Top 10 treatments for PMS/PMDD

Summary

From medical treatments to lifestyle changes, there are many effective ways to ease PMS and PMDD symptoms. This guide explores eleven of the most researched options - from SSRIs and contraceptives to mindfulness, nutrition, and exercise - so you can find the right combination for your body. Alongside these approaches, Evelyn's three-step Supplement Routine provides a clinically backed, hormone-free way to address the root causes of PMS and PMDD.

Pharmaceutical options

1. SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant and the primary recommended treatment for PMDD. They work by preventing the reuptake of serotonin, meaning more of it remains active in the brain to improve 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 has also been shown to improve quality of life for people with PMDD. SSRIs can be taken continuously or only during the luteal phase - your doctor will advise which approach is right for you.

2. Combined oral contraceptives

Combined oral contraceptives (COCs) are one of the most frequently used treatments for PMS - especially those containing drospirenone. It is recommended they are taken continuously (back-to-back packets rather than with a break) to maximise effectiveness. Not all pills can be taken this way, so check with your healthcare provider before making changes.

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

Typically reserved for people experiencing severe PMS or PMDD. GnRH analogues are usually given as injections and work by reducing oestrogen levels in the body, effectively pausing ovarian activity and inducing temporary menopause. This prevents the hormonal rises and falls that drive symptoms.

Research suggests GnRH analogues significantly reduce premenstrual depression, irritability, and headaches. However, because oestrogen plays many important roles in the body, they are not suitable as a long-term solution.

Non-pharmaceutical options

4. Non-hormonal supplementation

Evelyn's three-step Supplement Routine is a clinically backed, hormone-free approach designed to address the root causes of PMS and PMDD - targeting neurotransmitter balance, inflammation, and hormone metabolism across the full cycle.

5. Cognitive behavioural therapy (CBT)

CBT is a type of talking therapy that helps 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 delivered in person or online. CBT helps you identify unhelpful, negative thought patterns and replace them with more constructive ones - building your ability to respond to symptoms in a calmer, more effective way.

Studies have shown that CBT can reduce PMS and PMDD-related anxiety and depression, and improve the ability to cope with other symptoms. One of its key advantages over medication is that the benefits can persist after therapy ends.

6. Reflexology and acupuncture

Reflexology and acupuncture are based on the concept of stimulating specific pressure points to support nervous system function, blood flow, and overall wellbeing. Reflexology applies gentle pressure to specific body parts; acupuncture uses fine needles inserted at specific points.

A review of studies found that reflexology can help reduce both physical and psychological symptoms of PMS and PMDD, with longer sessions of around 60 minutes being the most effective.

7. Aromatherapy

Aromatherapy - practices using essential oils - does not have as robust an evidence base as some other treatments, but can offer real symptom relief and is easy to practice at home at low cost. Essential oils can be inhaled, used in a diffuser, or applied to the skin when diluted in a neutral carrier oil such as coconut or olive oil. Never apply concentrated essential oils directly to the skin.

Studies suggest aromatherapy may help ease period pain, and can reduce PMS symptoms including mood swings, depression, and fatigue.

Lifestyle approaches

8. Exercise and yoga

Exercise boosts endorphin levels and reduces cortisol and adrenaline - helping reduce the perception of pain, stress, and overstimulation. Yoga and breathwork are particularly helpful for getting the body moving while simultaneously regulating the nervous system and reducing anxiety and depression. Even gentle movement in the luteal phase can make a meaningful difference.

9. 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. Reducing sugar, caffeine, and alcohol in the two weeks before your period can also reduce irritability, sleep disruption, and anxiety. If getting enough of the right nutrients from food alone is difficult, targeted supplementation is a straightforward and effective way to bridge the gap.

10. Time in nature

Spending time in nature has been shown to have a calming effect on the mind and can help with mild to moderate depression. If you are feeling overwhelmed before your period, a walk in a green space or even sitting outside for a few minutes can provide a quick, accessible reset for your nervous system.

11. Journalling and cycle tracking

Not a treatment in itself - but one of the most powerful tools available. Understanding where you are in your cycle and knowing which symptoms tend to arrive when allows you to preempt and adapt, rather than react. Whether you give people a little more patience because you know you are likely to be short-tempered, choose less mentally demanding tasks during brain fog, or slow down your exercise on days when your body needs it - leaning into your cycle rather than fighting against it changes everything.

Final thoughts

There are many treatment options available to help ease the symptoms of PMS and PMDD. Whether you try one or a combination of the approaches above, remember that everyone is different - what works brilliantly for one person may not suit another. It may take time to find what works best for you. Be patient with the process, and go easy on yourself along the way.

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.