Jaclyn Cave
Naturopath, Sydney

Jaclyn Cave
Naturopath, Sydney

The Journal

How Naturopathy Can Support PMDD

May 28, 2026

If you’re someone who experiences significant, debilitating symptoms in the weeks leading up to your period, that can strain relationships, affect your work, and leave you feeling as though you’re “cleaning up the trail of destruction” once your period arrives, you may have something called Premenstrual Dysphoric Disorder (PMDD).

PMDD is a severe form of PMS and often misunderstood or dismissed. If you suspect PMDD, consider if the following symptoms are applicable to you:
  • A significant change in mood, including depression, anxiety, or feelings of hopelessness
  • Marked change in emotional regulation, anger or increased irritability
  • A lack of motivation or interest in things that usually interest you
  • Difficulty concentrating
  • Significant fatigue or a noticeable lack of energy
  • Changes in appetite, specific food cravings or overeating
  • Insomnia or changes in sleep patterns
  • Feeling overwhelmed or out of control
Jaclyn Cave, Naturopath
These symptoms occur in your luteal phase - second half of your cycle - and ease once you get your period, often described as a “Jekyll and Hyde” type shift.

The good news is that you’re not alone! The conversation around women’s health continues to grow, creating greater awareness and driving more research into this debilitating condition. Even better, naturopathic support can help by offering additional support and addressing underlying drivers.

How Naturopathy can help

Naturopathy can work brilliantly for PMDD, due to its holistic and individual approach, knowing not everyone will respond to the same treatment despite presenting with the same condition.

→ During a consultation, we may explore the following:

  • Is there a genetic predisposition?
  • Do you have a stressful life situation, or do you not manage your stress well? What can we implement to allow you to better navigate the effects of stress.
  • Is there systemic inflammation in the body? Do we need to address neuroinflammation?
  • How is your gut health? Do you have food sensitivities? Are you detoxing effectively? Is your immune system working optimally, or in overdrive?
  • Is histamine at play?
  • Is there chronic sleep disruption and a lack of melatonin secretion?
  • Is blood sugar balanced? Are there nutrient deficiencies such as B6, magnesium or calcium?
  • Are you going through a hormonal transition? Or Is there a hormonal imbalance at play?
  • How is your environment at home? Is there chronic mould exposure? A history of a brain injury?

To note: some individuals may be at an increased risk of developing PMDD, if there is a history of anxiety, depression, trauma, insomnia or neurodivergence. Research also shows that individuals with ADHD are significantly more likely to experience PMDD (areas that can be supported naturopathically).

Where to start?

Cycle tracking can help you gain some control over symptom predictability. Tracking your basal body temperature and using an app like Kindara can be an empowering tool. See our article on cycle charting to learn and we can go over your results in your consultation together.
Jaclyn Cave, Naturopath
Start moving your body daily and scheduling rest as a priority. Learn about the 7 types of rest and see what works for you.

Focus on adequate sleep and sleep hygiene, see our sleep article for guidance.

→ Additionally

  • Reduce or eliminate alcohol, smoking and other illicit drugs
  • Focus on a balanced diet with sufficient protein, carbohydrates and fats. Protein and carbohydrates are needed to increase tryptophan, which can help with serotonin, which can help with mood.

Bloodwork to consider

  • Peak luteal phase hormones: oestrogen, progesterone, prolactin
  • Day 2 or 3 of your bleed: FSH, LH, oestrogen, DHEA-S
  • Cholesterol panel
  • Fasting glucose and fasting insulin
  • Full thyroid panel, including antibodies
  • Inflammatory markers such as CRP and ESR
  • Liver function test, electrolyte panel
  • Full blood count
  • Iron studies
  • Vitamin D
  • Urinary iodine
  • Folate, vitamin B12, homocysteine, MTHFR, COMT SNPs
→ Additional testing to consider

  • Cortisol patterns throughout the day
  • Functional gut tests such as Microba

Nutrient considerations

  • Magnesium citrate or glycinate: Low levels are associated with PMS and magnesium can support an overactive nervous system response.
  • Calcium citrate: alterations in calcium are seen in PMDD and when oestrogen withdraws, calcium declines.
  • Vitamin B6: Supports GABA sensitivity and histamine clearance. B6 is a precursor for melatonin, serotonin and dopamine.
  • GABA: supports anxiety and promotes a relaxed nervous system response.
  • Zinc citrate or picolinate: Reduces neuroinflammation, supports brain-derived neurotrophic factor (BDNF), modulates GABA and is indicated for depression and mood imbalances.
  • Iodine: Relieves symptoms in those who have iodine deficiency, promotes healthy oestrogen metabolism and supports the thyroid.
  • NAC: is anti-inflammatory, immune modulating and promotes detoxification. Indicated for mood imbalances and other inflammatory conditions.
  • SAMe: reduces anxiety that is caused by high histamine.
  • Omega-3’s: anti-inflammatory and indicated for major depression.
  • Myo-inositol: involved in serotonin signalling and indicated for depression, anxiety and PMDD, improving outcomes associated with PMDD
  • Quercetin: supports our glymphatic system, influencing brain detoxification, immune function and neuroinflammation. Reduces histamine release which can alleviate PMDD symptoms.
  • Probiotics: supports the gut-brain axis and neural excitability, such as Lactobacillus spp. and Bifidobacterium spp.
Jaclyn Cave, Naturopath

Turmeric & NAC - two excellent anti-inflammatory mood supportive compounds

Herbal medicine to support PMDD:

  • Saffron: Helps to regulate our HPA axis and the expression of BDNF, reduces glutamate and modulates inflammation. Has a positive effect on anxiety and depression
  • St Johns wort: Traditionally used for depression and anxiety as it supports dopamine, serotonin and GABA
  • Curcumin: Modulates inflammation and supports neurotransmitter sensitivity.
  • Our adaptogenic herbs, as well as nervines and anxiolytic herbs support the cortisol response which can be a big driver behind PMDD

PMDD can feel isolating, overwhelming, and exhausting when you’re trying to navigate it on your own. Many people with PMS and PMDD describe feeling like a completely different person before their period, and struggling through it every month is something you shouldn’t have to simply put up with.

The good news is that support is available - with the right approach, a holistic health care team, and a listening ear, many people experience meaningful improvements in both their symptoms and quality of life. Through personalised naturopathic care, we work together to support your hormones and help you to feel calmer, minimise adverse symptoms, and get you back to feeling like yourself.

If you would like personalised guidance on your hormonal and cycle health, discovery calls and consultations with our practitioners can be booked here.

Author

Jacqueline Lovett
BHSc (Nat)

References:

Mishra, S., Elliott, H. and Marwaha, R. (2025) StatPearls.
Eisenlohr-Moul, T.A. (2019) Clinical Psychology, 72(1), pp. 5–17.
Osborn, E. et al. (2020) BMC Women’s Health, 20, 242.
Nappi, R.E. et al. (2022) Endocrines, 3(1), pp. 127–138./
Bixo, M., Stiernman, L. and Bäckström, T. (2025) British Journal of Psychiatry.
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