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Natural remedies for PMDD: Is serotonin the key to feeling brighter?

Published Feb 21, 2024 | Updated Jul 17, 2024
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Many women are familiar with PMS - when mood swings, irritability, and fatigue happen right before their periods. For some, these experiences are extreme enough to disrupt work, relationships, and their daily lives. This condition is called PMDD or premenstrual dysphoric disorder which is estimated to affect 3-9% of menstruating women[1 Trusted Source 2021 - Journal of Affective Disorders Reports Human study Premenstrual dysphoric disorder: Prevalence, quality of life and disability due to illness among medical and paramedical students . While there’s still a huge debate about why PMDD occurs in some women, there are many studies examining the mechanism behind it. Explore why it happens and what can help with PMDD with this review article of a 2016 Swedish study.  

What does a PMDD episode look like?

Ever heard of PMS? Now imagine the irritability and low mood being heightened to understand the difference between PMDD vs PMS. The diagnosable premenstrual dysphoric disorder lasts for around half of the menstrual cycle during the so-called luteal phase[1 Trusted Source 2021 - Journal of Affective Disorders Reports Human study Premenstrual dysphoric disorder: Prevalence, quality of life and disability due to illness among medical and paramedical students . It usually affects 3-9% of menstruating women around day 15 of the cycle which is the ovulation time[1 Trusted Source 2021 - Journal of Affective Disorders Reports Human study Premenstrual dysphoric disorder: Prevalence, quality of life and disability due to illness among medical and paramedical students . The symptoms are physiological and psychological, and far more severe compared to PMS. Changes in appetite or food cravings, fatigue, bloating, and insomnia or excessive sleep are some signs of PMDD. If that’s paired with worsened mental health, making you feel anxious and out of control during those two weeks of your cycle, you should consult with your GP. Luckily, the symptoms get better after women get their periods, however, living with PMDD for two weeks each month can take a toll on your relationships, work and self-esteem. That’s why researchers are determined to find the root cause and the best treatment for PMDD, to provide all women with a healthier and happier life. 

Does PMDD affect serotonin?

Your feel-good chemical serotonin levels are low during PMDD. Brain imaging studies have shown altered serotonin function and activation patterns in specific brain regions of women with PMDD[2 Trusted Source 2008 - Journal of Psychiatry and Neuroscience 3rd-party resource Premenstrual dysphoric disorder: burden of illness and treatment update . Their serotonin levels were lower compared to healthy women, and the serotonin function in the brain was altered[3 Trusted Source 2023 - Biological Psychiatry Human study Increase in Serotonin Transporter Binding in Patients With Premenstrual Dysphoric Disorder Across the Menstrual Cycle: A Case-Control Longitudinal Neuroreceptor Ligand Positron Emission Tomography Imaging Study . Two of the sex hormones, oestrogen and progesterone are known to influence serotonin levels. Studies have shown that women with PMDD have an abnormal brain response to normal hormonal fluctuations like changes in the sex hormones[3 Trusted Source 2023 - Biological Psychiatry Human study Increase in Serotonin Transporter Binding in Patients With Premenstrual Dysphoric Disorder Across the Menstrual Cycle: A Case-Control Longitudinal Neuroreceptor Ligand Positron Emission Tomography Imaging Study ,[4 Trusted Source 2000 - The Primary Care Companion for CNS Disorders Human study Premenstrual Dysphoria and the Serotonin System: Pathophysiology and Treatment . Here’s what is known to help with PMDD symptoms. 

How do I balance my hormones during PMDD?

