How to Improve Premenstrual Mood Symptoms (A Summary of Natural Treatments)

natural treatment for premenstrual mood

There’s a lot more to treating premenstrual mood symptoms than just calcium, the pill, and SSRI antidepressants. Alternative strategies for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) include iodine, magnesium, vitamin B6, vitex (chaste tree), progesterone, and a natural antihistamine approach.

Different strategies work for different women because there are several variables including mast cell activation, nutrient deficiency, high prolactin, and gut health. Consider your situation and then try one or more of the following treatments.

Just a little clarification before we survey the treatments: this is an article about mood symptoms that occur during the ovulatory and/or premenstrual phase of a natural ovulatory menstrual cycle. Possible symptoms include irritability, anxiety, sadness, anger, and a feeling of loss of control, sometimes with physical symptoms such as headaches and breast pain.

👉🏽 Tip: Post-menstrual mood symptoms are likely to be iron deficiency or a sign of an anovulatory cycle.

Mood symptoms on the pill are not “premenstrual” symptoms because as I explain in my book Period Repair Manual, pill bleeds are not periods and contraceptive drugs are not hormones. Instead, mood symptoms on the pill are the side effects of contraceptive drugs.

Mood symptoms on the hormonal IUD can be true premenstrual symptoms (because it’s possible to have natural menstrual cycles on the hormonal IUD) but can also be side effects of the contraceptive drug (levonorgestrel) released by the IUD.

Consider an antihistamine approach

As I discuss in my histamine blog post, mast cell activation and histamine can play a major role in premenstrual mood symptoms. Other symptoms of high histamine include urticaria (hives), headaches, and brain fog. In the histamine article, I recommend first trying an over-the-counter antihistamine medication such as diphenhydramine (drowsy) or loratadine (non-drowsy) to see if it helps. If it does help, the next step is to try histamine-reducing natural supplements such as quercetin and S-adenosyl-L-methionine (SAMe) as well as the histamine-reducing dietary strategy of avoiding normal A1 cow dairy. The potential mood-enhancing effect of avoiding A1 casein is currently being trialled at Deakin University.

Take iodine (but only if it’s safe)

As I discuss in my iodine blog post, milligram dose iodine (1-3 mg) is one of my favorite treatments for premenstrual mood symptoms and breast pain. It works by promoting healthy estrogen metabolism and stabilizing estrogen receptors in the brain. Milligram dose iodine is safe only if you do NOT have Hashimoto’s thyroid disease or thyroid antibodies on a blood test (also called anti-thyroid antibodies, or anti-TPO antibodies). Read more about iodine safety.

Try magnesium, taurine, and vitamin B6 (but be careful with B6)

As I discuss in my blog posts about magnesium, taurine, and vitamin B6, all three nutrients can improve premenstrual mood symptoms and work by reducing inflammation and boosting levels of the calming neurotransmitter GABA. Vitamin B6 can also reduce histamine. Take care with vitamin B6 because too much can cause nerve damage.

👉🏽 Tip: Magnesium supports GABA, regulates the stress response, and normalizes the action of progesterone on the central nervous system. It works so well that some scientists have proposed magnesium deficiency to be the main cause of premenstrual mood symptoms. It’s fine to use a combined calcium-magnesium supplement in line with the calcium research

Test prolactin

As I discuss in my prolactin blog post, high-normal prolactin is common and can cause premenstrual symptoms together with irregular periods, loss of libido, headaches, breast pain, vaginal dryness, acne, and facial hair. The best natural treatments are vitamin B6 and Vitex agnus-castus (chaste tree or chasteberry), which has been clinically trialled for premenstrual mood symptoms. Vitex is less likely to work for premenstrual mood symptoms when prolactin is low.

Understand progesterone

As I discuss in my progesterone-mood blog post, progesterone is usually soothing to mood but can sometimes cause anxiety. That’s true for endogenous progesterone (the progesterone we make) as well as for progesterone supplements in the form of cream or capsules (Prometrium and Utrogestan).

Many women have a negative mood reaction to the normal drop in progesterone (and estrogen) at the end of a natural menstrual cycle. Symptoms from “progesterone withdrawal” can be relieved by taking natural progesterone as a cream or capsule. This is especially true for migraine headaches.

