top of page

How to Treat PMDD

How to Treat PMDD: Why Progesterone Is Both Good and Bad for Mood. By Dr Briden

Premenstrual dysphoric disorder (PMDD). PMDD is very similar to PMS, but its symptoms are more severe. Many people with PMDD report feeling very depressed before their period, some to the point of thinking about suicide. While recent research estimates about 75 percent of women have PMS during their reproductive years, only 3 to 8 percent have PMDD. The below article is written by Dr Lara Briden, naturopathic doctor and women’s health activist. Her mission is to help women achieve healthy natural menstrual cycles without the use of hormonal birth control. Dr Lara Briden's book 'Period Repair Manual' provides practical period solutions and alternatives to hormonal birth control. Now in its second edition, 'Period Repair Manual' has been an underground sensation and has worked to quietly change the lives of tens of thousands of women. This article focuses on the cause of PMDD and the conventional and natural treatments for the condition. If you are noticing similar symptoms to those of PMDD and PME, please contact your GP or Naturopath to take the necessary precautions and steps to treatment and recovery. If you have any questions or inquiries please contact via the contact form.

How to take progesterone for premenstrual mood symptoms

The better approach is to stabilize GABA receptors and therefore be able to tolerate the normal ups and downs of progesterone.

It’s also possible to take progesterone. For women with mild premenstrual symptoms (PMS instead of PMDD), low-dose progesterone (such as progesterone cream) can be helpful to offset the “progesterone withdrawal” that occurs at the end of the cycle.

For women with neurosteroid change sensitivity and PMDD, it can be better to take an optimal “sweet spot” dose of progesterone (100 to 200 mg), rather than a higher dose capsule or a lower dose cream. That’s because of the bimodal association between serum allopregnanolone and adverse mood, which means that women with PMDD can feel good on a medium dose of progesterone, but experience mood side effects from both lower and higher doses.

Unfortunately, there are only a few studies of progesterone for premenstrual moodand most used doses that were too high (400 to 1200 mg).

Natural treatment of PMDD

As I discuss in my summary post about premenstrual mood symptoms, other strategies include:

  • Reduce histamine and mast cell activation, which relieves histamine-induced mood symptoms and may normalize the sensitivity of GABA receptors. Histamine is one aspect of chronic inflammation which is a known driver of premenstrual mood symptoms. Read The role of histamine and mast cells in PMS and PMDD.

Tip: For many of my patients, avoiding cow’s dairy is the fastest way to reduce a mast cell or histamine response. Another potentially beneficial effect of avoiding dairy is to reduce exposure to a casein-derived neuroactive peptide called BCM7, which affects levels of GABA.

  • Magnesium, which supports a healthy GABA response and relieves PMS by “normalizing the action of progesterone on the central nervous system.” The best form is magnesium glycinate or bisglycinate because the amino acid glycine also calms GABA receptors.

Tip: The therapeutic dose is 300 mg of elemental magnesium, so read the label carefully. Most magnesium capsules contain 100 mg.

  • Vitamin B6 (pyridoxine) has done well in at least one clinical trial for PMDD. It works by boosting GABA, lowering prolactin, and promoting the healthy clearance of histamine. Be careful with vitamin B6 because it can cause nerve damage.

Tip: I get the best results with magnesium plus vitamin B6 plus the amino acid taurine (because taurine calms GABA receptors).

By Lara Biden


bottom of page