You can balance the symptoms with hormone therapy for PMDD while also being mindful of your diet, workout routine and stress management. Currently, birth control and antidepressants are very popular ways of treating PMDD[5 Trusted Source 2017 - Depression and Anxiety Human study Treatment of premenstrual dysphoria with continuous versus intermittent dosing of oral contraceptives: Results of a three-arm randomized controlled trial ,[6 Trusted Source 2008 - CNS Spectrums Systematic and meta-analysis Selective Serotonin Reuptake Inhibitors and Initial Oral Contraceptives for the Treatment of PMDD: Effective But Not Enough . Usually, women experience a lot of side effects with these two PMDD treatments, therefore, a lot of them are looking for natural PMDD remedies and lifestyle changes, to say “I cured my PMDD naturally”. 3 favoured natural remedies for PMDD are: 

1. PMDD diet

Diet rich in vitamins and minerals especially calcium, magnesium, vitamin D, B vitamins, and herbal supplements was demonstrated to help you balance PMS and PMDD symptoms[7 Trusted Source 2023 - Frontiers in Nutrition Research evaluation Impact of nutritional diet therapy on premenstrual syndrome

2. Exercise

To boost the release of your feel-good chemical serotonin opt for regular physical exercise[8 Trusted Source 2018 - Women & Health Human study The prevalence of self-reported premenstrual symptoms and evaluation of regular exercise with premenstrual symptoms among female employees in Taiwan

3. Stress-coping techniques

Working on your stress-coping techniques like mindfulness and yoga or going to psychotherapy can help with the symptoms and maybe even stop them from happening in the first place[9 Trusted Source 2011 - Iranian Red Crescent Medical Journal Human study Work Stress, Premenstrual Syndrome and Dysphoric Disorder: Are There Any Associations? .

Implementing these in your routine means that your mood, energy levels, symptoms of PMDD & mental health can stay more stable during the whole cycle. While very important, those remedies can sometimes slip your mind when leading busy day-to-day lives. In that case, a small and mighty pill can help. Here’s what a new study found. 

What mood stabilizers are good for PMDD?

A promising new study finds lower serotonin activity in women with PMD, suggesting 5-htp, one of the natural serotonin-boosters as a natural remedy for PMDD[10 Trusted Source 2016 - PLoS ONE Human study 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 . The study examined differences in brain activity between women who experience severe PMD (premenstrual dysphoria) symptoms before their period compared to women who are premenstrual mood symptom-free. The researchers used a brain imaging method called a PET scans to measure serotonin activity in different brain regions of 12 women with PMD and 8 women without any symptoms during  2 phases of the menstrual cycle - after period (follicular phase) and before period (luteal phase). They also measured the levels of estradiol, a type of oestrogen, and progesterone at the time of each PET scan. Daily symptom ratings were collected using a scale and 5-htp, serotonin’s precursor, was used as a tracer substance to investigate differences in serotonin brain activity between women. They discovered a difference in the right vs left side of the brain in regards to serotonin activity in the upper frontal part of the brain (dorsolateral prefrontal cortex) between the groups.

What does PMDD do to your brain?

PMDD hinders the production of your feel-good chemical. The main finding was that women without PMD symptoms had increased serotonin activity on the right upper side of the brain in the premenstrual phase compared to the follicular phase[10 Trusted Source 2016 - PLoS ONE Human study 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 . In contrast, most women with PMD either lacked this right-sided increase in serotonin activity premenstrually or showed a decrease. This upper frontal part of the brain is important for regulating emotions and impulses. The results suggest that increased premenstrual serotonin activity specifically in this part may help boost pleasant feelings in women without PMD[10 Trusted Source 2016 - PLoS ONE Human study 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 . Women with PMD may lack this protective mechanism.

Does 5-htp help mood swings? 

5-htp is a helpful nutrient that the body uses to make more of your feel-good chemical serotonin, which is a brain messenger that helps regulate your mood. When you take 5-htp as a supplement, it easily travels to the brain. There, it gets converted step-by-step into serotonin through natural processes. Activities like exercising and being outdoors can then release serotonin which helps people maintain a balanced and cheerful frame of mind. brain feed developed a 100 mg 5-htp tablet that’s extracted and isolated from Ghanian Griffonia Simplicifolia seeds. 98% of the tablet is comprised of 5-htp making it the smallest, nutrient-dense tablet available without including unnecessary bulking agents. Get 15% off your 1st purchase with code ‘NEW15’


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Does 5-htp help PMDD?

