---
title: What causes PMDD and what treatments are available? | Niyora
description: PMDD seems to come from the body's abnormal response to hormone and brain-chemical shifts, shaped by genes, stress, immune function and opioid pathways. Sever
url: https://niyora.com/research/papers/updated-insight-into-the-pathophysiology-of-premenstrual-dysphoric-disorder-and-2026/
---

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- What causes PMDD and what treatments are available?

Review, 2026

# What causes PMDD and what treatments are available?

PMDD seems to come from the body's abnormal response to hormone and brain-chemical shifts, shaped by genes, stress, immune function and opioid pathways. Several treatments exist, from SSRIs to surgery in severe cases, but this paper only summarises existing research, not a new trial.

 Early or limited evidence

Not a patient study. It is a review of existing published research on women with PMDD.

## What they did

This is a narrative review, meaning the authors read and summarised existing research on PMDD rather than running a new study on patients. It covers what is known about why PMDD happens, how it shows up, how common it is, and how it is currently treated.

## What they found

PMDD involves dysregulated hormones and neurotransmitters, with genetic, psychosocial, immune and opioid factors affecting how severe symptoms are. Symptoms include mood changes, sleep disturbance and disordered eating. Treatment options mentioned include SSRIs, hormonal therapies, GnRH agonists, selective progesterone receptor modulators (SPRMs), sepranolone (UC1010), and surgical menopause for severe cases. The authors note that research into genetics and how it interacts with hormones is still limited.

## What it means for you

This gives a big-picture view of current medical thinking on PMDD and the range of treatments doctors can consider, including options beyond daily medication. Because it is a review of other studies rather than a new trial, it does not add fresh evidence of its own, and some areas, especially genetics, are described as under-researched.

## About the study

Original title Updated insight into the pathophysiology of premenstrual dysphoric disorder and therapeutic approaches Authors Sultana J, Sharma AR, Soha ST et al. Journal Journal of affective disorders Year 2026 Study design Review What was tested No new treatment tested. The review discusses existing options: SSRIs, hormonal therapies, GnRH agonists, SPRMs, sepranolone, and surgery. Read the paper [doi.org/10.1016/j.jad.2026.121593](https://doi.org/10.1016/j.jad.2026.121593)

## Topics

[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Surgical menopause](https://niyora.com/research/topics/treatment-surgery/)

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

Study, 2026

What treatments work for PMDD?

Review, 2012

Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause?

Survey study, 2025

How do PMDD treatments affect sleep?

Case report, 2023

Can stopping ovulation help severe PMDD when other treatments do not work?

Lab study, 2020

Can researchers create an animal model that shows depression linked to the menstrual cycle?

Review, 2018

How should doctors diagnose and treat PMDD?

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