Natural Treatment for PMDD
November 1, 2024 No Comments
Premenstrual discomfort is a feeling many women know well—
Nearly 90% of women in the United States have uncomfortable symptoms before their period.
I see women in my private practice every single day who complain about the classic PMS symptoms — mood swings, bloating, cramping, breast tenderness, headaches, insomnia — but what if, in addition to the classic PMS symptoms, you also experience severe depression, anxiety, irritability, and tension in the week leading up to your period?
You may be one of the 5% of women who have PMDD — Premenstrual Dysphoric Disorder.
Premenstrual dysphoric disorder is a condition similar to PMS that also happens in the 7-10 days before your period starts as hormone levels begin to fall in preparation for your next cycle; however, symptoms associated with PMDD are much more serious than PMS symptoms.
PMDD is a group of physical and behavioral symptoms that show up in a recurring pattern, usually during the second half of your menstrual cycle.
Premenstrual dysphoric disorder is a severe, sometimes disabling extension of premenstrual syndrome (PMS).
Although PMS and PMDD both have physical and emotional symptoms, PMDD causes extreme mood shifts that can disrupt daily life and damage relationships.
In both PMDD and PMS, symptoms usually begin 7 to 10 days before your period starts and continue for the first few days of your period.
Both PMDD and PMS may cause bloating, breast tenderness, fatigue, and changes in sleep and eating habits. In PMDD, however, at least one of the following emotional and behavioral symptoms stands out:
Unfortunately, experts do not know for sure what causes PMDD; however, many believe that it may be an abnormal reaction to normal hormone shifts that happen with each menstrual cycle.
During your menstrual cycle, you experience rising and dropping levels of both estrogen and progesterone. Low levels of progesterone in relationship to estrogen in the second half of your cycle is a common cause for PMDD. Studies have also shown that your menstrual cycle may also influence the neurotransmitters, like serotonin, in your brain. The impact on neurotransmitters can lead to behavioral symptoms such as anxiety, depression, or trouble controlling your emotions.
Hormones and neurotransmitters share many of the same receptor sites in the brain in areas that help regulate mood, making experts believe that women who are uniquely sensitive to hormone changes may have more mood issues throughout their cycle, and during other reproductive events, like postpartum or during perimenopause and menopause.
Underlying depression and anxiety are common in both PMS and PMDD, so it’s possible that the hormonal changes that trigger a menstrual period worsen the symptoms of mood disorders.
There are proven risk factors that increase your likelihood of developing PMDD, including:
Symptoms of PMDD start during the week before menstruation and end within two to three days of your period starting.
Symptoms of PMDD are so severe that people have trouble functioning at home, at work, and in relationships during this time. This is markedly different from other times during the month.
The following are common symptoms of PMDD:
The symptoms of PMDD may look like other health conditions, such as a thyroid condition, depression, or an anxiety disorder, making it important to see a healthcare provider for a diagnosis.
For some women, symptoms of PMDD last until menopause.
Aside from a health history and physical and pelvic exam, there are very few diagnostic tests. Your provider may also ask that you keep a journal or diary of your symptoms for several months in order to help the diagnosis process.
In general, to diagnose PMDD the following criteria must be met:
You should see your primary healthcare provider if you experience any of the following:
Hormone and specific nutrient testing is critical to informing treatment guidelines when it comes to PMDD—hormone imbalances, like low progesterone and/or estrogen dominance, are the primary cause of PMDD.
Ask your doctor to run the following lab tests:
Tests to have done on Day 3 of your cycle (first day of bleeding is considered day 1):
Tests to have done 6-8 days post ovulation of the same cycle, or 7 days before you expect your next cycle to start if you’re not testing ovulation or don’t know when you ovulate:
If you’d like to skip the doctor’s office and do a comprehensive at-home hormone test, you’ll find my favorite hormone test here. This tests estradiol, progesterone, DHEA, testosterone, cortisol x4, TSH, free T3, free T4 and TPO antibodies.
PMDD can be harder to treat than PMS, but this disruptive hormonal condition can absolutely be improved with changes to lifestyle, nutrition, and targeted supplement support.
First and foremost, know what’s going on with your menstrual cycle. The “norm” is 28 days, but we know that every body is different, so every body’s cycle will be different, too. There are a million cycle tracking apps, or you can go old school and use an actual calendar.
The important things to note are: when you experience PMS or PMDD symptoms, what PMS or PMDD symptoms you are experiencing, when you start to bleed and stop, and anything else that feels relevant to take note of regarding how you feel during the cycle.
PMDD most often strikes during the luteal phase – after your ovary releases an egg mid-cycle but before you start bleeding – when inflammation is more pronounced and may play an active role in PMDD.
It’s critical to support your body during the luteal phase with the right foods at the right times to help stabilize blood sugar, reduce inflammation, and support healthy hormone balance.
Likewise, it’s important during the luteal phase to hit the exercise sweet spot – not too little but not too much and/or not too intense – to decrease the cortisol output that can exacerbate symptoms. If you’re interested in taking your cycle tracking to the next level …
Yep, seriously. It’s no coincidence that the length of our menstrual cycles are about the same as the waxing and waning of the moon, occurring every 28 days on average.
Before industrialism, light pollution, and processed foods disrupted traditional cultures, women ovulated at the full moon and menstruated at the new moon. This is every woman’s intrinsic default setting.
Lunaception is the act of syncing your cycle to the moon, therefore encouraging regular menstrual cycles. I believe every woman should align her cycle with the moon, but it can be particularly helpful if you have irregular and/or painful cycles.
So how do you sync your cycle to the moon?
