PMDD: Understanding, Managing, and Alternative Approaches to Treatment

For many women, the days leading up to their period bring mild discomfort. But for those with Premenstrual Dysphoric Disorder (PMDD), these days can feel unbearable. Severe mood swings, depression, anxiety, and even suicidal thoughts can take over, making it feel like a completely different version of yourself appears every month.

At D9 Therapy, we work with clients who experience PMDD, helping them navigate the emotional and physical toll it takes. While traditional treatments like SSRIs and hormonal birth control can help, many people seek alternative approaches, including nutritional changes, holistic therapies, and even understanding the role of histamine in PMDD symptoms.

If you’re looking for ways to manage PMDD naturally, this blog explores evidence-based alternatives that might help.

The Link Between Histamine and PMDD

One lesser-known factor in PMDD is histamine intolerance. Histamine is a chemical involved in the immune system, digestion, and brain function. It plays a role in inflammation and neurotransmitter activity, including regulating estrogen levels.

Here’s why this matters:

🔹 Estrogen and Histamine Are Connected – Estrogen increases histamine levels, and histamine can, in turn, increase estrogen. This cycle can create mood instability, anxiety, and heightened PMDD symptoms.

🔹 PMDD Symptoms Overlap with Histamine Intolerance – Many women with PMDD also experience:
✔️ Migraines
✔️ Anxiety and panic attacks
✔️ Bloating, nausea, or digestive issues
✔️ Skin flushing or itching

Since histamine levels fluctuate with the menstrual cycle, some researchers believe histamine intolerance could worsen PMDD symptoms in sensitive individuals.

How to Reduce Histamine Levels Naturally

If histamine intolerance is contributing to your PMDD, these strategies may help:

🍎 Try a Low-Histamine Diet – Reduce aged cheeses, processed meats, alcohol, and fermented foods, which are high in histamine.
💊 Consider DAO Enzyme Supplements – DAO (diamine oxidase) is an enzyme that breaks down histamine in the gut. Some people with histamine intolerance have low DAO levels and may benefit from supplementation.
🫖 Drink Anti-Inflammatory Teas – Chamomile and ginger tea can help calm histamine reactions.
🥑 Balance Nutrients – Magnesium, vitamin B6, and vitamin C help regulate histamine levels.

Alternative and Holistic Approaches to Managing PMDD

If traditional treatments haven't worked for you, consider these alternative methods for managing PMDD:

1. Nutrition for Hormone Balance

What you eat directly impacts your hormones, neurotransmitters, and inflammation levels. A hormone-friendly diet can ease PMDD symptoms.

🍏 Reduce Sugar and Processed Foods – High sugar intake can worsen mood swings and fatigue.
🥑 Support Liver Health – Your liver processes excess estrogen, so eating foods like cruciferous vegetables (broccoli, kale, Brussels sprouts) can help clear excess hormones.
🥜 Increase Healthy Fats – Omega-3s (found in salmon, walnuts, and flaxseeds) reduce inflammation and support brain health.
☕ Limit Caffeine and Alcohol – Both can worsen anxiety, irritability, and sleep disturbances.

2. Herbal Remedies for PMDD

Certain herbs may help regulate hormones and ease PMDD symptoms:

🌿 Vitex (Chasteberry) – Helps balance progesterone and estrogen, which can reduce mood swings and breast tenderness.
🌿 Ashwagandha – Supports the stress response, reducing anxiety and irritability.
🌿 St. John’s Wort – Some studies suggest it can help with PMDD-related depression, but it can interact with medications, so consult your doctor.

3. Acupuncture & Traditional Chinese Medicine (TCM)

Acupuncture has been used to balance hormones, regulate mood, and reduce PMS symptoms. Many women report that regular acupuncture sessions reduce PMDD severity.

4. Exercise & Movement Therapy

Moving your body helps regulate hormones, improve mood, and reduce inflammation.

🏃‍♀️ Gentle Exercise: Walking, swimming, and yoga can reduce stress without overwhelming the body.
🧘‍♀️ Yoga & Breathwork: Poses that support the reproductive system (like child’s pose or legs-up-the-wall) calm the nervous system and relieve tension.
🥊 High-Intensity Workouts (in moderation): Some women find that intense exercise releases pent-up emotions and reduces PMDD rage.

5. Mindfulness & Cognitive Behavioral Therapy (CBT)

Since PMDD intensifies emotional responses, mindfulness techniques and therapy can help you regain control.

🧘 Mindfulness Meditation – Helps separate emotions from reality, reducing emotional spirals.
📝 Journaling – Writing down thoughts before and during PMDD episodes can help track triggers and patterns.
💬 CBT Therapy – Helps reframe negative thoughts and develop coping strategies.

Final Thoughts: Finding What Works for You

PMDD is a complex condition, and no single solution works for everyone. While medications like SSRIs and birth control help some, others find relief through nutrition, holistic therapies, and addressing underlying factors like histamine intolerance.

At D9 Therapy, we work with clients to find a personalized approach to managing PMDD. If you’re struggling with severe mood swings, anxiety, or depression related to your cycle, you’re not alone—and help is available.

💬 Ready to take control of your PMDD? Contact us today to book a session and start building a treatment plan that works for you.