What is Premenstrual Dysphoric Disorder and how can it be treated?

Qualified Nutritionist (BSc, MSc, RNutr)
Ask Emma

An introduction to PMDD

Premenstrual Dysphoric Disorder, or PMDD, occurs when ordinary PMS symptoms develop and become more persistent, having a profoundly negative impact on our everyday lives.

These types of intense symptoms make PMDD much rarer than PMS, with only approximately 2- 8% of women suffering from the disorder. When you are suffering from a severe form of at least 5 PMS symptoms, then you are considered to be experiencing PMDD.


It can sometimes be difficult to determine the line between experiencing PMDD and suffering from PMS. Most of the common PMS symptoms, such as bloating, anxiety, cramping etc., can be found in PMDD and, if you are having a bad month with your PMS symptoms, it can be easy to make the assumption that you could be suffering from PMDD.

However, PMS-like symptoms become unbearable with PMDD and your moods can become drastically altered, rapidly fluctuating from one emotion to the next. You might occasionally find your social life being impacted by PMS, but sufferers of PMDD find that they unable to cope at work or at home, and often do not leave the house when they are being affected by the disorder.

Their psychological symptoms are also much more prominent and persistent. You might experience some mild feelings of anxiety or have the occasional low mood with PMS, but if you suffer from PMDD, these conditions can become much worse, to the point where they share characteristics with serious mental health disorders such as depression, which is why PMDD is sometimes classified as a mental health complaint.

What causes PMDD?

There is no definitive cause of PMDD, but it can be linked to the hormonal changes that you experience throughout your menstrual cycle and the levels of serotonin present in your system.

Serotonin is a neurotransmitter, responsible for transmitting signals in your brain. It is thought to have an influence over your moods, which is why serotonin is often linked with mental health conditions such as depression.

This is interesting to consider since a study conducted by Dr. Eynav E. Accort etc, concluded that there was an “increased prevalence of PMDD was consistent across depression diagnosis.1”  In other words, people who suffered from psychological disorders, were often more vulnerable to PMDD.

If this is the case, then it might add some support to the idea that PMDD can be caused by lowered levels of serotonin, possibly already present in patients of depression. In a report carried out by the Department of Pharmacology at Goteborg University2, it was discovered that PMDD sufferers treated with serotonin inhibitors found that their symptoms were reduced.

These speculations had not come to a definite conclusion about the primary cause of PMDD, but they do offer some insight into what can trigger PMDD and how the disorder can be treated.

1 2

What are the symptoms of PMDD?

The symptoms of PMDD are more exaggerated forms of the symptoms that you can experience with PMS. These include common premenstrual side effect such as:

The main factor separating the two conditions is the severity of these symptoms. You might find ourselves becoming uncomfortable throughout the day with certain PMS symptoms, but sufferers of PMDD would be in agony with stomach cramps or borderline depressed when affected by low moods or anxiety.

Home remedies

Although the symptoms of PMDD can be overwhelming and seem unmanageable, there are a number of preventative steps you can take to reduce the intensity of your symptoms and to help make them more bearable.

  • Diet: When you are suffering from PMDD, it is important that you maintain a good diet, full of foods that can help your body to combat symptoms such as bloating or cramping. Avoid potential irritants such as coffee (or try our coffee substitute Bambu), or high sugar food products. Make sure your diet is rich in magnesium, wholegrains, and fruit and vegetables, and remember to drink plenty of water. If you want to read more about what you should be eating, visit our PMS and diet page for more information
  • Exercise: If you are suffering from PMDD, then the last thing you will feel like doing is exercising, however it is important for your overall health and wellbeing, and it can help you to tackle symptoms such as bloating. Exercise has also been shown to improve your mood, so it might be worth considering, especially if you are being affected by the psychological symptoms of PMDD
  • Relaxation: When you are going through PMDD, you have to allow yourself to rest and relax, especially if you are being affected by psychological symptoms such as anxiety or stress. Try having a long hot bath, or practicing simple breathing techniques to help calm mind. Meditation might be beneficial at it teaches you to be more aware of your body and mind, and help you to cope with physical and psychological symptoms.

Herbal remedies

Depending on the symptoms that are affecting you, there are a number of herbal treatments that can help you to cope with the unpleasant side-effects of PMDD.

  • Agnus Castus: Agnus castus is normally advised if you are struggling with symptoms such as mood swings, menstrual cramps or bloating. The formula works to regulate your hormones, reducing PMS-like symptoms. However, it should not be taken in conjunction with contraceptive medicines like the Pill
  • Hypericum: Hypericum, or St John’s Wort, is used as a plant based antidepressant, usually taken by those who suffer from low moods or anxiety. It works to improve your mood and alleviate any feelings of low-confidence and mild depression
  • Dormeasan: Dormeasan is a sleep remedy, used to help you fall asleep naturally. This might be beneficial if you are struggling to get to sleep at night due to anxiety, low moods or physical symptoms such as menstrual cramps
  • Stress Relief Daytime: Stress Relief Daytime can be taken to help you cope with feelings of being overwhelmed, stress and anxiety. It is a natural solution harvested from Valerian and Hops, and it can be taken by anyone over the age of 18.

Conventional medicines

PMDD is a serious medical complaint, with debilitating symptoms that should not be left lingering. If you suffer from PMDD, then it is crucial that you speak to your doctor about medications and treatments to help you cope with your symptoms.

  • Oral contraceptives: The most common answer to any premenstrual problems, oral contraceptives are usually taken to reduce PMS symptoms and to regulate your hormones throughout the month. However, not every variant is compatible with your body, so you may have to try a few different types before you settle on a pill that is suitable for you
  • Selective serotonin reuptake inhibitors: Selective serotonin reuptake inhibitors, or SSRI’s, are generally used to treat psychological conditions such as OCD, PTSD or phobias. The treatment works by increasing the serotonin levels present in the brain, impacting upon our emotions and moods. Since it is suspected that PMDD can be linked to lowered levels of serotonin, SSRI is often prescribed by doctors to alleviate symptoms of PMDD
  • Anti-depressants: Anti-depressant drugs are often taken by those who suffer from Depression. They are commonly prescribed with PMDD because of the negative impact the disorder can have upon our moods and emotions. However, anti-depressants can often trigger a whole host of side-effects and not all of them are compatible with your body.

My PMS Journal

Keep track of your symptoms with our PMS Diary to identify patterns & help discover ways to minimise them.

Agnus castus


£ 10.85

find your local stockist

A traditional herbal remedy used to relieve the symptoms of PMS
More info

What's being asked

What is PMS?

PMS is a combination of any of around 150 recognised symptoms experienced in the run up to a ...
Read more >

What can I do to minimise PMS?

The good news is that almost anything you do to improve your diet, lifestyle or general health will ...
Read more >

I am experiencing period pains but nothing else. Could I be pregnant?

If your period is late then the best thing to do would be to take a pregnancy test. However, stress ...
Read more >

Here's what I recommend

As the A.Vogel Women's Health advisor, I recommend Agnus castus to help relieve symptoms such as menstrual cramps, breast tenderness and irritability.

Learn more

Healthy & nutritious dinner ideas

Get new recipes in your inbox every week. Sign up now

Buy A.Vogel Pollinosan Hayfever Luffa Nasal Spray Was £8.25 Now £4.99

     Receive healthy recipes from A.Vogel      every month.


Receive healthy recipes from A.Vogel every month

Sign up now