Women’s Health | IVANA MD | Missouri City, TX
If you dread the week before your period because of mood swings, bloating, fatigue, or emotional overwhelm, you are not alone and you are not overreacting. Premenstrual syndrome and premenstrual dysphoric disorder are real, recognized medical conditions that affect millions of women every month, and both are manageable with the right support.
What Is PMS?
Premenstrual syndrome, commonly known as PMS, refers to a collection of physical and emotional symptoms that appear in the one to two weeks before menstruation and typically resolve once your period begins. Symptoms can range from mild to disruptive and affect up to 75 percent of menstruating women according to the American College of Obstetricians and Gynecologists.
Common PMS symptoms include:
- Bloating and water retention
- Breast tenderness
- Headaches
- Fatigue and low energy
- Irritability and mood swings
- Food cravings
- Difficulty concentrating
- Sleep disturbances
What Is PMDD?
Premenstrual dysphoric disorder, or PMDD, is a severe form of PMS that goes beyond typical discomfort. PMDD is a clinically recognized condition listed in the Diagnostic and Statistical Manual of Mental Disorders and is characterized by intense emotional and psychological symptoms that significantly interfere with daily life, relationships, and work. It affects approximately 3 to 8 percent of menstruating women according to research published in the American Journal of Psychiatry.
Symptoms of PMDD include:
- Severe depression or feelings of hopelessness
- Intense anxiety or panic attacks
- Extreme mood swings or anger
- Feeling out of control
- Severe fatigue
- Difficulty functioning at work or in relationships
- Physical symptoms similar to PMS but more intense
What Causes PMS and PMDD?
Both conditions are linked to hormonal fluctuations during the luteal phase of the menstrual cycle, specifically the drop in estrogen and progesterone that occurs before menstruation. Research suggests that women with PMDD may have an abnormal sensitivity to these hormonal changes rather than abnormal hormone levels themselves. A landmark study published in the Proceedings of the National Academy of Sciences found that women with PMDD have an altered expression of a gene complex called ESPR1 that makes their cells more sensitive to estrogen and progesterone, essentially creating a biological vulnerability to hormonal shifts.
How to Manage PMS and PMDD Naturally
Diet and Nutrition
What you eat has a measurable impact on hormonal symptoms. Research published in the American Journal of Clinical Nutrition found that women with higher intakes of calcium and vitamin D had significantly lower rates of PMS. Focus on:
- Increasing calcium-rich foods like dairy, leafy greens, and fortified foods
- Eating complex carbohydrates to stabilize blood sugar and mood
- Reducing salt, caffeine, sugar, and alcohol in the week before your period
- Adding magnesium-rich foods like nuts, seeds, and dark chocolate to reduce bloating and mood symptoms
Exercise
Regular aerobic exercise is one of the most well-supported natural interventions for PMS and PMDD. A study in the Journal of Psychosomatic Obstetrics and Gynecology found that women who exercised regularly reported significantly fewer and less severe premenstrual symptoms. Aim for at least 30 minutes of moderate activity most days of the week.
Stress Management
Chronic stress worsens hormonal imbalances and amplifies PMS and PMDD symptoms. Practices that have shown benefit include:
- Yoga and mindfulness meditation
- Deep breathing exercises
- Journaling
- Consistent sleep schedules of seven to nine hours per night
Supplements with Scientific Support
Several supplements have clinical evidence supporting their use for PMS and PMDD, including:
- Calcium 1200mg daily, shown in multiple studies to reduce mood and physical symptoms
- Magnesium glycinate, which helps reduce bloating, anxiety, and headaches
- Vitamin B6, which supports serotonin production and has been shown to improve mood-related symptoms
- Chasteberry, also known as Vitex agnus-castus, which a review in the Journal of Women’s Health found to significantly reduce both PMS and PMDD symptoms
Medical Treatment Options
For women whose symptoms are severe or do not respond to lifestyle changes, medical treatments are available and effective. These include:
- Antidepressants called SSRIs, which are considered the first-line medical treatment for PMDD and have been shown in multiple clinical trials to significantly reduce emotional symptoms even when taken only during the luteal phase
- Hormonal contraceptives, particularly the pill containing drospirenone and ethinyl estradiol, which is FDA-approved specifically for PMDD
- GnRH agonists for severe cases that do not respond to other treatments
- Cognitive behavioral therapy, which research has shown to be as effective as medication for managing PMDD symptoms long term
When to See a Doctor
You should speak with a women’s health provider if your premenstrual symptoms are severe enough to affect your relationships, work, or daily functioning, if you feel depressed or anxious in the weeks before your period, if natural remedies have not provided enough relief, or if you are unsure whether what you are experiencing is PMS or PMDD. A proper diagnosis makes all the difference in getting the right treatment.
You do not have to white-knuckle your way through every cycle. Effective help is available.
📍 Schedule your women’s health appointment with IVANA MD in Missouri City, TX.
📞 346-585-4077.
4220 Cartwright Road, Suite 201, Missouri City, Texas 77459.
References
American College of Obstetricians and Gynecologists. (2021). Premenstrual Syndrome (PMS). ACOG Patient Education FAQs. https://www.acog.org/womens-health/faqs/premenstrual-syndrome
Epperson, C. N., Steiner, M., Hartlage, S. A., et al. (2012). Premenstrual dysphoric disorder: evidence for a new category for DSM-5. American Journal of Psychiatry, 169(5), 465–475. https://pubmed.ncbi.nlm.nih.gov/22764360/
Loch, E. G., Selle, H., & Boblitz, N. (2000). Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. Journal of Women’s Health & Gender-Based Medicine, 9(4), 355-361. https://journals.sagepub.com/doi/abs/10.1089/152460900318515
Nevatte, T., O’Brien, P. M. S., Bäckström, T., et al. (2013). ISPMD consensus on the management of premenstrual disorders with PMDD as a distinct entity. Archives of Women’s Mental Health, 16(4), 279–291. https://pubmed.ncbi.nlm.nih.gov/23624686/
Thys-Jacobs, S., Starkey, P., Bernstein, D., et al. (1998). Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. American Journal of Obstetrics and Gynecology, 179(2), 444–452. https://pubmed.ncbi.nlm.nih.gov/9731851/







