What Medication Treats PMDD?

Learn how different medications can help treat PMDD safely and effectively—plus other treatments for managing PMDD symptoms.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects many people, causing debilitating emotional, physical, and mental health symptoms. Unlike typical PMS, which may cause mild symptoms, PMDD can severely disrupt daily life and overall well-being, often making it difficult to carry out regular activities and maintain relationships. Here are the various PMDD medication options, different treatment approaches, and how healthcare providers can help manage the PMDD safely and effectively for each person.

What is premenstrual dysphoric disorder (PMDD)?

PMDD is a type of mood disorder characterized by severe symptoms that occur during the luteal phase of the menstrual cycle, typically in the two weeks leading up to menstruation. It is thought to be related to hormonal fluctuations that occur during the menstrual cycle, which can lead to significant emotional and physical disruptions. PMDD is much more intense than typical PMS and can involve debilitating symptoms, such as depressive episodes, insomnia, or physical pain, that interfere with everyday activities. Unlike general PMS, PMDD is considered a more severe and persistent form of premenstrual disorder that can significantly impact a person’s quality of life, requiring professional diagnosis and management to help alleviate its effects.

Common symptoms of PMDD

PMDD symptoms are caused by hormonal fluctuations and can range from emotional changes to physical discomfort. These symptoms significantly affect mental health and daily functioning, often to the point of debilitation. Here are some of the most common PMDD symptoms. 

• Irritability
• Depression 
• Fatigue 
• Changes in appetite 
• Mood swings or sudden emotional outbursts
• Physical symptoms like bloating, breast tenderness, or headaches
• And more

Is there a medication that can treat PMDD?

There are various forms of treatment for PMDD, involving a multi-faceted approach with no one-size-fits-all solution. While treatment may not get rid of the PMDD entirely, it can significantly decrease symptoms, helping the disorder become more manageable. Here are some medications that may be prescribed in the treatment of PMDD.

1. Hormonal birth control 

Hormonal birth control, such as oral contraceptives (birth control pills), hormonal IUDs, and birth control implants, is one of the most common treatments for PMDD. These are used to regulate hormone levels and prevent the more severe fluctuations that often lead to PMDD symptoms, particularly mood swings and irritability. One specific type of oral contraceptive, which contains ethinyl estradiol, is frequently prescribed, helping to balance estrogen and progesterone levels. While birth control is a popular treatment option, it may not work for everyone. Some people may experience side effects or find it ineffective, making consulting a healthcare provider important to determine if this option is appropriate.

2. Selective serotonin reuptake inhibitors (SSRIs)

Controlled trial research has shown that SSRIs can help improve overall mood and reduce the frequency and intensity of PMDD symptoms. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat PMDD, especially for those experiencing severe emotional symptoms. SSRIs work by increasing serotonin levels in the brain, which is a neurotransmitter that plays a crucial role in regulating mood. SSRIs are particularly effective in treating depressive symptoms and anxiety disorders that arise with PMDD. While effective, SSRIs may come with side effects, including gastrointestinal issues, weight gain, and changes in sexual health. Therefore, working with a healthcare provider is necessary to find the right medication and dosage.

3. GnRH agonists

Sometimes, a GnRH agonist (gonadotropin-releasing hormone agonist) is prescribed when other treatments, such as birth control or SSRIs, are ineffective. These medications suppress ovarian function, inducing a temporary menopause-like state and helping to alleviate PMDD symptoms caused by hormonal fluctuations. A GnRH agonist is often used in combination with other therapies, such as add-back therapy, to prevent side effects like bone loss and hot flashes. However, this treatment option carries more significant risks and side effects, so it’s typically reserved for those who have not responded to other therapies.

4. Vitamin B6 

For people seeking complementary treatments, vitamin B6 has been suggested as a potential remedy for more mild PMDD symptoms. Research indicates that vitamin B6 may help regulate serotonin production, which is key to managing mood swings, irritability, and anxiety associated with PMDD. Although more research is needed, some studies suggest that vitamin B6 supplements may help reduce PMDD symptoms when used alongside other treatments. As with any supplement, it’s important to consult a healthcare provider before adding it to one’s regimen, as high doses can lead to side effects.

The role of healthcare providers in PMDD treatment 

A healthcare provider plays a critical role in the diagnosis and treatment of PMDD. They can help identify the symptoms of PMDD, recommend appropriate medications, and monitor progress. In addition, healthcare providers may suggest other treatment options, including lifestyle changes, that can complement the effectiveness of medications. A healthcare provider can also help manage potential side effects, ensuring that the treatment plan is customized to each person’s needs. If medications like SSRIs or hormonal treatments are not effective, the provider may suggest alternative therapies or refer the patient to a specialist for further evaluation.

Lifestyle modifications for PMDD

In addition to medications, lifestyle changes can significantly impact the severity of PMDD symptoms.

1. Diet and nutrition

Maintaining a healthy diet is crucial for managing PMDD symptoms, as certain foods may help reduce inflammation, stabilize blood sugar levels, and improve mood. Nutrient-rich foods, particularly those high in omega-3 fatty acids, magnesium, and vitamin B6, can support mental health and ease symptoms. Reducing the intake of caffeine, sugar, and processed foods may also help manage the physical and emotional symptoms of PMDD. Additionally, balanced meals that help regulate blood sugar levels can reduce irritability and improve energy levels.

2. Regular exercise

Regular physical activity is another effective way to manage PMDD symptoms. Exercise has been shown to increase serotonin levels, which can help stabilize mood while also promoting better sleep, reducing fatigue, and alleviating physical symptoms like joint pain or bloating. For people with PMDD, incorporating exercise into their daily routine can be particularly beneficial, especially during the luteal phase when symptoms are most intense. Whether it’s yoga, walking, or strength training, staying active can significantly improve both physical and mental health.

3. Stress reduction

Given the impact of stress on PMDD, incorporating stress reduction techniques into daily life can be extremely beneficial. Practices such as mindfulness, meditation, and deep breathing exercises can help lower anxiety and improve mood. Reducing daily stressors can help minimize the severity of symptoms and improve emotional well-being. By integrating these stress-reducing practices into daily routines, people with PMDD may find it easier to cope with the emotional and physical challenges associated with the condition, leading to a better quality of life.

How Charlie Health can help

If you or a loved one are struggling with a mental health condition, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.