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PMS, PMDD and alternative and complementary therapies: the evidence behind their effectiveness for easing PMS/PMDD
Summary
Complementary and alternative therapies can meaningfully support PMS and PMDD - especially for those who want options alongside or before medication. This guide reviews the evidence behind lifestyle changes, CBT, mindfulness, aromatherapy, acupuncture, chiropractic care, and reflexology. The strongest data tends to support psychological and stress-regulating approaches, but results vary by person. We explain potential benefits, safety notes, and how to find reputable practitioners.
⚠️ A note on PMDD: Evelyn encourages a holistic approach to health, and recognises the value of complementary therapies. We also recognise the severity and potentially life-threatening nature of PMDD. If you think you may have PMDD, please prioritise seeking medical advice. Never delay speaking to a healthcare professional if you are concerned about your wellbeing or safety.
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🌿 Key takeaways
Complementary therapies for PMS and PMDD: what to know
- Complementary therapies are used alongside conventional medicine - not instead of it, especially for PMDD
- CBT and MBCT have the strongest evidence base for reducing PMS and PMDD-related anxiety and depression
- Mindfulness is recommended by NICE for mild depression and is free, safe, and accessible to everyone
- Aromatherapy, acupuncture, and reflexology all have evidence for reducing PMS symptoms - from pain and bloating to mood and anxiety
- Always use accredited practitioners for hands-on therapies, and speak to your GP before starting if you are on medication or managing a more serious condition
What are complementary therapies?
The NHS defines complementary therapies as any treatment or practice not included in conventional healthcare - from using essential oils to receiving a relaxing massage.
The terms "complementary" and "alternative" therapy are sometimes used interchangeably, but they mean different things. Complementary therapy means using practices alongside conventional healthcare. Alternative therapy means replacing conventional medicine with these practices altogether. The distinction matters - particularly for conditions like PMDD, where medical treatment may be necessary.
Complementary therapies are a popular choice for natural PMS relief. If you are already taking medication or would like to understand whether a particular therapy is safe to combine with existing treatment, speak to a healthcare professional first.
Lifestyle changes
Many people find that general lifestyle modifications meaningfully ease PMS and PMDD symptoms. These are often the most accessible starting point.
Exercise
Exercise boosts endorphin levels and reduces cortisol and adrenaline - helping reduce pain perception and making us feel less stressed and overstimulated. Even gentle movement during the luteal phase can make a meaningful difference.
Diet
A well-balanced diet supports energy levels, tops up vitamins and minerals, and provides the body with what it needs for hormone production, nervous system function, and brain health. If getting enough of the right nutrients from food is difficult, targeted supplements are a straightforward way to bridge the gap.
Time in nature
Spending time in nature has been shown to have a calming effect on the mind and is particularly helpful for mild to moderate depression. A short walk in a green space or even sitting outside for a few minutes can provide a quick nervous system reset.
Stress reduction
Yoga, meditation, mindfulness, and breathwork can all help reduce stress, anxiety, and feelings of depression. Each works by regulating the body's stress response and nervous system - which is particularly relevant in the luteal phase, when cortisol reactivity increases.
CBT and mindfulness-based CBT
Cognitive behavioural therapy (CBT) is a talking therapy that can help with a wide range of mental health issues, including PMS and PMDD-related symptoms. It is available in individual, couple-based, or group formats, and can be offered in person or online. CBT works by helping you identify unhelpful, negative thought patterns and replace them with more constructive ones.
Studies show that CBT reduces PMS and PMDD-related anxiety and depression and improves coping ability. Research indicates it is generally more effective for psychological symptoms than physical ones. One key advantage over medication is that the benefits can persist after therapy ends.
🌿 MBCT: Mindfulness-based cognitive therapy (MBCT) combines traditional CBT with mindfulness strategies - teaching specific relaxation techniques and non-judgmental awareness of current emotions. Existing studies show it can reduce PMDD anxiety and improve quality of life. Further research is ongoing.
Mindfulness
Mindfulness is a practice that encourages awareness of the present moment - paying attention to thoughts, feelings, and experiences without judgement. It can be used as part of CBT, or practised on its own.
A review of studies on mindfulness found it likely increases feelings of wellbeing, improves behavioural regulation, and reduces psychological and mood-based symptoms across a range of mental health issues. One study in the review found that people who meditate frequently report higher levels of mindfulness, self-compassion, and general wellbeing.
