Natural treatment for PMS and PMDD: What Every Woman Should Know
What is PMS?
PMS (Premenstrual Syndrome) refers to a group of physical, emotional and behavioural symptoms that occur in the luteal phase of the menstrual cycle which occurs after ovulation and before menstruation begins. These symptoms typically resolve within the first few days of menstruation.
Common symptoms include:
Emotional: mood swings, irritability, sadness and anxiety.
Physical: breast tenderness, bloating, headaches and fatigue.
Behavioural: appetite changes, sleep disturbances and poor concentration.
Physiological mechanisms behind PMS:
Hormone fluctuations: A drop in oestrogen and progesterone after ovulations can influence mood and physical symptoms.
Neurotransmitter changes: Lower serotonin levels may contribute to irritability, low mood and food cravings.
Inflammatory response: subtle increases in the inflammatory markers have been associated with more severe PMS symptoms.
Blood sugar imbalances: Dysregulated glucose and insulin responses can worsen fatigue, mood swings and food cravings.
Nutrient deficiencies: Low levels of magnesium, vitamin B6, calcium and essential fatty acids have been observed in individuals with PMS.
PMS affects up to 75% - 80% of menstruating individuals with symptoms ranging from mild to moderate.
What is PMDD?
PMDD (Premenstrual Dysphoric Disorder) is a severe hormone-related mood disorder that occurs in the luteal phase and resolves within the first few days of menstruation. It is recognised in the DSM-5 (diagnostic and statistical manual of mental disorders) and affects approximately 3-8% of menstruating individuals.
Core PMDD symptoms:
Severe irritability or anger
Depressed mood or hopelessness
Anxiety or tension
Marked mood swings
Physical symptoms: bloating, breast tenderness, joint pain and fatigue.
Underlying mechanism:
PMDD is not due to abnormal hormone levels alone, but rather an increased sensitivity to normal cyclic changed in oestrogen and progesterone.
These hormonal shifts influence neurotransmitter pathways; particularly serotonin, GABA and dopamine - leading to mood dysregulation.
Emerging research also highlights the potential link between histamine activity and PMDD. Oestrogen can increase histamine release and reduce the affects of the DAO enzyme significantly impairing the metabolism or histamine. High histamine has been linked to symptoms such as anxiety, sleep disturbances, irritability and migraines.
PMDD can significantly impair social, occupational and daily functioning.
Why Does It Happen?
Premenstrual syndrome (PMS) and Premenstrual dysphoric disorder (PMDD) are more than just mood swings or monthly inconveniences, they are clinical conditions rooted in hormonal sensitivity, neurotransmitter changes and inflammation. Understanding the mechanisms behind these symptoms is the first step toward effective, personalised treatment. Below are the key contributors:
Hormonal sensitivity
PMS: Often linked to hormonal fluctuations, especially changes in oestrogen and progesterone during the luteal phase, in many cases imbalances and poor hormone clearance are heavily contributing factors.
PMDD: Involves a heightened neurological sensitivity to hormone levels, particularly progesterone, this interacts with GABA receptors in the brain. Whether hormones are balanced or not can be a factor in PMDD but the relationship between our body and these natural shifts and changes is where we see the symptoms.
Neurotransmitter dysregulation
PMS: Symptoms like mood swings, low energy or food cravings may be linked to drops in serotonin, dopamine or GABA levels, often made worse by hormonal imbalances, stress or nutrient deficiencies.
PMDD: Marked dysregulation of serotonin and GABA systems, leading to more intense symptoms such as rage, anxiety, panic or depressive episodes. PMDD may have a genetic predisposition to poor neurotransmitter regulation in response to progesterone.
Histamine Sensitivity
PMS: Histamine-related symptoms may be present (e.g. headaches and bloating) in those with oestrogen dominance or poor hormone metabolism.
PMDD: Histamine and mast cell activation may be more pronounced which could potentially amplify neuroinflammation and contribute to heightened emotional and physical reactivity in the luteal phase.
Inflammation and Immune response
PMS: Mild inflammation may exacerbate symptoms especially with poor diet, high stress and gut issues.
PMDD: Research shows increased markers or neuroinflammation and systemic inflammation possibly involving central nervous system mast cells which could explain the cognitive and emotional severity of PMDD.