A few women (about 1 in 20) have a negative mood reaction to the rise in progesterone at the beginning of the luteal phase. Symptoms of “progesterone sensitivity” or “neurosteroid change sensitivity” can be relieved by stabilizing GABA receptors, supporting gut health, and supplementing progesterone at a slightly higher dose of 100 to 200 mg (above normal endogenous levels).

👉🏽 Tip: The progestins of hormonal birth control often cause mood side effects but they are drug side effects (not progesterone sensitivity) because progestins are not progesterone.

Other strategies

Because the nervous system is a complex system, there are many, many additional considerations for improving premenstrual mood symptoms. For example, a recent study found that women benefit from access to green space. Another study linked premenstrual mood symptoms to intestinal permeability and gram-negative bacteria, and yet another explored the possible role of posttraumatic stress disorder (PTSD). Iron and zinc are also important.

As a general takeaway: the way to relieve premenstrual mood symptoms is to improve general underlying health, including nutritional status and gut health. That is particularly true during the turbulent time of perimenopause or second puberty (from age 35).

Natural treatment for premenstrual mood symptoms.

Ask me in the comments.

47 thoughts on “How to Improve Premenstrual Mood Symptoms (A Summary of Natural Treatments)”

  1. Hello, I tried natural progesterone once and it made me feel more irritable and ragey. I also tend to feel terrible when my progesthterone is rising and the worst at its peak. then I feel realllly bad again post-menstrually, starting aroun day 5. I’m not sure what hormones I’m sensitive to.

  2. I get hives every month prior to my menstrual period. They are accompanied by migraine headaches and sometimes digestive distress. I have been approaching these symptoms separately, until I noticed a correlation with my cycle. Two weeks ago I saw an allergist who injected progesterone beneath my skin to see if that was causing my allergic reaction/hives. Nothing happened. Two weeks later (today) my injection sites swelled up and began itching like mad. The hives also began. I am at day 14 in my cycle, just past ovulation. So my body has no issue with progesterone until post ovulation when it releases histamine, I am assuming? I am trying to put the puzzle pieces together.

  3. Hi Lara,
    I’m 48 this May and my periods have started to change significantly in that they are becoming later and longer, heavier and more painful. I have gut issues that I’ve been working on in earnest for the past year now with a naturopath. I have chronic back pain which I’m looking at using prescribed CBD oil for as pain killers mess with my very delicate gut biome. I keep physically active and eat an anti inflammatory diet. I take magnesium, a multivitamin, and escitalopram for depression. I would love to come off the escitalopram as I’ve been on it for years. My gut health and back pain as well as a family history of depression, keep me on it.
    My naturopath suggested progesterone cream to help with the heavy painful periods. Can you please suggest something?

  4. Do you have a podcast or have you ever thought of having a audio of your blogs. I have more time to listen than stop and read. 😊

  5. Hi Lara,

    I have been diagnosed with PMDD. The symptoms are extreme, and begin at ovulation and last until I bleed. I seem to be very sensitive to my own progesterone and my mood is at its worst as progesterone starts rising after ovulation.

    I was Initially prescribed oestrogel to ‘even out’ these fluctuations, it seemed to work brilliantly and my mood improved but resulted in histamine intolerance which is bad enough to stop me taking it. Interestingly these symptoms only abated during my progesterone peak which suggests to me that my own progesterone ‘cleared’ the excess histamine.

    Now the gynaecologist who prescribed it to me doesn’t seem to listen to me regarding the histamine problem, and I don’t know where to go from here. I’m considering the possibility of supplementing with progesterone as suggested by another naturopathic specialist but I’m very nervous about it. Do you usually recommend taking it in the luteal phase only for PMDD or continuously? Can I take some estrogel with it? Help ! 😬😬

  6. Hi, Wondering if you have content on lipedema and hormones, etc. I searched your site and got no hits. Maybe in one of your books? Thanks in advance.

  7. Thank you so much for your contribution to women’s health! I have suffered from undiagnosed pmdd for years, and it has put an enormous strain on my marriage. Now that I see all of this turmoil for what it is, I’m determined to heal. I believe that the explanation of ptsd creating a nervous system that is not resilient to the hormonal shifts is what is going on for me. I’ve always had very regular cycles (currently 34 yo) and 3 healthy pregnancies.
    I look forward to try going dairy free, magnesium, and anti-histamines as a first pass. My question is, do you ever find that hormonal birth control is the right fit? I have never been on it and don’t want to be- but I am nervous/desperate for my extreme irritability and anxiety to change. Hoping these natural solutions do work, but what if they don’t?

