Herbal supplements, quality sleep, and regular exercise are just a few of the natural remedies that can help with PMDD. If natural remedies aren’t effective, talk with a healthcare professional about other treatments.

Premenstrual dysphoric disorder (PMDD) is a type of premenstrual syndrome (PMS) caused by fluctuating hormones. It affects between 2 and 5 percent of premenopausal women. Although it shares many of the same symptoms of PMS — including food cravings, irritability, and fatigue — they’re much more severe.

For many women with PMDD, symptoms are so intense it’s hard to function. If medication isn’t working or isn’t an option, you may find the following natural remedies beneficial. They focus on improving overall well-being, promoting stress-relief and relaxation, and managing symptoms.

Keep reading to learn more.

Aromatherapy involves inhaling essential oils to improve your physical and mental health. It’s used to reduce stress, improve sleep, and relieve pain.

Some of the best essential oils for PMDD symptoms are:

  • chamomile to promote relaxation and sleep
  • clary sage to relieve menstrual cramps and anxiety
  • lavender to experience a calming effect
  • neroli to ease anxiety and relieve PMS
  • rose to reduce stress and relieve PMS

You can add diluted essential oils to a warm bath or inhale the scent directly by placing a few drops on a cotton ball and breathing in.

To apply on your skin, add 15 drops of essential oil to 1 ounce of carrier oil. Popular carrier oils include sweet almond, jojoba, and coconut. Massage the diluted oil into your skin.

Undiluted essential oils may irritate your skin. And even with dilution, it’s best to do a patch test before using.

To do a patch test:

  1. Add a few drops of diluted essential oil to your wrist or inner elbow.
  2. Leave it on for 24 hours. You shouldn’t rub lotion or add any other product to the area.
  3. If no irritation occurs, it should be safe to apply elsewhere.

Research suggests that mindful meditation can reduce anxiety, depression, and pain — all common symptoms of PMDD. Meditation requires you to focus on the present moment and concentrate on your breathing. This can help you relax and detach from uncomfortable symptoms.

To get started, try these guided meditations from UCLA Health. You can also access hundreds of how-to meditation videos on YouTube, or you can download a meditation app to your mobile device.

Warm baths are good for almost anything that ails you. They can help soothe menstrual cramps, ease anxiety, and relax you for a better night’s rest.

Try these tips to get the most from your bath:

  • Choose a time when you won’t be interrupted, such as after the kids are in bed.
  • Light lavender- or rose-scented candles before you slip into the tub.
  • Play soothing background music, such as soft jazz or classical piano.
  • Add essential oils to your bathwater. The water will dilute the oil, so there’s no risk of irritation.

Keep the relaxation momentum going after your bath by slipping into a plush robe and slippers. Prepare a hot water bottle and place it on your belly or lower back for further pain relief.

Although menstrual products are a necessary evil during your period, they may make PMDD symptoms worse. Tampons, for instance, can cause some people to cramp more. If you have sensitive skin, some ingredients in pads may cause irritation.

There aren’t any scientific studies on how menstrual products impact PMDD, but anecdotal evidence suggests changing them up may help. Try using all-organic pads or organic period panties.

Menstrual cups may also be a good option. These reusable bell-shaped cups are worn internally to collect menstrual flow.

Eating the right foods is critical to managing PMS. It’s unclear how diet impacts PMDD, but eating healthy may help minimize uncomfortable symptoms that make you feel worse.

For example, salty foods increase bloating. Foods high in sugar may cause drastic blood sugar fluctuations, which may worsen fatigue and mood swings. Meat and high-fat foods increase prostaglandin levels, which could increase the severity of menstrual cramps.

You should:

  • Eat small, frequent meals to combat bloating and stomach upset.
  • Eat plenty of fruits and vegetables.
  • Choose complex carbs such as whole grains over processed carbs.
  • Avoid salt and salty snacks.
  • Avoid caffeine.
  • Avoid alcohol.
  • Eat high-protein foods to help increase tryptophan levels.
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Research has shown that getting the required dietary nutrients helps PMS. The best way to get the required nutrients, minerals, and vitamins is to eat whole fresh foods. Supplements are an option if you don’t get enough from your foods. More studies are needed to determine if they help PMDD.

