PMDD (premenstrual dysphoric disorder) can be a debilitating condition. I didn't realize just how debilitating until I started seeing it in my practice:
Patients and online forums have shared sentiments similar to these while describing their experiences of PMDD.
April is Premenstrual Disorders Awareness Month. Check out this blog post on PMDD diagnosis and what it can look like.
Regardless of what role conventional medicine is playing in your care, there are natural supports available to you. We borrow some of our strategies from PMS research. PMDD used to be lumped in with PMS, but the mechanisms of action are different.
That being said, if you need medication or if meds are the affordable option (due to drug plan coverage) to support your mental health, please know that meds can be life-changing and life-saving. Anti-depressants are the typical meds used in PMDD cases, and can actually be used cyclically (i.e., only in the second half of the cycle), which helps mitigate some of the side-effects from continuous use.
Here are some non-drug options:
Counselling and therapy, especially CBT (cognitive behavioural therapy) have been shown to help significantly with PMDD. In fact, this is the first-line treatment option conventionally for this condition, and forms a large portion of PMDD support.
Vitamin D: Vitamin D deficiency is associated with PMDD and correcting this deficiency can actually improve PMDD, so test and supplement appropriately with your ND or MD.
Nutrition: Luteal phase nutrition support should typically include eating enough food for your body (low food = low & anxious & irritable mood). This includes eating adequate carbs, as well as lots of fibre, vitamins, minerals and antioxidants through plant foods.
Exercise is good for your whole body. It is beneficial for cognitive, mood, and physical symptoms during the second half of the cycle.
Quitting smoking can be beneficial for smokers with PMDD.
Sleep disturbances are common in PMDD, so improving sleep quality is essential. Mindfulness techniques, sedating herbs such as chamomile and passionflower, and supplements like melatonin and magnesium might be of use here.
Managing stress by using coping techniques and having a support system in place can be a vital step to support mood and mental health.
Acupuncture has been shown to be an effective support for PMDD, especially for physical symptoms, anxiety, and depression.
Chaste tree, or Vitex (Vitex agnus-castus), which is also used to decrease PMS symptoms is a good option here.
There are other herbs and supplements that can be helpful, but please, always consult with a healthcare provider to ensure that supplements, meds, and herbs are appropriate for you. Some natural PMDD solutions can be used alongside meds, but there are some herbs that might be contraindicated. If you're looking to add in a PMDD naturopath (anywhere in Ontario virtually, in person in Newmarket), I accept a few new patients every month.
Brzezinski AA, Wurtman JJ, Wurtman RJ, Gleason R, Greenfield J, Nader T. d-Fenfluramine suppresses the increased calorie and carbohydrate intakes and improves the mood of women with premenstrual depression. Obstet Gynecol. 1990 Aug;76(2):296-301.
Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Womens Ment Health. 2017 Dec;20(6):713-719.
