Options for Managing Your PMDD Symptoms

Apr 27, 2020

Dr. Ashley Margeson

Dr. Ashley Margeson


PMDD, or premenstrual dysphoric disorder, is a very underreported diagnosis. It is a dramatic difference in mood, energy and quality of life triggered by a hormonal change in the body. It can be so dramatic that women have suicidal desires in the week before their period, they can lash our or get depressed, or they can become very anxious. And then, your period starts, and you feel fine. 

There has been some research delving into why PMDD occurs, and what can be done about it. There are a few anti-depressants that have been proven to be helpful when taken only during the second half (or luteal phase) of the cycle, and some natural supplements as well. My clinical practice has shown that, like many things related to women’s health, the best outcome usually involves using both options. 

And then, the research gets really interesting. See, PMDD has been linked to a specific enzyme that is responsible for both estrogen levels and serotonin metabolism. When estrogen is at a higher level in the body, this enzyme breaks down less serotonin, leaving more in the brain. When estrogen drops, like it does right around ovulation, and then stays at a lower level in the second half of the cycle, but then drops even further in the week before the period starts, serotonin gets broken down at a faster rate. 

This means we lose our buffering system.

The change in estrogen affects this specific enzyme’s ability to maintain serotonin levels in the brain. When those serotonin levels drop, we feel AWFUL. Some of us don’t feel the change that much. In fact, the majority of women don’t feel that change that dramatically. But in women with PMDD, it is extreme. 

So, if our hormones influence our brains buffering system… what can help? Amino Acids. The amino acids that are the building blocks for serotonin are one of the possible components of how we design our treatment plans. IV amino acids ensures that they don’t go towards repairing walls of your digestive system or other necessary (but not necessary right now) body tasks. Instead, we time our treatments, like possibly including IV Therapies, to your cycle. This helps to ensure that your brain gets an influx of the exact nutrients required to build serotonin at the time that your brain needs it the most. 

We then pair that with daily supports to support your hormonal cascade, so you don’t have to rely on the IVs as often. My goal is to get you to “nice to have”, not “need to have to survive”. 

*as with all our treatment plans, we customize everything to our patient’s individual needs to ensure that our plans reflect the conversations we have during our visits.*

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