    • Hi Sarah, I found Magnesium, vitamin B6 (for 10 days prior ) And DIM helped enormously, I also take antihistamines. It took a couple of cycles to see full effects.

      Yoga or other breath work also helped. I did find the pill helped with my moods but the side-effects were not worth it.

  8. Hi Dr. Briden! My question isn’t about PMS but rather ovulation. In your Period Repair Manual book, you state that an elevated temperature over a few days is the indication that ovulation has occurred and pregnancy isn’t possible for the remainder of that cycle, but you also caution the interpretation of cervical fluid because fertile mucus (which can happen more than once per cycle) is a possible indicator of fertility. I’m a bit confused and suppose my question is this: is it safe for someone to rely solely on BBT to determine ovulation and the ‘safe’ days for intercourse?

    Thank you so much for your commitment to women’s health and safer, natural alternatives. I hope you know how appreciated you are!

  9. Thanks, its all very helpful. I recently decided to try 5htp and St John’s wort for PMS/PMDD, but I am worried it will not help with the fatigue and low concentration. Is SAMe better? Can you advise about dosage and when to take them, whether just for two weeks or the whole cycle?

  10. Hi again! I’m so happy you consider our conversation useful to readers! I want to digest what you replied to me (wow) and read up/brush up on things a bit more so I can give a well-thought-out response (I too find our conversation invaluable, of course!).

    I’d like to ask something simpler for the time being, which I’ve wondered for a long time.

    Do you recommend B6 for PMDD/severe PMS even if the blood testing comes back normal or even optimal? (If not, what do you consider normal and, even more importantly, as conventional doctors only care if you are outside the normal range, optimal?)

    But, most importantly, I remember reading a comment on one of your Facebook posts some time ago that somebody took a vitamin B (I think it was B6) and felt depressed. And you replied that the specific B, or Bs in general, can cause depression if taken alone. I’ve searched high and wide (in your two books, blogposts and then anywhere online) and I can’t find what Bs (or B6) need to be taken with in order to not risk causing depression!

    Thank you so much!!

  11. I am at my wits end as I have been going to my GP for years and he just keeps wanting to put me on the Pill or give me an IUD.
    I have had many ultrasounds with no results.
    I had a very bad bout of dizziness/vertigo and went to many doctors and one did mention that it was most likely hormonal which I was skeptical but after reading many of your articles Im now convinced it is.
    My GP said to me that I more than likely have endo but as I dont have health insurance and dont tick the boxes to get funding thats as far as I get. Its terribly frustrating.
    One of our sons needed to go dairy and gluten free and I did it with him and I felt amazing but life got in the way with sick relatives and kids pushing back on the dairy and gluten free stuff so we went back to our old ways.

    I am keen to read read read loads more and see if things improve. Thank you for all the information. I wish GPs were more willing to talk more about this.

  12. Hi Dr. Lara Briden, I was recently diagnosed with PCOS in 2020. However I’m finding a hard time treating my specific situation since most supplements and diets are tailored to insulin resistance and/ or elevated androgens. Neither is the case for me. I do have significantly low progesterone with irregular periods. I am desperately trying to navigate this journey the right way. Is there any information you can give me that will help my kind of PCOS?

    • If you don’t have elevated androgens, then (according to some criteria) it is not PCOS. Is irregular periods your only symptom?

  13. Lara! I developed MCAS this year out of the blue (no Covid). My estrogen is really high – higher than 3 years ago on Dutch and while my progesterone is still within range, that too has dropped a little in 3 years. Thing is I’ve now tried progesterone twice and it makes my histamine / MCAS worse! Why is this? It’s the opposite of what you say in your book…! I also have low cortisol and dhea so trying dhea next….

    • yes, a few women can get a mast cell reaction to exogenous progesterone, especially when they first start taking it. In that case, I usually recommend first using other antihistamine strategies (especially dairy-free) and gut work, and then maybe try the progesterone again but at a reduced dose. One of my colleagues has some experience with progesterone-mast cell reactions. I’m going to ask her to chime in here.

    • Thanks Lara and hi Haley! From what I can ascertain, in some women with MCAS/high histamine/high oestrogen, progesterone can act more like oestrogen at the progesterone receptor site and therefore worsen histamine reactions/symptoms (still unsure if this is down to a progesterone receptor SNP or if that’s just anecdotal in myself and some of the clients I’ve experienced this with). Similar to Lara, I typically suggest to go super low dose with progesterone (perhaps 1/4 dose on alternate days or avoid altogether in the initial stages) and work with more with oestrogen-modulating strategies, gut and methylation first before adding in progesterone.

