important to achieving optimal health. A healthcare provider, especially one trained in the treatment of those with PMDD, can provide the tools to regulate symptoms and maintain hormone levels appropriately throughout the month.

While there is still some uncertainty regarding the effectiveness of treatments such as herbal supplements and other at-home remedies, adequate research is indicated to ensure sufficient health education.

By doing research and asking questions, women with PMDD can advocate for both themselves and others with their diagnosis. Health education is one of the first steps toward identifying and seeking out effective medical treatment.