The first step in managing symptoms of PMDD is making lifestyle changes to reduce stress, improve sleep, increase exercise, and improve diet. While lifestyle changes have not been well studied in women with PMDD, some do show promise. Women who show the most improvement at this initial step typically suffer from less severe or fewer symptoms, however, these changes can have a positive impact on all women with all levels of severity.
Anybody will benefit from a whole and nutritious diet. Women with PMDD stand to benefit even more. Studies show a strong correlation between what we eat and emotional well-being. A common symptom of PMDD is an intense craving for food during the luteal phase, specifically foods high in carbohydrates and with good reason. Carbohydrates influence the production of serotonin which directly and indirectly control mood, sexual desire and function, appetite, sleep, memory, body temperature, and social behavior. While serotonin is produced in the brain, about 90% of our serotonin supply is in the digestive tract and blood platelets. The connection between mood and food is clear.13,14
The path from carbohydrate to serotonin looks like this: carbohydrate > insulin > tryptophan > serotonin. While high protein foods like chicken and beef contain a high amount of tryptophan, the brain is unable to efficiently absorb a small amount of this necessary nutrient. When a meal high in carbohydrates is consumed, the resulting insulin aids in getting more tryptophan to the brain and increasing levels of serotonin.15,16,17
It is important to choose the right kind of carbs, however, as choosing the wrong kind can make symptoms worse. Foods high in the carbohydrate sugar will have the opposite effect and reduce serotonin. While intense cravings may want otherwise, choosing whole grains will achieve the desired boost. Ultimately a diet rich in whole grains, fruits, vegetables, and calcium will benefit the most.18
In addition to a well-balanced diet, studies show great benefit from adding the following supplements:19
- Vitamin B6, up to 100 mg per day
- Vitamin E, up to 600 IU per day
- Calcium carbonate, 1,200 to 1,600 mg per day
- Magnesium, up to 500 mg per day
- Tryptophan, up to 6 g per day
A recent study reviewed efficacy and safety data on herbal supplements marketed for women. The author concluded that two herbal products, evening primrose oil and chaste tree berry, have been effective in treating breast tenderness and engorgement that typically accompanies PMS. There is no definitive evidence that these herbal supplements will have a positive effect on the emotional symptoms of PMDD.19,20
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A great way to reduce stress and get gentle exercise is Restorative Yoga. Restorative yoga is the centering of your breath and body - aligning the physical and mental by practicing stillness or gentle movement for extended periods of time. Props are used to assist in holding poses. This form of yoga is perfect for all women regardless of experience or current fitness level.
There is no single option that works for all women with PMDD. You will want to work with your health care and support team to find the best treatment option for you.
Many women find it is a combination of several treatment options that help the most.
There are several options for treatment that are currently prescribed to manage symptoms of PMDD. Some have been proven to be effective and others have not. Some may lessen symptoms in the short term and others may have no effect or worsen symptoms over time. Always consult with your medical team before stopping or starting any medications or treatments.