While the exact cause of PMDD is unknown, medical researchers have linked its cause to ovulation, simply because the symptoms are absent when a woman is pregnant. To back this up, researchers have found that hormone levels differ in women with PMDD. In addition, these women often have lower levels of the neurochemical serotonin than women who do not have PMDD.

One of the most important treatments for PMDD, then, has been to prescribe selective serotonin reuptake inhibitors, commonly known as SSRIs. The better-known SSRIs include such popular brand names as Prozac^®, Zoloft^®, Paxil^®, Celexa^®, and Luvox^®. SSRIs have been successful in treating the depression of many sufferers and have relatively few side effects.

 

In fact, the medication found in Prozac has been used in the creation of the new medication Sarafem^®, by Lilly. While the drug Sarafem is just Prozac with a new name, the idea behind marketing the drug under a different name is so that women will associate the name with treatment of PMDD and PMS, not depression.

 

Women and their physicians who have embraced Zoloft, Paxil and other SSRIs for the treatment of PMDD are aware that the low doses required for treatment reduce the likelihood of unacceptable side effects. The drawback: over time the SSRIs appear to lose their effectiveness.

Since ovulation appears to be the trigger for PMDD, the cessation of ovulation is clearly warranted for extreme cases. A medical method for causing the cessation of ovulation is the use of gonadotropin-releasing hormone agonists (GnRH agonists). The problem with GnRH agonists, however, is that many women find the side effects unacceptable. They include weight gain, increased facial hair, and acne, among others. Worse yet, the cost of this medication is very high—almost $500 a month.

 

A second method for stopping ovulation is with hormonal treatments. For example, scientists are studying the use of progestin and estradiol. Results are not available, though, and these approaches have not yet been deemed safe and effective for PMDD.

 

A third strategy for ending ovulation prior to menopause is the surgical removal of the ovaries. Needless to say, this is a drastic and invasive approach that is reserved for extreme cases. The effects of such surgery are similar to the onset of menopause: increased risk of osteoporosis and loss of libido are among the disadvantages.

Because a lower dose of medications than have been used to treat depression appear effective in treating PMDD in some women, herbal alternatives, such as St. John's Wort, are occasionally used as a 'natural' alternative. Medical literature often lumps together methods for treating PMS and PMDD so the medical evidence for these alternatives is unavailable.

 

While diet and exercise are not conclusively proven remedies for PMDD, common sense tells us that any boost to a woman's health is likely to help her fight off symptoms of any depressive or mood disorder. Furthermore, relaxation techniques are often used to augment any other treatment. Any method that is helpful in combating depression is a good candidate for helping to relieve the more extreme premenstrual symptoms. Relaxation techniques, including meditation, yoga and self-hypnosis, continue to be popular alternatives or complements to antidepressant medication.