1. SSRIs

‍Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medication and are the primary recommended treatment for PMDD. They work by preventing the reuptake of serotonin (the happy hormone), meaning there’s more of it around in the brain to help improve our mood. The most common SSRIs include sertraline, citalopram and fluoxetine. Studies have found sertraline effective in relieving PMS symptoms, including pain, mood, irritability, depression and anxiety. It’s also been shown to improve quality of life for people with PMDD. SSRIs are prescribed by your doctor and can either be taken continuously or solely during the luteal phase (a doctor will advise you on this).

2. Combined oral contraceptives

Combined oral contraceptives (COCs) are one of the most frequently used treatments for easing symptoms of PMS – especially the variety containing drospirenone, a specific type of progestogen. It’s recommended these COCs are taken continuously (back-to-back packets) rather than cyclically (whereby you have a break from taking the pill and have a period) to maximise the chances of them working. Not all pills can be taken continuously though, so check with your healthcare provider before making any changes to your medication. According to research, COCs containing drospirenone can significantly reduce breast pain and help reduce fluctuations in weight, appetite, mood swings, and acne.

3. GnRH analogues

GnRH analogues are also an option for PMS symptom relief but are typically reserved for people experiencing severe PMS. GnRH analogues are usually given as injections, and work by reducing the levels of oestrogen in the body. In a way, these injections ‘turn off’ the ovaries and induce temporary menopause. This prevents the rest of the sex hormone levels from rising and falling, leading to a reduction in PMS symptoms. Research suggests that GnRH analogues significantly reduce premenstrual depression, irritability, and headaches, and can help people feel happier. However, because oestrogen plays many important roles throughout the body, these are less suitable as a long-term solution.

4. Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a variety of mental health issues, including PMS/PMDD-related symptoms. CBT is available in individual, couple-based, or group-based formats, and can be offered in-person or online. CBT helps you to think, feel, and act differently in response to PMS/PMDD-related anxiety and other symptoms. The idea is that you become more capable of identifying unhelpful, negative thought patterns and replacing them with more positive ones. Studies have shown that CBT can help to reduce PMS/PMDD-related anxiety and depression, as well as improve our ability to cope with other symptoms.

5. Reflexology and acupuncture

Reflexology and acupuncture are based on the ancient Chinese concept of energy or Qi. Qi is supposed to flow freely through the body but can be blocked by issues like stress, resulting in imbalance and illness. Reflexology is a massage technique where practitioners apply gentle pressure to specific body parts. Acupuncture involves a practitioner inserting fine needles into specific parts of the body to manage or prevent illness. Massaging, pressing, or inserting fine needles into specific parts of the body known as pressure points are meant to stimulate the nervous system, relaxing the body and having a positive effect on breathing, blood flow, the immune system, and more. A review of studies found that reflexology can help to reduce both physical and psychological symptoms of PMS/PMDD, with longer sessions (approximately 60 minutes) being the most effective.  

6. Aromatherapy

Although aromatherapy (practices using essential oils) doesn’t have as much evidence behind its effectiveness as some other treatments, it can be effective for PMS/PMDD relief. The best thing about aromatherapy is that it can provide instant relief from certain symptoms, and can easily be practiced at home at very little cost. Essential oils can be inhaled or absorbed through the skin. It’s popular to combine aromatherapy with massage by including essential oils in the massage oil. In other cases, people might use an oil diffuser, rub diluted oil onto their skin, or even add a few drops to a warm bath. If you’re putting oils on your skin, make sure you mix them with a neutral carrier oil like coconut or extra virgin olive oil first, as concentrated essential oils can irritate the skin. Studies have found that aromatherapy may help ease the pain experienced around the time of our period, as well as ease PMS symptoms including mood swings, depression, and fatigue.

7. Exercise and yoga

Some people find that general lifestyle modifications can help ease their PMS/PMDD symptoms. Activities such as exercising can help boost our endorphin levels and reduce our cortisol and adrenaline levels. This in turn helps reduce our perception of pain, stress and overstimulation. Additionally, many people find that yoga (along with other activities such as breathwork) can be particularly helpful in both getting our bodies moving and reducing stress, anxiety and feelings of depression by regulating the body’s stress response and nervous system.

8. Diet

A well-balanced diet can help us feel better for a number of reasons: we’re likely to have more energy, topping up our vitamin and mineral levels, and providing our body with all the nutrients it needs to function properly (eg, for skin health, hormone production, nervous system function, brain function, etc). If you’re concerned about getting enough of the right nutrients into your diet, supplements can be a simple and effective way to boost your intake.

9. Nature

The great outdoors. Spending time in nature has been shown to have a calming effect on the mind, so if you’re feeling overwhelmed and in need of a quick relaxant, head outside to a green space for a walk or find a bench to sit and take some time out.

10. Journaling and tracking

Journaling and tracking. This may sound like a funny one, and although it’s not a treatment per se, it can really change how we approach our PMS and PMDD symptoms. Knowledge and understanding are the first steps toward making changes that will impact our lives. If we know what stage of our cycle we’re in, and have an idea of which symptoms we usually experience, we can start to preempt them at certain times of the month. How we adapt to those changes everything. Whether we give people a little more patience (because we know we’re likely to be short-tempered), work with the brain fog and confusion (by choosing less mentally taxing tasks), or choose to take it a little slower on an afternoon jog, we’re guaranteed to feel better by leaning into our cycle, not fighting against it.