You’ll sleep in complete darkness from the beginning of your cycle until day 12.
On days 13, 14, and 15, turn on a dim night-light in your bedroom while sleeping, or even better, google the moon cycles and base your “nightlight” nights on the day before, the day of, and the day after the full moon. If you have a bedroom window that faces the full moon, you can open your curtains to experience natural moonlight.
The rest of the month, sleep in total darkness (use an eye mask, if necessary).
After a few cycles, you should find that you ovulate at the full moon and menstruate at the new moon.
Begin by eliminating the foods that cause inflammation and increase estrogen in the body.
Aim to avoid the following foods:
You’ll want to ADD IN lots of these anti-inflammatory and liver supporting foods:
You can reduce inflammation and regulate hormone production with healthy fats, like:
A few more tips and tricks to encourage healthy eating habits throughout your cycle:
〰️ Eat enough high quality protein for your body. Aim for 1 gram of high quality protein per pound of ideal body weight. This includes organic grass-fed meat, wild caught fish, organic eggs, lentils, quinoa, organic non-GMO tofu or tempeh and raw nuts, seeds and nut butters.
〰️ Eat plenty of organic fruits and vegetables. Focus on a variety of brightly colored produce every day.
〰️ Choose real food carbs such as whole non-gluten grains, (quinoa, oats, millet, buckwheat, amaranth, spelt, Einkorn), beans, lentils and starchy veggies instead of processed refined carbs.
〰️ Avoid white refined salt and ultra processed foods in boxes and packages.
〰️ Avoid caffeine.
〰️ Avoid alcohol.
〰️ Eat high-protein foods to help increase tryptophan levels.
In a perfect world, you would receive all your vitamins and minerals through diet alone. But, the reality is, that’s dang near impossible for most people. And that’s why high-quality, bioavailable supplements were created :).
Due to large-scale farming and soil depletion, our vegetables don’t take up as much magnesium as they did hundreds of years ago, meaning that most Americans are magnesium-deficient … which is bad news because magnesium plays a huge role in the way our cells function, head to toe.
A good supply of magnesium supports our hormones, which affects menstruation, PMS, and PMDD. Researchers found that women who experienced PMS and/or PMDD had a lower magnesium concentration in their red blood cells than women who did not experience PMS and/or PMDD. Magnesium supplements have been tied to reduced PMS and PMDD symptoms in general, and supplementing relieved mood swings.
This combination of calcium and magnesium helps the liver more efficiently metabolize hormones, and prevents spasms/tension in your muscles. Magnesium helps keep adrenal stress hormones under control, and helps to promote optimal progesterone levels. Magnesium also helps keep the bowels regular by maintaining bowel muscle function, which can also ease menstrual pain.
A study by the University of Western Ontario found that fish oil containing two specific compounds, EPA, and DHA, can relieve pain by decreasing levels of inflammatory prostaglandins.
DIM-Evail is a compound that helps to support healthy estrogen metabolism. DIM balances the hormones by breaking down estrogen and removing it from the body.
Inflammatone contains a blend of protein-digesting enzymes that promote circulation to the reproductive system and get the “stagnant blood” cleared out, bringing fresh oxygenated blood to your uterus and ovaries which can be very helpful in reducing menstrual pain.
Studies have found that depressed women had lower levels of vitamin D, and those with the lowest vitamin D levels had the greatest risk of depression. Vitamin D has also been found in studies to help reduce menstrual pain. Because many women have a Vitamin D deficiency, this is an important supplement to naturally treat PMDD/PMS.
Easier said than done, I know. Existing diagnoses of depression and anxiety are more common in women with PMDD, so it’s important to tend to your mental health as well as your hormonal health. To this end, I encourage women to engage in unapologetic self-care, find and do activities that bring them joy, practice meditation or other mindfulness practices, and seek out extra support, such as finding a therapist, when needed.
The truth is that there’s no way to eliminate stress from your life completely, but there are ways to manage it. The best method is to indulge in healthy activities that relax you and bring your unique soul pleasure.
Here are a few resources to help you dig a little deeper into finding a mind/body practice that works for you and your body:
Mind/Body Therapy Series: Meditation
Mind/Body Therapy Series: Yoga
Mind/Body Therapy Series: Acupuncture
Although menstrual products are a necessary evil during your period, they may make PMDD symptoms worse. Tampons, for instance, can cause some people to cramp more. If you have sensitive skin, some ingredients in pads may cause irritation. There aren’t any scientific studies on how menstrual products impact PMDD, but anecdotal evidence suggests changing them up may help.
Try using all-organic pads, definitely organic tampons (if you continue using) and/or organic period panties. Or, my personal fav, try using a menstrual cup! It’s better for the environment, much more cost effective, and you needn’t worry about bleached products in and around your lady bits.
PMDD is a much more severe form of premenstrual syndrome (PMS), and the exact cause of PMDD is not known.
PMDD is different from other mood disorders or menstrual conditions because of when symptoms start and how long they last.
Symptoms of PMDD are so severe that it affects your ability to function at home, work and in relationships.
You don’t have to live with the symptoms of PMDD! There are many natural treatment remedies including: tracking your cycle, lunaception, adjusting your diet and nutrition, using targeted supplements, reducing stress and prioritizing your mental health, and swapping out your toxic menstrual products.
Premenstrual Syndrome Prevalence and Fluctuation over Time
Premenstrual dysphoric disorder: burden of illness and treatment update
Alleviation of premenstrual syndrome symptoms with the relaxation response
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) | Office on Women’s Health
What is premenstrual dysphoric disorder (PMDD)?
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