Treatment Options for PMDD (Premenstrual Dysphoric Disorder)

PMDD causes intense physical and mood symptoms, but treatment can help.

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Given how common menstrual cramps and mood changes are before and during periods, it’s hard to know what’s “normal.” Many people with severe physical symptoms and mood changes may not realize they actually have something called premenstrual dysphoric disorder, or PMDD. Treatment for PMDD can relieve symptoms and even help prevent more serious issues, like substance misuse or suicidal ideation.

PMDD is similar to PMS (premenstrual syndrome), but it’s more intense. It’s a hormone condition that causes depressive episodes in relation to the menstrual cycle. Treatment for PMDD helps stabilize hormones and relieve symptoms. It usually involves a combination of lifestyle changes, medicines, and/or therapy.

Medication Treatment Options for PMDD

There are two primary medications to treat PMDD: antidepressants and hormonal birth control.

Antidepressants for PMDD help by improving serotonin levels. When estrogen levels fall (which happens between ovulation and the start of the period), serotonin typically does as well. There’s a theory that people with PMDD are more sensitive to these changes. Antidepressants like SSRIs (selective serotonin reuptake inhibitors) may help cope with those changing levels.

Usually, people take SSRIs every day consistently. However, some people with PMDD actually use the “pulsing” method, meaning they only take the antidepressant during the two weeks before their period. You should discuss this with your doctor since it’s not right for everyone.

Hormonal birth control helps treat PMDD by stabilizing your hormone levels. As a result, depression and other mood changes may be less intense. Hormonal birth control (including the Pill, patch, or hormonal IUD) can also help reduce physical symptoms, including cramps, breast tenderness, and body aches.

Talk Therapy for Premenstrual Dysphoric Disorder

PMDD is technically a hormonal disorder, but it overlaps with mood disorders. As a result, it benefits from psychotherapy, or “talk therapy.” Plus, many people with PMDD also have other mood disorders, such as:

Talk therapy, especially a subtype known as cognitive behavioral therapy, may help individuals learn how to recognize and adjust their thought patterns. Unproductive ways of thinking (such as jumping to conclusions or black-and-white thinking) can cause anxiety to spiral. This in turn can lead to destructive behaviors, like isolation, rumination, or substance misuse. Cognitive behavioral therapy basically seeks to disrupt that pattern.

Lifestyle Changes That May Help

A healthy lifestyle may help with symptoms of PMDD, or it may help make medications more effective. This includes:

  • A healthy diet: Eating well and having regular meals can help stave off low mood and energy, which may worsen feelings of depression or anxiety.
  • Exercising regularly: Exercise releases endorphins. Not only can this improve mood, but it may also help with pain.
  • Limiting alcohol and avoiding smoking: These habits may worsen depression and anxiety.
  • Getting enough sleep: Obviously, being slow on sleep can worsen your mood and overall health.

Work with a doctor or psychiatrist to find the right combination of treatment options for you. Your exact needs may vary depending on your symptoms and the severity. The good news is that PMDD tends to go away for most people, and it’s generally not a lifelong condition. However, seeking treatment can help you find relief sooner. What’s more, it may help prevent your overall mental health from worsening and becoming a more life-threatening concern.