Nutrient deficiencies
PMS: Often associated with low magnesium, B6, calcium and zinc which can be improved with diet and supplementation.
PMDD: Nutrient imbalances may exacerbate underlying neurological sensitivity, targeted support may reduce severity especially when paired with hormonal and neurotransmitter modulation.
Blood sugar and stress
PMS: Blood sugar fluctuations and cortisol dysregulation are common contributors to moodiness, fatigue and cravings.
PMDD: These factors may amplify symptoms but are usually secondary triggers.
In summary:
PMS is more often the result of hormonal imbalances, nutrient depletion and lifestyle triggers.
PMDD is a neuroendocrine disorder where the brain has a severe and abnormal response to hormone changes requiring more targeted neurological and inflammatory support.
Natural approaches for managing PMS and PMDD symptoms
A naturopathic consultation dives deep into your symptoms, history, and contributing factors, treatment is individualized but may include:
Herbal Support for PMS and PMDD Support:
Herbal medicine offers a gentle way to support the body in navigating the hormonal fluctuations that drive PMS and PMDD symptoms. Working to restore balance by reducing inflammation, easing mood changes and supporting the nervous and endocrine system.
Balancing Hormones:
Chaste tree (Vitex agnus castus) - Supports progesterone and hormonal regulation, reduces breast tenderness, irritability and irregular cycles.
Peony (Paeonia lactiflora) - Helps to balance oestrogen and androgens, reduces mood swings, cramping and irregular cycles.
Supporting Oestrogen detoxification in order to balance hormones:
St Mary’s Thistle (Silybum marianum) - Enhances phase I and II liver detoxification assisting in removal of excess oestrogen and other hormones to reduce symptoms of breast tenderness, bloating and mood swings.
Dandelion Root (Taraxacum officinale) - Supports liver and digestive function, useful in the removal of metabolised hormones via the digestive tract, supports a reduction in hormone symptoms like breast tenderness, bloating and mood swings.
Supporting Mood:
St John’s Wort (Hypericum perforatum) - Supporting low mood, irritability and emotional reactivity, helps to balance serotonin levels.
Saffron (Crocus sativus) - Antidepressant, anti-inflammatory herb that Improves mood, reduced anxiety and reduced fatigue.
Withania (Withania somnifera) - Adaptogenic herb that helps to regulate the stress response, calm anxiety and support hormone balance.
Passionflower (Passiflora incarnata) - Supports GABA activity in the brain, helps to ease restlessness, racing thoughts and tension-related insomnia.
Ginko (Ginko biloba) - Improves circulation, great for brain fog in the luteal phase, irritability and breast tenderness.
Reducing Histamine:
Nettle (Urtica dioica) - Antihistamine and anti-inflammatory herb, eases bloating and headaches and can reduce the intensity of PMDD symptoms.
Baical Skullcap (Scutellaria baicalensis) - Mast-cell stabilising herb with anti-inflammatory and anti-histamine effects.
Reishi (Ganoderma lucidum) - Calms the release of histamine, supports moods and hormonal balance while reducing the stress response.
Nutritional Support for PMS and PMDD:
Targeted nutritional support can be a very useful tool in supporting individuals with these conditions. Tailored support can be offered to support a reduction in inflammation, regulating mood, supporting hormonal balance and improving neurotransmitter formation.
Magnesium: Calms the nervous system and supports serotonin and GABA production, relieves cramps, headaches and muscle tension, helps to reduce irritability, anger and sugar cravings, support oestrogen metabolism and progesterone balance.
Vitamin B6: Essential for the production of mood-regulating neurotransmitter - serotonin, GABA and dopamine, reduces symptoms such as low mood, irritability and breast tenderness, works synergistically with magnesium for nervous system support, supports healthy oestrogen metabolism.
Zinc: Regulated hormonal levels and supports ovulation, anti-inflammatory and immune-modulating, may reduce mood swings, acne and cramps, supports progesterone production and tissue repair.
Calcium: Reduces PMS symptoms such as fatigue, cravings and mood changes, supports nerve and muscle function, helps reduce irritability and physical discomfort in the luteal phase.
Quercetin: A powerful antioxidant and natural antihistamine, stabilises mast cells and reduces histamine symptoms (breast tenderness, headaches and anxiety), supports inflammation control.