      • Thanks for this. I am feeling low on continuous progesterone (200mg as 100mg orally / vaginally made me feel completely crazy – 200mg is better but still hard). Am 16 days in and don’t know whether to keep going or throw in the towel. The low mood is bearable but certainly no fun.

        I am taking it for a post-menstrual mood disorder which is similar in nature to PMDD which occurs post bleed.

        I previously did a complete histamine-elimination diet for four weeks as a practitioner suspected that my poor response (intense anxiety) to oestrogen was based on this, in spite of no physical symptoms or reactions to any high histamine foods. My mood symptoms remained the same. Is there any other reason I might not be doing well on the progesterone?

        My specialist has said 4-6 weeks to adjust

  14. Hi Lara, im 29 and i’ve been struggling with severe PMDD for the last 2 years. extreme anxiety, fatigue and now night sweats. i don’t have a ‘bleed’ but still get all the symptoms – i track my ‘cycle’ and it’s almost to the day with the luetual phase being 2weeks of feeling like a crazy person and depressed. exactly how you have described in the symptoms above. specialist here in the UK only suggest for me to go on the pill which i tried and made me 10x worst. they also diagnosed me being one of the unlucky ones who is very sensitive to progesterone. i’ve tried vitex and that did not work for me and think it actually made me a bit worse. already take magnesium, zinc and vitamin b6. not sure where to go from here – any advise would be grately appreciated. i have your book ! i also have low estrogen. thank you xx

    • Why don’t you have a bleed? Because you’re on the hormonal IUD? or because you have stopped having cycles?
      Because if you’ve stopped having periods/cycles, then the first step is to figure out WHY and work to get your period back. For example, if you have hypothalamic amenorrhea, the resulting low estrogen could be causing anxiety and night sweats.

      • Hi Lara, thanks so much for responding. No i am not on the IUD or any contraceptive pill. I haven’t had a bleed since I was about 20 yrs old, it first disappeared after a stressful time in my life and never came back. The doctors here in the UK have diagnosed me with PCOS but as i know from your book this doesn’t really mean anything it just means i haven’t ovulated. I am also insulin resistant but not over weight. I did put on a lot of weight but my period didn’t come back then either. So now im stuck on what to do or where to go and have 2 weeks of the month where i feel horrendous.

        • oh ok. So you definitely have insulin resistance? As in, you have elevated insulin on a blood test? If that’s truly the case and especially if you have a high LH to FSH ratio, you may want to look at PCOS treatments including inositol and cyclic progesterone therapy.

          • Hi Lara, extremely grateful for your response. I actually tried to get an appointment with you and contacted your assistant a while ago but i understand you do not have capacity to see international patients right now. So really appreciate you getting back to me on this.
            I am extremely tired after eating carbohydrates (even healthy slow release, no white sugar or flour etc). I’ve tried to get a formal blood glucose test here in uk but doesn’t seem to be true test like you describe in your book. When i bought a glucose meter my fasting measurement in the morning suggested that of pre diabetes (when i had eaten carbohydrate in the evening). So i switched up my diet in the past year and I still eat beans and lots of vegetables so i am not ‘carb free’. This diet works well for me and i have sustained energy thought out the day with no crashes. I eat a lot of avocado, olive oil etc.
            If my LH to FSH is low – does this suggest i am not eating enough? Could there be a few factors at play here?
            My question is the specialist here in UK believe i am sensitive to progesterone and that is why i feel so awful in the luetual phase. I am wondering if i am sensitive to it because my estrogen is so low? i’m actually entering it now and the anxiety has already set in. Any further advice would be greatly appreciated. Thank you.

  15. Your perimenopause book is excellent. Prior to reading it, I had no clue that all the trouble have had for several years with dizziness was vestibular migraines. I had seen many specialists and been diagnosed with various things, including Ménière’s disease. Your advice of supplementing with magnesium and taurine has completely turned things around for me. I had nearly given up hope of ever feeling “normal” again. I am so much calmer and almost can’t even tell that I have pms anymore. My husband is very grateful too. Thank you for all you do!

