What are the treatment options for Premenstrual Dysphoric Disorder (PMDD)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 12, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the FDA Drug Label

It is also marketed for the treatment of premenstrual dysphoric disorder (Sarafem®, fluoxetine hydrochloride).

  • Treatment options for Premenstrual Dysphoric Disorder (PMDD) include fluoxetine (PO) 1.
  • The drug label mentions that fluoxetine is marketed for the treatment of PMDD, indicating its use as a treatment option.

From the Research

Premenstrual dysphoric disorder (PMDD) treatment typically begins with selective serotonin reuptake inhibitors (SSRIs) as first-line therapy, as they have been shown to be effective in reducing symptoms of PMDD, particularly when taken continuously 2. The most recent and highest quality study, a 2024 systematic review, found that SSRIs probably reduce overall self-rated premenstrual symptoms in women with PMS and PMDD, with moderate-certainty evidence 2. Some key points to consider when treating PMDD include:

  • SSRIs, such as fluoxetine, sertraline, or escitalopram, can be taken either continuously or during the luteal phase only (2 weeks before menses) 2
  • Hormonal treatments, including combined oral contraceptives containing drospirenone, can also be effective in reducing symptoms of PMDD 3, 4
  • Lifestyle modifications, such as regular exercise, stress management techniques, and a balanced diet, can accompany medication and provide additional symptom relief 3
  • Calcium and vitamin B6 supplements may also be beneficial in reducing symptoms of PMDD, although the evidence is not as strong as for SSRIs and hormonal treatments 5 It's worth noting that the 2024 study found that SSRIs were probably more effective when taken continuously compared to luteal phase administration, and that they probably increase the risk of adverse events, such as nausea, asthenia, and somnolence 2. Overall, the treatment of PMDD should be individualized and based on the severity of symptoms, medical history, and patient preferences, with a focus on reducing symptoms and improving quality of life 3, 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.