Omega-3 fatty acids: Anti-inflammatory and mood-supportive, reduced period pain by lowering prostaglandin production, supports brain health and emotional regulation.
Dietary Interventions for PMS and PMDD:
Supporting overall health and working to reduce symptoms throughout the month is integral to the management of these conditions. Balancing hormones, stabilising energy and supporting the nervous system can all be supporting with how and what you eat.
Balancing blood sugar: Eat regular meals with a balance of protein, healthy fats and fibre to avoid spiking blood sugar which can intensify mood swings, cravings and fatigue.
Reducing inflammatory foods: Minimising process foods, excess sugar, seed oil and alcohol which drive inflammation and reduce effective hormone metabolism and production.
Reduce dietary histamine: Minimise aged, fermented and smoked foods, limit alcohol and avoid eating leftover foods (these increase histamine levels each day they sit - so limit to consuming 1 day after cooking max). Reducing histamine levels can help relieve anxiety, headaches, insomnia and mood swings.
Support gut health: A healthy gut regulates and clears hormones well, include prebiotic foods (onion, garlic and asparagus), consume a wide variety of fruit and vegetables to support your microbiome and minimise foods you have recognised as trigger food (may cause bloating, gas, pain and changes in bowel motions when consumed).
Support liver detoxification pathways: Your liver is responsible for clearing excess oestrogen and histamine. Consuming cruciferous vegetables (broccoli, cauliflower and kale), bitter greens (rocket and dandelion leaves), sulphur rich foods (onion, egg and garlic) will help to support liver function as well as staying hydrated with 2.5L of water a day.
Limit caffeine if anxious or sleep-deprived: Caffeine can heighten nervous system reactivity and interfere with sleep.
Increase anti-inflammatory foods: Reducing chronic low-grade inflammation which can worsen symptoms affecting hormone metabolism, increase prostaglandins (which contribute to period pain) and dysregulate the nervous system. Key foods to add in to reduce inflammation: Fatty fish (SMASH - Salmon, mackerel, anchovies, sardines and herring), colourful fruit and veg, herbs and spices (turmeric, ginger, rosemary and cinnamon), extra virgin olive oil, nuts and seeds, green tea, legumes and whole grains.
Lifestyle support:
Prioritise restorative sleep: Quality sleep is essential for hormonal regulation, mood balance and stress resistance. 7-9 hours a night of undisturbed sleep is ideal especially during the luteal phase. If sleep is an issue, herbal and nutritional support is advised through a qualified naturopathic practitioner.
Exercise regularly: Movement regulates mood, improved circulation and reduced inflammation. Gentle activities like walking, yoga and Pilates can be beneficial during this period.
Practice stress reduction: Chronic stress worsens both PMS and PMDD, supporting your nervous system with practices such as deep breathing, meditation, time in nature and vagus nerve stimulation (cold showers, singing, humming or dancing).
Establish routines: A regular rhythm with sleep, meals, movement and “me time” will help to stabilise your nervous system, circadian rhythm and hormonal signals, especially when mood and energy fluctuates cyclically.
Track your cycle: Understanding your own pattern helps you anticipate and prepare for more vulnerable days. Prioritising tasks that take a lot out of you (like assignments, cleaning, organising, social gatherings etc.) for the other half of your cycle is essential when struggling with these conditions.
Create space for emotional processing: PMDD can bring up intense emotions, journalling, therapy or gentle self reflection can help you to move through these thoughts and feeling that present in this time period.
Know when to say no to others: Honour your limits, allowing yourself to say no and let go of the expectations of others where possible.
When to Seek Help
If your symptoms disrupt your relationships, work, or mental wellbeing, lead to significant depression or anxiety before your period and persist despite self-care strategies, you don’t have to suffer silently. Naturopathic care can offer support tailored to your body’s needs, uncovering what the root cause of this condition is using thorough case taking and testing and using this information to create a tailored plan to bring you back to health. Suffering through your cycle each month is not sustainable and with some work, symptoms can resolve.
A Personalised Plan Back to Wellness
PMS and PMDD are real, valid experiences—not something you just have to “push through.” Natural medicine offers powerful tools to help your body restore balance, regulate hormones, and support your emotional wellbeing. If you're ready to understand your cycle and get off the monthly emotional rollercoaster, I’m here to help. Together, we can create a functional, personalised plan to reduce your symptoms and help you feel like yourself again.