What are the treatment options for premenstrual dysphoric disorder?

PMDD symptoms follow a menstrual pattern and can affect mood, relationships, work, sleep and physical comfort. Selective serotonin reuptake inhibitor antidepressants may improve irritability, low mood, anxiety and tension; some people take them throughout the cycle and others during the symptomatic phase. The combined pill may suppress ovulation and reduce hormonal fluctuation, although it is not suitable for everyone. Cognitive behavioural therapy can build tools for distress, conflict and difficult thoughts. Regular sleep, movement, balanced meals and reducing alcohol may support treatment, but lifestyle changes should not be used to dismiss severe symptoms.

Track mood and physical symptoms each day for at least two cycles, including when bleeding starts and stops. This helps distinguish PMDD from depression or anxiety that continues beyond the premenstrual phase. Discuss your health history, migraine, blood pressure, smoking, medicines and pregnancy plans before choosing hormonal treatment. Review benefits and side effects after starting a medicine, and do not stop an antidepressant suddenly without guidance. A mental-health clinician can help when symptoms disrupt relationships, work or daily safety.

Seek urgent mental-health help if you feel unable to stay safe, have thoughts of suicide or self-harm, or fear you may harm someone else. Contact a clinician promptly for severe mood change, panic, inability to function, or symptoms that do not ease after the period begins. Emergency services are appropriate when immediate safety is at risk.

Ask how to track cycles, whether an antidepressant or combined pill suits you, what side effects need review, and how therapy can fit alongside medical treatment.