Natural Relief for Premenstrual Dysphoric Disorder

Written by Institute for Natural Medicine Staff

Medically Reviewed by Sarah Daglis, ND, MS

Published December 9, 2025
Last Updated December 9, 2025

Although the exact cause of PMDD remains unclear, research shows a strong link between monthly hormonal changes and heightened brain activity. In women with PMDD, the brain responds differently to normal post-ovulation hormone fluctuations, suggesting greater sensitivity in the regions that regulate emotions.²^,³

PMDD symptoms

On average, a woman will have 481 menstrual cycles in her lifetime. Women with PMDD experience about six days of severe symptoms per cycle.³

According to the Diagnostic and Statistical Manual for Mental Disorders (fifth edition), there are 11 distinctive PMDD symptoms—five of which must be present for an official diagnosis.⁴ Symptoms start one week before a woman’s period begins³ and fall into three categories:¹

Mood: temperament changes and feelings of sadness, depression, worthlessness, anger, anxiety, and irritability
Behavioral: fatigue, lack of energy, brain fog, changes in appetite, sleep issues, and feeling overwhelmed or out of control
Physical: breast pain, tenderness or swelling, joint aches, muscle pain, bloating, food cravings, weight gain, and headaches

There are known risk factors, such as past traumatic or abusive events, preexisting anxiety disorders, smoking, obesity, and family history of premenstrual syndrome (PMS) or PMDD.¹

“Proper diagnosis requires a thorough intake that includes a detailed look at symptoms, health history, and a physical exam,” says Michelle Brannick, ND, DC, founder and director of the Brannick Clinic of Natural Medicine in Illinois. “I also ask if there has been any mental, physical, or sexual abuse or if the patient has had an abortion. Sleep is a big issue for many of my patients. Chronic sleep deprivation can have a major impact on hormonal balance. I ask about falling asleep and staying asleep—two different issues that often need to be addressed.”

Natural treatment for pain & discomfort

PMDD treatment prioritizes symptom management, pain relief, and reducing emotional distress.

Dr. Brannick recommends dietary and lifestyle changes, herbs, specific nutrients, hands-on therapies, and constitutional hydrotherapy. “From a naturopathic perspective,” she notes, “I want to uncover the root cause or causes of the severe hormone imbalance, which then helps me create a plan to restore balance.”

Lab testing reveals any issues with blood sugar, cholesterol, and nutrient deficiencies. Insufficient levels of magnesium, calcium, vitamin B6, and vitamin D are common among women with PMDD.⁵

Dr. Brannick suggests four key dietary changes:

Eliminating dairy and soy to avoid excess estrogen
Cutting out or reducing sugar
Consuming organic fruits and vegetables when possible
Eating grass-fed beef or eliminating red meat entirely

Being consistent with a balanced diet of fresh foods and whole grains and avoiding simple carbohydrates, refined fats, salt, alcohol, and stimulant drinks may help manage and reduce PMS and PMDD symptoms.⁵ Consuming complex carbohydrates right before menstruation could also help alleviate premenstrual symptoms, as carbs boost serotonin, a crucial mood-regulating neurotransmitter.⁶

“I encourage walking and other forms of regular physical activity to lift endorphins [and] enhance mood,” says Dr. Brannick. “Research indicates that exercise can help ease menstrual symptoms and [support] sleep, which is very important when it comes to treating PMDD.”⁷

Nutrients and herbal remedies

Certain supplements may help ease PMDD symptoms. Vitex agnus castus, or chasteberry, has been studied for its role in alleviating menstrual discomfort, including symptoms related to PMDD.⁸

Some studies suggest saffron may be as effective as fluoxetine (an antidepressant often prescribed for PMDD) but with fewer side effects and a better safety profile.⁹,¹⁰ Evening primrose oil,¹¹ St. John’s wort,¹² and magnesium—with or without vitamin B6¹³^,¹⁴—can be useful in providing overall menstrual comfort.

Research suggests differences in brain processing of the amino acid 5–HTP among women with PMDD. These differences may be linked to premenstrual irritability.¹⁵

“I often recommend 5–HTP to my patients experiencing disabling mood symptoms,” says Dr. Brannick, “However, the treatment plan I create is individualized to each case based on [an extensive history intake] and lab testing.”

Hope for women with PMDD

PMDD is a complex condition, and in its most severe forms, can profoundly disrupt daily functioning, relationships, and quality of life. For truly effective PMDD treatment, Dr. Brannick says it’s necessary to do some investigative work, ensuring underlying issues are understood rather than overlooked.

“Successful PMDD treatment requires getting to the root cause, and then utilizing a combination of diet, exercise, sound sleep strategies, and stress management techniques supported by targeted nutrients and herbal remedies.”