  16. Hi Lara,

    I healed my period and did not have PMS or any horrible symptoms for months. I was then given a supplement containing boron which stopped me getting my period and gave me breast swelling and pain, then as soon as I stopped taking it my period started. Through my own research I found studies saying it could increase estrogen levels, and also strip your body of iodine. I’ve started supplementing iodine and it’s not been a huge help so far, breast pain just continues to become worse.

    I was wondering how long it usually takes while supplementing these things to see/feel improvements?

  17. Mood symptoms on the pill CAN be premenstrual mood symptoms, as, otherwise, people having PMDD would not need chemical menopause or surgical menopause. I guess not all ovarian activity is stopped by the pill, that’s why chemical menopause (which may still not stop all ovarian activity for some) or surgical menopause may be needed as an effective treatment.

    And please, as the progressive and brilliant ND that you are, don’t make those of us that experience menstrual and post menstrual cyclical mood symptoms feel unseen like the mainstream medical establishment does (so far). Please check out this paper by Tory Eisenlohr-Moul , which is (only) a good start on the way of officially acknowledging more cyclical patterns associated with the ovarian activity cycle.
    In the PMDD groups we see all kinds of patterns. And as we get older, they seem to change in a similar way for many of us (some end up having only 3 non-PMDD days per month, even if cycle is not short and while still not in perimenopause – premature or not).
    It’s not just iron.

    Thank you.

    I really appreciate your work, I am following you on Facebook and receiving your extremely interesting newsletters, and I appreciate you taking on the complex beast that PMDD is. We need all the help we can get and, to be honest, you are our only hope (to put it otherwise, I don’t trust anyone else as much as you) regarding less invasibe/non natural solutions.

    Oh, and something more. Another thing that is not acknowledged enough, is the debilitating fatigue that may accompany (or, for at least a few, who get no acknowledgement whatsoever, it may be the main or only symptom) the emotional and cognitive issues. Not just headaches and breast pain. There’s a huge list of physical symptoms that we see on the groups; Johns Hopkins Medicine website – though it has many other things about PMDD wrong – has the most comprehensive list, but it’s still not exhaustive at all. And the insomnia and hypersomnia of course (I know of at least four studies that have studied melatonin and/or the effects of morning/evening light on people who suffer from PMDD – I say this because I know that you are aware of circadian rhythm problems and disorders, and appreciate is so much as well, since I also seem to suffer from such a disorder, independently of PMDD, and doctors seem hugely unaware).

    • Thanks so much for your detailed comment and the link to Tory Eisenlohr-Moul’s paper. I have spoken to Dr Tory a few times and mention her in my progesterone sensitivity post. And you’re right about ovarian function not being entirely suppressed by the pill (depending on the pill). According to the latest research, progesterone IS entirely suppressed by the pill but estrogen is not. So, the low amplitude ups and downs of estrogen could have an effect. And of course, progestins can cause mood side effects, perhaps especially in women with PMDD, but a negative mood reaction to progestins is not technically PMDD.

      And I agree that some women can have mood symptoms throughout most of the cycle, but again (semantically), that’s technically not PMDD, although it can occur in women with a history of PMDD, and definitely does still require treatment. With the short cycles of perimenopause, I think what is sometimes happening is mood symptoms leading up to an early (possibly day 7) ovulation, and then mood symptoms post-ovulation, so it can feel like the entire cycle. When I mentioned iron deficiency for post-menstrual mood symptoms I was referring to symptoms that occur ONLY for a few days post-menstrual, not symptoms that occur throughout all the cycle including post-menstrual.

      • You are very right that the term ‘PMDD’ has a very specific, strict definition (at least in the DSM-V, not sure about the ICD-11). That’s why in the UK (with leading doctors on PMS/PMDD and hormones) they prefer not to use the word ‘PMDD’ as they find it not inclusive enough for all the suffering people who need treatment ( (Though the association of PMDD with PMS brings a lot of grief to PMDD sufferers, when it comes to both general public awareness and educating doctors who have never heard of PMDD before).

        I think someday ‘PMDD’ (or other forms of ‘severe PMS’) may end up encompassing all cyclical patterns associated with the ovarian function. If PMDD is the sensitivity to hormonal fluctuations accross the cycle, it would make sense that it could happen anytime there are hormonal fluctuations and these do not only happen during the luteal phase, right?