A study of 60 women found that mindfulness-based cognitive therapy helped reduce anxiety and depression experienced during PMS. Part of the study involved helping participants become more aware of how these feelings influence other PMS symptoms.
🧠 In simple terms: NICE guidelines recommend mindfulness-based therapies for mild depression. If you experience mild depressive symptoms as part of PMS, mindfulness is a well-established, safe, and free option to try. If symptoms are more severe, speak to your GP to make sure you are getting the full support you need.
Aromatherapy
Essential oils are made from distilled parts of plants or flowers. Aromatherapists believe the scent of essential oils stimulates receptors in the nose that send signals through the nervous system to the emotional processing areas of the brain. Essential oils can be inhaled, diffused, or applied to the skin when diluted in a carrier oil such as coconut or olive oil. Never apply concentrated essential oils directly to the skin, and always do a patch test first.
While there is no evidence that aromatherapy can cure illness, there is evidence it can help with symptom relief:
- Researchers have found essential oils may help ease pain around the time of a period
- A review of existing research shows aromatherapy can reduce PMS symptoms including mood swings, depression, and fatigue
- One study found that students who inhaled lavender oil for five sessions per cycle, over three cycles, showed significant reductions in anxiety, depression, nervousness, pain, and bloating
- Another study found that aromatherapy with Rosa Damascena for five minutes twice daily during the luteal phase improved psychological, physical, and social PMS symptoms after two cycles
⚠️ Quality matters: Not all essential oils are created equal. Some are synthetically produced. Look for oils that are 100% pure, GMO-free, and extracted via steam distillation or cold pressing. Never ingest essential oils - even small amounts can be toxic. Essential oils diffused or used on skin can also be highly toxic to pets.
Acupuncture
Acupuncture involves a practitioner inserting fine needles into specific parts of the body. It is based on traditional Chinese medicine (TCM), which holds that an energy called Qi flows through meridians in the body. When Qi is blocked, illness is thought to result. Acupuncture aims to restore free flow.
Western medical acupuncture is an adaptation of this practice that focuses on stimulating the nervous system to release endorphins - the body's natural pain-blocking chemicals. It is used by the NHS in some pain clinics and hospices, and NICE recommends acupuncture for chronic pain and headaches.
A review of scientific studies found acupuncture is a promising treatment for relieving PMS symptoms, though further research is needed. Some studies show that specific acupuncture points can reduce anxiety and depression and improve quality of life for people with severe PMS.
Safety and finding a practitioner
Acupuncture is usually safe when carried out by a trained practitioner. Some people experience mild side effects such as bruising or dizziness. It is best avoided if you have a bleeding disorder or are taking blood-thinning medication. To find an accredited practitioner, visit the Professional Standards Authority for Health and Social Care.
Chiropractic
Chiropractic uses hands-on adjustment and manipulation of the body to manage joint and muscle pain. A review of scientific literature found it may help with muscle and joint pain - which some people experience as part of PMS or PMDD. However, it is important to note that there is no substantial evidence that chiropractic can help with psychological symptoms.
⚠️ Safety note: Chiropractic carries some risks - including stiffness, soreness, and in rarer cases slipped discs or stroke, particularly with neck adjustments. Always ensure your chiropractor is registered with the General Chiropractic Council - which is a legal requirement in the UK.
Reflexology
Like acupuncture, reflexology is based on the concept of Qi and energy flow. Practitioners apply gentle pressure to specific points on the hands, feet, and ears - each of which is thought to correspond to internal organs and systems. The aim is to unblock energy channels, restore balance, and support the body in healing itself.
In a review of studies on reflexology and PMS, researchers found it can help reduce both physical and psychological symptoms. The review also found that longer sessions of around 60 minutes had the greatest effect on symptom relief compared to shorter 30-minute sessions.
🌿 Good to know: Reflexology is a low-risk option, though more research is needed before it can be considered a formally recommended treatment for PMS. As with all hands-on therapies, choose a qualified and insured practitioner.
Related articles
- Can supplements really help PMDD? Here's what the science says
- Evelyn's guide to talking to your GP about PMS and PMDD
Disclaimer: This content is for informational purposes only and is not intended as medical advice. Always speak to a qualified healthcare professional about any health concerns.
