PMS and PMDD treatments: what the evidence says

Treatments

What's in Midol, and does it help PMS?

Midol is an over-the-counter brand for period pain and bloating that combines a pain reliever with caffeine or an antihistamine, depending on the formula. It can ease cramps and water retention, but it contains no hormone or mood-acting ingredient, so it doesn't treat PMDD's mood symptoms or ordinary PMS mood changes.

Treatment

Vitex (chasteberry): what it is and whether it helps PMS

Vitex (chasteberry) is an herbal extract most consistently shown to help premenstrual breast tenderness; its effect on PMS mood symptoms is weaker and inconsistent across trials, and it hasn't been studied specifically in PMDD. There's no single proven dose, it's generally well tolerated, and a doctor's input matters if you take dopamine-related medication.

Treatment

Evening primrose oil: what it is and whether it helps PMS

Evening primrose oil is a seed oil supplement often tried for PMS, hot flashes and breast pain. The best-controlled PMS trials found it worked no better than placebo, though it's shown more promise for breast tenderness. No study has tested it in women with a confirmed PMDD diagnosis.

Treatment

Yaz birth control: what it is and whether it helps PMS

Yaz is a combination birth control pill with ethinyl estradiol and drospirenone that stops ovulation. It's approved for contraception, moderate acne, and PMDD in women who also want oral contraception, based on two placebo-controlled trials from the mid-2000s.

Treatments

PMDD treatment: what actually helps

First-line PMDD treatment is SSRIs, taken daily or only in the luteal phase, and CBT, both backed by the most consistent trial evidence. Some hormonal options help too, and Vitex agnus-castus has supporting evidence for premenstrual symptoms generally. No herbal or homeopathic remedy outperforms placebo for PMDD itself, and a doctor should guide any medication choice.

Treatment

PMS treatment: what actually helps

PMS treatment works best when it's matched to how severe your symptoms are: lifestyle changes and Vitex agnus-castus for mild symptoms, SSRIs or CBT for moderate to severe mood symptoms, and GnRH analogues for severe, treatment-resistant cases. Most options take two to three cycles to show an effect, and tracking daily symptoms is how you know if one is working.