        For example, you are very correct about ‘severe PMS’ happening also before ovulation (my ovulation ‘severe PMS’ happens for 2 days before my actual ovulation) – which, again, is not acknowledged by the definition of PMDD as far as I know.

        Regarding PMDD/severe PMS patterns changing as we get older, mine used to stop right away after my menstruation blood started. Then it didn’t stop until day two. Then it didn’t stop until day four (it stayed that way for at least a couple of years – I was still under 35). Then until the last drop of blood was shed. And this progression went on…
        There seems to be a pattern of PMDD/severe PMS moving around the menstrual cycle (or expanding) as years go by for many of us. It happens before the age of 35 as well, without the cycles becoming shorter, so, would that have to do with perimenopause?

        I am confused whether progesterone/oestrogen intolerance is a part of PMDD (not just their rise and fall), or something (independent?) that often co-exists with PMDD.

        It seems like around half of the people experiencing PMDD/severe PMS have a big problem with progestins (do they also have with body-identical progesterone? Not necessarily, from what I have observed on the groups). For some it was actually a (permanent) trigger to their PMDD.
        I learnt about the difference between progestins and progesterone from you (what a revelation) and I hope there is more awareness on this with more research being done on it, both for the people who suffer from PMDD/severe PMS and for those who suffer from less severe forms of PMS.

        Again, I am truly grateful to you. For being the bridge between the evidence-based and the anecdotal. For using your scientific background and thinking to restore nature and to try and bring better solutions for women and AFAB individuals. For caring so much to communicate these solutions to laypeople in a clear way (not underestimating our intelligence preemptively like many doctors) and for being close to us.

        • Dear Eva,

          what a thoughtful comment, thank you. I hope readers scroll down to read the comments as this has been a very useful discussion.

          The complexity comes from the fact that there are so many moving parts in the interaction between mood and the menstrual cycle including (as you say) symptoms that occur leading up to ovulation and even during the flow. Some of the moving parts include 1) sensitivity to progestins (which is common), 2) sensitivity to real progesterone (less common), and 3) all the dynamics associated with estrogen including changes to serotonin as well the whole mast cell-estrogen side of things. There’s also 4) the role of the gut and LPS toxin as described in the new paper, which could be a game-changer in our understanding. The authors start by acknowledging the role of LPS toxin in negative mood and were able to describe a situation in which an underlying problem of chronically low progesterone and high estrogen (very common) could set women up to being more sensitive to the slight rise in ovulatory progesterone because the gut is primed to become hyperpermeable (ie. release LPS into the serum) under the influence of progesterone.

          Then there’s the prostaglandin release associated with menstrual flow, as well as prolactin dynamics, plus the strong interaction between the HPO and HPA axis. So many factors! No wonder there are so many different theories and strategies.

          I will keep a close eye on the research and write some future blog posts as more information comes to light.

        • Eva, this has been my exact experience as well. I’m pretty sure I ovulate around day 7-8 so it feels like my whole cycle. 🙁

    • Absolutely agree with this and describes my symptoms too – the fatigue is horrendous, not to mention night sweats, anxiety and depression that goes with it. Interesting to read about the ovulation mood shift – I experience this too even though I do not have a bleed. When I told my doctor this he thinks im crazy but ive been tracking my ‘cycle’ and its almost to the day every month. I have night sweats during this time too. No idea where to go for help here in the UK – do you know of anywhere Eva/ Lara? Really interesting read and thanks for sharing.

      • Hi Rebecca!

        Unfortunately conventional doctors give us PMDDers/severe PMSers a very hard time. Also, as most have so little clinical experience on PMDD/severe PMS they go entirely by the book and there is still infinitely more wealth in the anecdotal right now regarding these two conditions. (It’s actually not uncommon for us to cry after every visit to a doctor, or give up on seeing doctors for years, in order to not feel unseen, invalidated and, just as you say, ‘crazy’ again. Take a look at this if you like, it may make you feel a bit better as far as doctors making you feel crazy when it comes to these symptoms goes – it’s rather intense though, so please take care

        Are you in any PMDD support group on Facebook? You will find emotional support there as well as support with advocating for yourself with doctors. My favourite one is the IAPMD one (I hope it’s okay by Lara to say this). The same organisation (International Association of Premenstrual Disorders) also facilitates a non Facebook support forum and also has a (patient-recommended) Provider Directory ( so you can have better chances at finding someone helpful.

        As far as I know, UK is one of the (very few) countries on the frontline of PMDD medical treatment and one of the leading doctors there is Nick Panay.