Footnotes

1
Mishra S, Elliott H, Marwaha R. Premenstrual dysphoric disorder. StatPearls. 2023;Feb 19. https://www.ncbi.nlm.nih.gov/books/NBK532307
2
Chan K, Rubtsova AA, Clark CJ. Exploring diagnosis and treatment of premenstrual dysphoric disorder in the US healthcare system: a qualitative investigation. BMC Women’s Health. 2023 May 17;23(1):272. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02334-y
3
Naik SS, Nidhi Y, Kumar K, Grover S. Diagnostic validity of premenstrual dysphoric disorder: revisited. Front Glob Womens Health. 2023 Nov 27;4:1181583. https://doi.org/10.3389/fgwh.2023.1181583
4
Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health. 2016 Jun. Table 3.24, DSM-IV to DSM-5 Premenstrual Dysphoric Disorder Comparison. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t24
5
Siminiuc R, Turcanu D. Impact of nutritional diet therapy on premenstrual syndrome. Front Nutr. 2023 Feb 1;10:1079417. https://doi.org/10.3389/fnut.2023.1079417
6
Oboza P, Ogarek N, Wojtowicz M, et al. Relationship between premenstrual syndrome (PMS) and diet composition, dietary patterns and eating behaviors. Nutrients. 2024;16(12). https://doi.org/10.3390/nu16121911
7
Kocak M, Sevgin O. The effect of exercise on menstrual symptoms: a randomized controlled trial. BMC Women’s Health. 2025 Aug 23;25(1):406. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-025-03940-8
8
Rafieian-Kopaei M, Movahedi M. Systematic review of premenstrual, postmenstrual and infertility disorders of Vitex agnus castus. Electron Physician. 2017 Jan 25;9(1):3685-3689. https://doi.org/10.19082/3685
9
Rajabi F, Rahimi M, Sharbafchizadeh M, Tarrahi M. Saffron for the management of premenstrual dysphoric disorder: a randomized controlled trial. Adv Biomed Res. 2020 Oct 30;9:60. https://doi.org/10.4103/abr.abr_49_20
10
Rajkumar M, Vaishnavi S, Shribalaji S, Shuru A. Comparing the efficacy of saffron with fluoxetine for the effective management of premenstrual dysphoric disorder: a review. IJSRA. 2024;12(02).https://ijsra.net/sites/default/files/IJSRA-2024-1484.pdf
11
Gandhi A, Desai A. Pharmacological basis of evening primrose oil in premenstrual syndrome—an evidence based approach. Indian Med J. 2022;120(7).https://onlinejima.com/journals_doc/download-journals/2022/july/75-79.pdf
12
Canning S, Waterman M, Orsi N, et al. The efficacy of Hypericum perforatum (St. John’s wort) for the treatment of premenstrual syndrome: a randomized, double-blind, placebo-controlled trial. CNS Drugs. 2010;24(3):207-25. https://pubmed.ncbi.nlm.nih.gov/20155996
13
Facchinetti F, Borella P, Sances G, et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991;78(2):177-81. https://pubmed.ncbi.nlm.nih.gov/2067759
14
Fathizadeh N, Ebrahimi E. Valiani M, et al. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010;15(Suppl1):401-405. https://pubmed.ncbi.nlm.nih.gov/22069417
15
Eriksson O, Wall A, Olsson U, et al. Women with premenstrual dysphoria lack the seemingly normal premenstrual right-sided relative dominance of 5-HTP-derived serotonergic activity in the dorsolateral prefrontal cortices—a possible cause of disabling mood symptoms. PLoS One. 2016;11(9). https://doi.org/10.1371/journal.pone.0159538

This article is provided by

The Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform health care in the United States by increasing public awareness of natural medicine and access to naturopathic doctors. Naturopathic medicine, with its person-centered principles and practices, has the potential to reverse the tide of chronic illness overwhelming healthcare systems and to empower people to achieve and maintain optimal lifelong health. INM strives to fulfil this mission through the following initiatives:

Education – Reveal the unique benefits and outcomes of evidence-based natural medicine
Access – Connect patients to licensed naturopathic doctors
Research – Expand quality research on this complex and comprehensive system of medicine

About The Author(s)

Writer

Institute for Natural Medicine Staff

Our team of professional writers brings decades of experience researching and translating complex health information. United by a passion for whole person health and evidence-based natural medicine, contributors deliver trusted insights and practical guidance to inspire healthier living.

Explore Reproductive Health & Women's Health Articles

Explore

Public

Practitioners

Partners

Natural Relief for Premenstrual Dysphoric Disorder

In This Article:

PMDD symptoms