---
title: What causes PMDD and which treatments actually help? | Niyora
description: This review explains that PMDD likely comes from an unusual brain response to normal hormone changes, involving serotonin and a brain receptor called GABA-A,
url: https://niyora.com/research/papers/premenstrual-dysphoric-disorder-2019/
---

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- What causes PMDD and which treatments actually help?

Review, 2019

# What causes PMDD and which treatments actually help?

This review explains that PMDD likely comes from an unusual brain response to normal hormone changes, involving serotonin and a brain receptor called GABA-A, and it says serotonin reuptake inhibitors (SSRIs) are the first choice of treatment, with other options available if those do not work.

 Early or limited evidence

Not a specific group of women; this is a review focused on women with PMDD in general.

## What they did

The authors wrote a review summarising current understanding of what causes PMDD and what treatments are used, based on existing research rather than a new trial of their own.

## What they found

Women with PMDD seem to respond differently to normal hormone fluctuations than other women. This may involve the serotonin system, changes in how sensitive the GABA-A receptor is to a hormone-related substance called allopregnanolone, and differences in brain circuits involved in emotion and thinking. SSRIs are described as the first-line treatment. Second-line options mentioned include birth control pills containing drospirenone, other methods that stop ovulation, calcium, chasteberry, and cognitive-behavioural therapy (CBT).

## What it means for you

For someone with PMDD, this suggests SSRIs are usually tried first, and if they do not help enough, there are several other options worth discussing with a doctor, including certain birth control pills, calcium, chasteberry, or CBT. The main limit is that this is a review piece, not a clinical trial, so it does not give specific success rates or numbers for how well each treatment works.

## About the study

Original title Premenstrual Dysphoric Disorder Authors Lanza di Scalea T, Pearlstein T Journal The Medical clinics of North America Year 2019 Study design Review What was tested SSRIs first-line; drospirenone pills, ovulation suppression, calcium, chasteberry, CBT second-line. Read the paper [doi.org/10.1016/j.mcna.2019.02.007](https://doi.org/10.1016/j.mcna.2019.02.007)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Cognition, concentration and memory](https://niyora.com/research/topics/symptom-cognition/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Cognitive behavioral therapy](https://niyora.com/research/topics/treatment-cbt/)[Calcium](https://niyora.com/research/topics/treatment-calcium/)[Vitex agnus-castus (chasteberry)](https://niyora.com/research/topics/treatment-vitex/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

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Review, 2015

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Review, 2016

How common are PMS and PMDD, and what are the best treatments?

Review, 2024

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Review, 2011

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