Premenstrual Dysphoric Disorder (PMDD): Symptoms, Causes, Diagnosis, and Treatment

Treatments for PMDD include antidepressant medicines, hormone therapy, and lifestyle changes.

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Commonly used SSRIs include:

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Venlafaxine (Effexor) is an SNRI prescribed to treat PMDD, and tends to be used if you experience unpleasant side effects with SSRIs.

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Hormone therapy using birth control pills may reduce PMDD symptoms. A pill containing the progestin hormone drospirenone and a form of estrogen called ethinyl estradiol is FDA approved for treating PMDD.

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Leuprolide (Lupron), a type of medicine called a gonadotropin-releasing hormone (GnRH) agonist, reduces PMDD symptoms by essentially stopping ovulation and menstruation. Because it has a lot of side effects, including hot flashes, vaginal dryness, and bone loss, Lupron is only used when SSRIs and birth control pills haven’t helped.

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Researchers are studying new medications that might help relieve the symptoms of PMDD. A class of drugs called selective progesterone receptor modulators that’s under investigation might be helpful for the emotional symptoms of PMDD. These drugs work by blocking the hormone progesterone.

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Research suggests that exposure to bright light in the morning may improve mood in people with PMDD. Though light therapy is safe to try, additional studies are needed to confirm that it works.

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This form of talk therapy focuses on changing a person’s perceptions to improve their symptoms. Early evidence suggests that CBT may offer some benefit for PMDD without the side effects of medication, but it warrants further investigation.

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Surgery to remove the uterus, fallopian tubes, and ovaries (hysterectomy and bilateral salpingo-oophorectomy) is a final option for women who have tried every other treatment but still have debilitating symptoms.

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 Surgery relieves PMDD symptoms by stopping ovulation. It will put you into menopause and you won’t be able to get pregnant afterward.

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Some research suggests that chasteberry (Vitex agnus castus) may improve PMDD symptoms. Dosing recommendations vary, so it may take some trial and error to determine what works for you.

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St. John’s Wort seems to help with the physical symptoms of PMDD, but it doesn’t do much to relieve emotional symptoms like depression, anxiety, and irritability. Also, it can interact with birth control pills and reduce their effectiveness.

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The FDA doesn’t regulate supplements like it does medicines. Talk to your doctor before you try any complementary therapy, to make sure it’s safe for you.

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Dietary supplements like vitamin B6, calcium, and magnesium have also been studied for treating PMDD. So far, none of these supplements have been confirmed to work.

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