PMS and PMDD: Understanding the Hormonal Impact on Women and How to Find Relief

Stacia Aaron | Women’s Health Blog | Frisco, TX

For many women, the days leading up to their period bring familiar changes—mild cramps, fatigue, or mood swings. But for others, these symptoms are far more intense, interfering with relationships, work, and emotional well-being. These more severe symptoms are often signs of premenstrual syndrome (PMS) or its more serious counterpart, premenstrual dysphoric disorder (PMDD).

At our women’s health clinic in Frisco, TX, we believe women deserve more than “just dealing with it.” PMS and PMDD are not simply parts of womanhood to be endured—they are signs that the body’s hormones, neurotransmitters, and stress responses are out of balance. With proper evaluation and treatment, relief and stability are possible.

Understanding PMS and PMDD

PMS (Premenstrual Syndrome) is a collection of physical, emotional, and behavioral symptoms that occur one to two weeks before menstruation and usually subside once bleeding begins. While up to 75% of women experience some form of PMS during their reproductive years, symptoms can vary in severity.

PMDD (Premenstrual Dysphoric Disorder) is a more severe form of PMS that affects about 3–8% of women. PMDD is recognized as a clinical condition involving significant mood disturbances—such as depression, irritability, and anxiety—that can disrupt daily functioning.

Symptoms of PMS and PMDD

Common PMS Symptoms:

• Bloating or water retention

• Breast tenderness

• Headaches or migraines

• Fatigue or sleep disturbances

• Food cravings, especially for carbohydrates or sweets

• Mild mood changes, anxiety, or irritability

PMDD Symptoms (more severe and disruptive):

• Intense mood swings

• Feelings of hopelessness or sadness

• Severe irritability or anger

• Panic attacks or anxiety

• Trouble concentrating

• Insomnia or excessive sleep

• Physical symptoms similar to PMS but often more debilitating

For women with PMDD, these symptoms can mimic major depression or anxiety disorders but are cyclical—occurring specifically during the luteal phase of the menstrual cycle and easing once the period starts.

What Causes PMS and PMDD?

The exact causes are multifactorial, involving hormonal fluctuations, neurotransmitter imbalances, and inflammatory processes.

1. Hormonal Changes – Shifts in estrogen and progesterone after ovulation can affect serotonin, a brain chemical that influences mood and emotions. Women with PMS and PMDD may be more sensitive to these normal hormonal changes.

2. Neurotransmitter Sensitivity – Low serotonin levels are linked to mood changes, food cravings, and sleep problems during the luteal phase.

3. Stress and Cortisol Dysregulation – Chronic stress can exacerbate PMS symptoms by altering the body’s cortisol rhythm and adrenal function.

4. Nutritional Deficiencies – Low magnesium, calcium, B6, and vitamin D have all been associated with worsening PMS and PMDD symptoms.

5. Inflammation and Gut Health – Inflammation, leaky gut, and imbalanced gut bacteria (gut dysbiosis) can worsen hormone metabolism and serotonin production, amplifying symptoms.

6. Genetic and Environmental Factors – A family history of mood disorders or hormonal sensitivity can increase susceptibility.

How PMS and PMDD Affect Women’s Lives

Beyond the physical discomfort, PMS and PMDD can take a heavy emotional and social toll. Many women experience difficulty concentrating at work, conflict in relationships, or loss of motivation and energy.

PMDD, in particular, can lead to significant emotional distress and may overlap with depression or anxiety disorders. Left untreated, it can lower quality of life, impair career performance, and strain interpersonal relationships.

Recognizing these symptoms as medical—not emotional weakness—is key to getting the right help.

Diagnosis

Diagnosis typically involves tracking symptoms over at least two menstrual cycles to confirm their cyclical nature. A healthcare provider may recommend:

• Symptom journaling (documenting timing, duration, and severity of symptoms)

• Hormone testing (to assess estrogen, progesterone, thyroid, and cortisol balance)

• Mental health screening (to distinguish PMDD from depression or anxiety disorders)

For some women, additional tests—like a DUTCH hormone panel or thyroid evaluation—may help reveal underlying hormonal imbalances.

Treatment Options for PMS and PMDD

The goal of treatment is to restore hormonal balance, stabilize mood, and reduce inflammation. An integrative approach often provides the best results.

1. Lifestyle and Nutrition

• Balanced Diet: Focus on whole foods, lean proteins, healthy fats, and complex carbohydrates to stabilize blood sugar and support hormone metabolism.

• Limit Caffeine and Alcohol: These can worsen anxiety and sleep disruption.

• Exercise Regularly: Physical activity improves mood and reduces bloating by supporting serotonin production and circulation.

• Prioritize Sleep and Stress Management: Yoga, deep breathing, and meditation can lower cortisol and improve emotional resilience.

2. Nutritional Supplements

Certain vitamins and minerals can help relieve symptoms:

• Magnesium: Reduces bloating, cramps, and irritability.

• Calcium and Vitamin D: Support hormone regulation and mood balance.

• Vitamin B6: Assists serotonin production and alleviates mood changes.

• Omega-3 fatty acids: Reduce inflammation and support brain health.

3. Hormone Support

For women with clear hormonal imbalances, treatment may include:

• Bioidentical progesterone therapy to support the luteal phase.

• Oral contraceptives to regulate hormone fluctuations (though not ideal for everyone).

4. Medications for PMDD

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), or escitalopram (Lexapro) have been shown to effectively reduce PMDD symptoms. Some women only take these medications during the luteal phase rather than daily.

5. Gut and Adrenal Support

Because gut health and stress hormones play a major role in PMS and PMDD, restoring digestive balance and regulating cortisol levels can dramatically improve symptoms. Probiotics, adaptogenic herbs (like ashwagandha or rhodiola), and dietary changes are often part of a holistic plan.

Taking Back Control

PMS and PMDD are not “all in your head.” They are physiological conditions rooted in hormonal, neurological, and metabolic changes that deserve care and understanding. With proper testing, nutrition, lifestyle shifts, and individualized treatment, most women experience significant improvement—or even complete resolution—of symptoms.

At our women’s health clinic in Frisco, TX, we take an integrative, whole-person approach to hormonal health. Whether your symptoms are mild or severe, we’ll help you uncover what’s really driving them and create a treatment plan that restores balance and peace of mind.

Fill Out a New Patient Request Form Today

If you’re struggling with PMS or PMDD symptoms that interfere with your daily life, you don’t have to navigate them alone. There are real solutions that can help you feel calm, energized, and in control again.

Fill out a new patient request form with our women’s health team in Frisco, TX today and take the first step toward balanced hormones, emotional stability, and lasting relief.

References:

1. American College of Obstetricians and Gynecologists (ACOG). (2023). Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD). https://www.acog.org

2. Freeman, E. W. (2019). Premenstrual syndrome and premenstrual dysphoric disorder: Definitions and diagnosis. Psychiatric Clinics of North America, 42(1), 43–54.

3. Rapkin, A. J., & Lewis, E. I. (2013). Treatment of premenstrual dysphoric disorder. Women’s Health (Lond), 9(6), 537–556.

4. Mayo Clinic. (2023). Premenstrual syndrome (PMS). https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome