Treatment for Premenstrual Dysphoric Disorder

Woman with PMDD.

Getty / LumiNola

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). PMDD affects approximately 5% of women of reproductive age. PMDD is characterized by a number of physical and psychological symptoms that occur during the two weeks before menstruation, including mood swings, depression, fatigue, and sleep disturbances. These symptoms typically resolve within a few days after menstruation begins.

The most popular and effective treatments for premenstrual dysphoric disorder (PMDD) include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft). These medications can help relieve the symptoms of PMDD by increasing levels of serotonin, a brain chemical that helps regulate mood.

Other treatments for PMDD include birth control pills, which can help regulate hormone levels. In some cases, surgery may be recommended to remove ovaries and Fallopian tubes (oophorectomy).

If you think you may have PMDD, talk to your doctor about treatment options. With proper treatment, most women are able to manage their symptoms and live healthy, productive lives.


Some women benefit from psychotherapy to help them deal with the emotions and behaviors associated with PMDD. Below are some examples of types of therapy that have been shown effective at reducing symptoms of PMDD:

Cognitive behavioral therapy (CBT)

This type of therapy can help you identify and change negative thinking patterns and behaviors that may be contributing to your PMDD symptoms. For example, some women have thoughts about being inadequate or worthless during the days leading up to their period.

CBT can help you challenge and change these negative thought patterns. A study published in the Archives of Women's Health showed CBT to be a promising treatment option for PMDD.

Interpersonal therapy

This type of therapy focuses on your relationships and their relation to your mood. For example, if you have a history of conflict with your partner or family members, interpersonal therapy (IPT) can help you learn to communicate more effectively and resolve disagreements.

A 2016 meta-analysis published in the American Journal of Psychiatry showed IPT to be an effective treatment for depression and a variety of other mental health disorders.


There are a number of different medications that can be used to treat PMDD, including the following:

  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs are a type of antidepressant that can help relieve the symptoms of PMDD by increasing levels of serotonin in the brain. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs are another type of antidepressant that work by increasing levels of both serotonin and norepinephrine in the brain. Examples of SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).
  • Birth control pills: Birth control pills can help regulate hormone levels, which can in turn reduce the symptoms of PMDD.

Surgery and Invasive Procedures

In severe cases of PMDD, your doctor may recommend surgery to remove your ovaries and Fallopian tubes (oophorectomy). This is typically only done if other treatments have been unsuccessful at relieving your symptoms.

Complementary Alternative Medicine (CAM) & Over-the-Counter (OTC)

There are a number of CAM and OTC treatments that have been shown to be effective at relieving the symptoms of PMDD, including the following:

  • Dietary supplements: Supplements such as calcium, magnesium, vitamin B6, and omega-3 fatty acids may help reduce the symptoms of PMDD. However, further research is needed to confirm their effectiveness.
  • Herbal remedies: Herbal remedies such as chasteberry (vitex), ginkgo biloba, and St. John’s wort have been suggested to relieve the symptoms of PMDD. However, evidence of their effectiveness has been mixed.
  • Acupuncture: Acupuncture is a form of traditional Chinese medicine that involves inserting thin needles into the skin at specific points on the body. More research is needed to confirm whether acupuncture may be effective at treating PMDD.
  • Yoga: Yoga is a form of exercise that can help reduce stress and promote relaxation. There is some evidence to suggest that yoga may be effective at helping to manage PMDD.
  • Massage: Massage can help relieve stress and promote relaxation. Research has shown that massage may be effective at treating PMDD.
  • Stress management: Stress management techniques such as meditation, breathing exercises, and progressive muscle relaxation may help reduce the symptoms of PMDD.
  • Exercise: Exercise can help improve mood and reduce stress. It is important to find an exercise routine that you enjoy and stick with it on a regular basis.
  • Diet: Eating a healthy diet and avoiding trigger foods (such as caffeine, alcohol, and sugar) can help reduce the symptoms of PMDD.
  • Sleep: Getting adequate sleep is important for overall health and can help reduce the symptoms of PMDD.

It is important to speak with your doctor before starting any new treatment. This is because some CAM and OTC treatments can interact with medications you may be taking or have other side effects.

How to Make Your Treatment Most Effective

There are a number of things you can do to make your treatment for PMDD most effective. It's important to do the following:

  • Work with your doctor to find a treatment plan that is right for you. If your symptoms are severe, you may benefit from seeing a specialist such as a psychiatrist or a gynecologist.
  • Consider cost: When choosing a treatment for PMDD, it is important to consider the cost as well as the effectiveness. Some treatments, such as medication and surgery, can be expensive.
  • Be patient. It may take some time to find the right combination of treatments that work for you. It is important to stick to your treatment plan even when you are feeling better. This will help prevent your symptoms from returning.
  • Keep a symptom diary. Keeping a symptom diary can help you and your doctor track your progress and make adjustments to your treatment plan as needed.
  • Stay positive and hopeful. Many women with PMDD are able to effectively manage their symptoms with treatment.
  • Seek support from family and friends. Talking about your symptoms and experiences can help you feel better and cope with your condition. There are also support groups available for women with PMDD.

If you think you may have PMDD, it's important to speak with your doctor so you can get the help and treatment you need. Don't suffer in silence. There are effective treatments available that can help you manage your symptoms and live a full and healthy life.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."