        But not so much for natural solutions (unless it’s the administration of hormones – hopefully natural ones). I don’t know of anyone reliable in the UK (or anywhere to be honest, besides Lara in New Zealand) helping through the natural route – I can ask for any recommendations on the FB groups for you if you prefer not to join them (there’s also at least one UK FB group, but I’m not on it as I’m not in the UK) – only if that is okay with Lara of course. And you can maybe take your chance with them, if you can’t find nobody else.

        I really hope Lara has some suggestions and is able to share them! I am interested too, especially if they accept international clients, because if she doesn’t get cloned anytime soon, I’ll have to move to New Zealand and perform a great act of bravery in the hopes of being awarded a NZ citizenship!!
        (Honestly, I know of nobody with the scientific brain and the being on top of the latest research as Lara’s. And it’s hard for me personally to trust someone who involves spiritual stuff in their practice, even though I consider myself a somewhat spiritual person and of course I am not ignorant of the interconnection between the mental and the physical. But the spiritual is too vast and practitioners who involve it in their practice are free to associate it with the physical evidence any way they want/feel – possibly pushing and twisting things to fit or seeing everything through their preferred spiritual glasses which may not be objective enough and may also just not coincide with mine. It’s just not scientific enough for me.)

    • Dear Lara,

      Here is a very interesting recent webinar by Tory Eisenlohr-Moul, PhD, explaining the research I linked above ( You probably do not need the explanation (as the webinar was meant for PMDD suffering laypeople mostly, I think), but I’m sure there will be some hidden gems for you in there as well! It’s 1.15 hour long, please watch the Q&A as well (maybe even if nothing else) starting at 38:50, since it raises a lot of interesting issues and provides the opportunity for mention of the future research goals (some are already underway).

      Thank you so much again!

  18. I’ve had terrible PMDD that lasts the entire 2 weeks of the luteal phase that includes irritability, anxiety, depression, fatigue, joint pain, water retention and VERY tender and swollen breasts. The rest of my cycle I feel amazing. The last 2 years I’ve also started to get perimenopause symptoms of hot flashes and night sweats. I’ve started on 25 mg of estrodiol and have a mirena. The first 8 weeks of having the mirena were terrible, now I seem back to my normal cycle of only feeling terrible during the luteal phase. I also have been on sertraline for 2 years which has been amazing for my anxiety but doesn’t seem to be helping as much now. I’m not sure where to go next! More estrogen? Remove mirena? Stop everything and start again? Help!!

    • Before stopping everything, you could look at some of the simple strategies mentioned in the article including dairy-free diet, magnesium, and especially iodine (maybe Violet iodine) but only if you’re negative for thyroid antibodies.

  19. Hi Lara, I’m a practicing naturopath and would like to know a little more about supplementing with progesterone cream/capsules. Is this approach a long term treatment ? Or do you supplement with this while you are building the their bodies natural progesterone secretion? Also, would you use this in younger females say age 18-35? Are there any contraindications for its use ? Or any women where you would not use this ?
    Thank you for sharing your knowledge !

    Warm regards,

    • I generally don’t recommend progesterone for women younger than 25. But there can be exceptions, especially for cyclic progesterone for PCOS.

      I generally try to use it only in the luteal phase (ie. start a couple of days after ovulation) and still work to promote healthy ovulation (and therefore progesterone production). Except in the case of perimenopause, when a good level of progesterone production is often no longer possible.

      • Hi! I have suspected adenomyosis and I’m 38. Terrible mood towards end of cycle and first couple days of new cycle. Going to start with progesterone cream… with my age should I just be using it in the luteal phase? Or every night?

  20. Hi Lara, my 17yr old daughter becomes a demon when her period is due! She has high functioning adhd and aspergers which is tricky at the best of times. I think she has gut issues and has hayfever and dermatitis but refuses to change her diet as I’ve had to do due to food intolerances, leaky gut etc. One of her brothers has taken himself off wheat as it flares up his dermatitis which has just developed this year (15yrs).
    She won’t let me help – fair enough, she doesn’t get period pain or sore breaststroke but her mood is out of this world!! She’s over weight too which is a touchy subject…how can I support her?

    • The simplest first step strategy would be to coax her off dairy and wheat for a few months. Maybe offer an antihistamine on the really bad mood days. (but of course, talk to her doctor)


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