According to the Mayo Clinic, these supplements may be worth a try:

  • Calcium. 1,200 milligrams (mg) calcium daily can help ease physical and emotional symptoms.
  • Magnesium. 360 mg can help ease breast soreness and bloating.
  • Vitamin E. 400 international units (IU) daily can help reduce prostaglandins in the body. Prostaglandins are known to cause pain.
  • Vitamin B-6. 50 to 100 mg daily can help ease fatigue, irritability, and insomnia.

Remember that supplements aren’t monitored for quality or purity by the FDA, so do your research on brands and choose wisely.

There’s little scientific research on the effectiveness of herbal remedies for PMDD or PMS. Still, some women claim they work. Some to try are:

Evening primrose oil. According to an article published in American Family Physician, EPO is the most-studied herb for PMS. However, research is still inconclusive. There appears to be some benefit. In studies, participants took 500 to 1,000 mg of EPO daily.

Chasteberry. Chasteberry is thought to reduce prolactin production and reduce breast pain.

St. John’s wort. Dubbed Mother Nature’s antidepressant, St. John’s wort may help anxiety, depression, and irritability. It may also ease some physical symptoms of PMDD. Check with your doctor for dosage information. To avoid drug interactions, report all medications and supplements.

Gingko. According to a 2010 study, taking 40 mg of gingko three times daily reduced PMS symptoms better than a placebo. This included bloating, fatigue, and insomnia. It’s thought gingko reduces prostaglandins in the body and increases the release of neurotransmitters in the brain.

In some cases, herbal remedies may interact with prescription medications or cause serious side effects. You should talk with your doctor or a qualified natural health practitioner before adding any herbal supplement to your routine. The sale of herbs isn’t monitored, and you may need help choosing quality products. Many herbs interact with medications or treatment.

Yoga is an ancient practice that uses deep breathing, meditation, and specific poses to warm the body and help ease pain and promote relaxation.

According to a 2016 study, yoga can improve menstrual pain and overall health. It also helped women become more aware of their physical and emotional distress, which may help them cope better.

You might find the following poses beneficial:

  • Bridge
  • Downward-Facing Dog
  • Butterfly

Exercise in general is good for you too. The more you move and stretch, the better.

Other exercises to try:

  • Pilates
  • walking
  • swimming

If possible, exercise outdoors to enjoy nature and get a powerful punch of mood-boosting vitamin D.

During an acupuncture session, thin needles are inserted into specific points on your skin to help relieve pain and reduce stress. According to a 2011 systematic review, acupuncture shows promise for treating PMS symptoms. More study is needed, but risks are low when conducted by a licensed acupuncturist.

The best acupuncture points for menstrual symptoms are:

  • two finger-widths below the naval to ease cramps and bloating
  • the bony area between the hips and buttocks to relieve pelvic pain and back pain
  • the fleshy area between the thumb and forefinger to relieve headaches and abdominal pain

It’s hard enough for people to function without sleep when they’re healthy. If you have PMDD and don’t sleep, it’s almost impossible to get through the day successfully. Chronic insomnia can lead to depression and anxiety. It also increases irritability and fatigue.

You should:

  • Go to bed the same time each night.
  • Don’t take long naps during the day.
  • Avoid caffeine and other stimulants for several hours before bedtime.
  • Only use your bedroom for sex and sleep.
  • Avoid TV and computer screens before bedtime.
  • Keep your bedroom a comfortably cool temperature.
  • Do something relaxing before bedtime such as reading or taking a warm bath.
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Over the years, doctors and psychologists have disagreed about whether PMDD is real. In the past few years, understanding of this condition has significantly improved. But for the women who have it, it’s not only real, it’s devastating. Though most premenopausal women experience some degree of PMS, it’s not typical to experience symptoms so severe that it impedes your day-to-day life.

Call your doctor if PMS symptoms are so severe they prevent you from performing your daily activities. You may have PMDD. Natural remedies may help, but you may also need a prescription antidepressant to help manage PMDD-related depression, anxiety, and other symptoms.