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Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). If you have PMDD, you’ll likely have emotional and physical symptoms a week or two before your period starts. This is a chronic (ongoing) condition that’s severe enough to disrupt normal activities and daily life.

There are several treatments available for PMDD, including medication and lifestyle changes to manage your symptoms.

Depending on the severity of your symptoms, one option your doctor may discuss is hormonal birth control pills, also called oral contraceptives. Birth control pills affect your hormone levels and can provide relief from some PMDD symptoms.

The Food and Drug Administration (FDA) has approved only one type of birth control pill to treat PMDD, but your doctor may discuss other types of birth control pills with you.

Let’s take a closer look at how hormonal birth control works in treating PMDD.

PMDD is a more severe form of premenstrual syndrome (PMS) that causes mood, behavior, and physical symptoms a few days to a couple of weeks before your period begins.

Some common symptoms of PMDD include:

These symptoms generally go away soon after your period begins.

The exact cause of PMDD is not known, but it’s believed that multiple factors may play a role, including:

  • changes in hormone levels during your menstrual cycle
  • progesterone-based neurosteroids (synthetic steroids made in the brain), which affect mood, stress, and anxiety levels
  • changes in certain brain chemicals, like serotonin
  • family history

For most women, PMS symptoms are manageable. However, 5 to 8 percent of women have more severe PMDD symptoms that affect daily life, disrupting their normal activities.

There aren’t any specific diagnostic tests for PMDD. Having 5 of 11 symptoms of PMDD is necessary to confirm this diagnosis. A healthcare professional will do a physical exam, take your medical history, and review your symptoms to diagnose your condition.

Oral contraceptives (birth control pills) contain various amounts of certain hormones. They have some benefits over other treatments used to treat PMDD, like antidepressant drugs.

Research shows that oral contraceptives that have combinations of ethinyl estradiol and drospirenone help improve some mood and physical symptoms of PMDD. They also prevent unintended pregnancy. Many women prefer birth control pills for these dual benefits.

Ethinyl estradiol and drospirenone combination pills come in several different brands, but currently the only FDA-approved option for treating PMDD is Yaz. A healthcare professional may prescribe another type of birth control pill off-label. This means the medication is prescribed for a use other than the one it’s been approved for.

If you’re already taking the pill and it’s not helping with your PMDD symptoms, talk with a doctor about other options.

Birth control pills do carry some side effects. Most go away after a few days to a few weeks. If you have a serious reaction to a birth control medication, call your doctor or seek medical attention.

Some common side effects of birth control pills include:

Serious side effects include:

If you’re experiencing a medical emergency, call 911 or go to your nearest medical center right away.

These are not full lists of all the possible side effects of birth control pills. If your doctor prescribes an oral contraceptive for you, ask about all the drug’s benefits and risks for you.

Furthermore, birth control pills may not be right for everyone. Avoid birth control pills if you have a history of:

Avoid taking the pill if you’re pregnant or plan to become pregnant, or you are over age 35 years and smoke.

There are many treatments for managing PMDD symptoms. They include prescription medications, over the counter (OTC) products like pain relievers and natural supplements, as well as lifestyle options. Here are some more details on the available options for coping with PMDD:

  • Medications. Selective serotonin reuptake inhibitors (SSRIs) are FDA approved to treat PMDD and have shown proven effectiveness. Some examples include paroxetine (Paxil), sertraline (Zoloft), and fluoxetine (Prozac). They are thought to help with PMDD symptoms by increasing serotonin levels.
  • Lifestyle adjustments. Managing stress through exercise and eating a healthful diet while avoiding excess salt, caffeine, and sugar can help manage PMDD symptoms. At least 30 minutes of exercise per day can also provide benefits for both emotional and physical symptoms of PMDD.
  • Natural remedies. There are also several natural therapies like ayurvedic, homeopathic, and other natural treatments (aromatherapy, acupressure). These may help with stress, sleep, anxiety, and other emotional and physical symptoms.
  • Counseling. Cognitive behavioral therapy (CBT) can also improve your sleep, anxiety, depression, and other PMDD symptoms.
  • Other medical and nonmedical treatments. OTC pain relievers like ibuprofen can help with cramps, pain, and headaches. Certain vitamins like B6, calcium, vitamin E, and magnesium may help relieve some mood and physical symptoms.

Be sure to discuss these different treatment options with your doctor to avoid side effects. Always talk with them first before taking any herbs, supplements, or other over the counter products. Your doctor or a pharmacist can help you choose the safest option for you.

To decide which treatment may work best for your needs, it’s important to carefully review your symptoms, health history, and how PMDD is impacting your life and share this with your doctor.

You may benefit from one or more therapies (exercise, diet, and medication) together.

Here are a few suggestions for you to consider:

  • Keep a diary to track your symptoms and take note of when symptoms start and the level of intensity.
  • Review treatments you’ve tried in the past that were effective or not effective and share this with your doctor.
  • Have you had any allergic or adverse reactions to birth control pills?
  • Do you have a history of health conditions or are taking medications that can interfere with birth control pills?
  • Do you have other physical or emotional symptoms that fall outside of PMDD?
  • Do you prefer to try nonmedication options or lifestyle options over prescription drugs?

Keep in mind that medications and other treatments may take time to work. And with lifestyle changes like diet, therapy, and exercise, it’s important to be as consistent as possible to see improvement in your symptoms.

PMDD is a serious chronic condition that may require medical treatment. PMDD is different from PMS or other mood disorders. If you think you have symptoms of PMDD, make an appointment to speak with healthcare professional. They can diagnose your condition and help form a treatment plan.

Birth control pills may be a good option if you have PMDD symptoms and need contraception. They also carry some benefits over other treatments for PMDD.

Your symptoms may change over time and go away after menopause. There are also many organizations like the International Association for Premenstrual Disorders that provide information, provider listings, support groups, and other helpful tips.