While there’s still a need for further studies, the theory sounds promising. 5-htp could help women with managing PMDD by regulating their serotonin levels. Results of the study on women with PMD do support the theory that premenstrual mood symptoms involve reduced serotonin activity in brain regions that regulate emotion, especially on the right side[10 Trusted Source 2016 - PLoS ONE Human study 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 . That suggests that supplementation with 5-htp could boost serotonin activity and help suppress unpleasant moods in women experiencing PMS, PMD or PMDD. As 5-htp helps serotonin production, this might be one of the most important PMDD supplements and the key to maintaining higher serotonin levels which in turn boost serotonin activity in the brain. The small number of subjects in the presented study, however, means the results should only be considered preliminary. 



Dealing with either PMS or PMDD, 5-htp boosts your serotonin levels which can help you fight the mood changes you experience across your cycle. 

 

References

[1] Thakrar, P., Bhukar, K., & Oswal, R. (2021). Premenstrual dysphoric disorder: Prevalence, quality of life and disability due to illness among medical and paramedical students. Journal of Affective Disorders Reports, 4, 100112. https://doi.org/10.1016/j.jadr.2021.100112

[2] Pearlstein, T., & Steiner, M. (2008). Premenstrual dysphoric disorder: burden of illness and treatment update. Journal of Psychiatry and Neuroscience, 33(4), 291–301. https://www.jpn.ca/content/33/4/291

[3] Sacher, J., Zsido, R. G., Barth, C., Zientek, F., Rullmann, M., Luthardt, J., Patt, M., Becker, G. A., Rusjan, P., Witte, A. V., Regenthal, R., Koushik, A., Kratzsch, J., Decker, B., Jogschies, P., Villringer, A., Hesse, S., & Sabri, O. (2023). Increase in Serotonin Transporter Binding in Patients With Premenstrual Dysphoric Disorder Across the Menstrual Cycle: A Case-Control Longitudinal Neuroreceptor Ligand Positron Emission Tomography Imaging Study. Biological Psychiatry, 93(12), 1081–1088. https://doi.org/10.1016/j.biopsych.2022.12.023

[4] Steiner, M., & Pearlstein, T. (2000). Premenstrual Dysphoria and the Serotonin System: Pathophysiology and Treatment. The Primary Care Companion for CNS Disorders, 2(Suppl 4: Editor Choice), 15260. https://www.psychiatrist.com/jcp/depression/premenstrual-dysphoric-disorder/premenstrual-dysphoria-serotonin-system-pathophysiology-2/

[5] Eisenlohr-Moul, T. A., Girdler, S. S., Johnson, J. L., Schmidt, P. J., & Rubinow, D. R. (2017). Treatment of premenstrual dysphoria with continuous versus intermittent dosing of oral contraceptives: Results of a three-arm randomized controlled trial. Depression and Anxiety, 34(10), 908–917. https://doi.org/10.1002/da.22673

[6] Halbreich, U. (2008). Selective Serotonin Reuptake Inhibitors and Initial Oral Contraceptives for the Treatment of PMDD: Effective But Not Enough. CNS Spectrums, 13(7), 566–572. https://doi.org/10.1017/S1092852900016849

[7] Siminiuc, R., & Ţurcanu, D. (2023). Impact of nutritional diet therapy on premenstrual syndrome. Frontiers in Nutrition, 10, 1079417. https://doi.org/10.3389/fnut.2023.1079417

[8] Tsai, S.-Y., Kuo, F.-C., Kuo, H.-C., & Liao, L.-L. (2018). The prevalence of self-reported premenstrual symptoms and evaluation of regular exercise with premenstrual symptoms among female employees in Taiwan. Women & Health, 58(3), 247–259. https://doi.org/10.1080/03630242.2017.1296056

[9] Namavar Jahromi, B., Pakmehr, S., & Hagh-Shenas, H. (2011). Work Stress, Premenstrual Syndrome and Dysphoric Disorder: Are There Any Associations? Iranian Red Crescent Medical Journal, 13(3), 199–202. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371938/

[10] Eriksson, O., Wall, A., Olsson, U., Marteinsdottir, I., Holstad, M., Ågren, H., Hartvig, P., Långström, B., & Naessén, T. (2016). 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, 11(9), e0159538. https://doi.org/10.1371/journal.pone.0159538

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