Menstrual Cycles and Emotions
March 5, 2025
Is this a "Cure" for PMDD?
Today, I want to talk about PMDD: Premenstrual Dysphoric Disorder.
Many of us may be familiar with the term PMS (Premenstrual Syndrome). Here's how I describe that for a teen audience in my Cycle Charting for Girls book:
Premenstrual syndrome (PMS) is kind of a fancy way doctors refer to the common symptoms women experience at the end of our luteal phase and the first fews days of our period. We have already seen that our energy levels, dietary needs, and emotions can be impacted by shifting hormones, so it should be no surprise that many women experience different sorts of food cravings, fatigue, or mood changes as our period approaches. Along with these symptoms we may also feel breast tenderness, bloating, acne, headaches, or a number of other issues. As someone who is equipped to chart her cycles, you can make note of these symptoms and observe when they happen relative to the start of your period and how long they last after your period has started. For many of us, PMS symptoms are fairly manageable with a little bit of intentional rest, nutrition, and self-care.
PMS can occur in a sort of mild way—as the natural result of our shifting hormones after ovulation. Or it can be moderately disruptive, which is a sign that some adjustments could possibly be made to our diet, supplements, etc. and yield some healthy improvement.
But when ANY of these symptoms cross that line to being severe—anything that produces major disruptions in our ability to function— that's when we start looking at a "PMDD" possible diagnosis.
I've written before about the need for better mental health education and support for women throughout their cycles, as well as the complicated relationship between oxytocin (the "bonding" hormone) and our ovarian hormones. Most speculation about PMDD revolves around the effective blocking of serotonin and other neurotransmitters (and I'll call it "speculation" because the medical community agrees that they really don't know the cause), which means that most women who experience PMDD are prescribed SSRIs (selective serotonin reuptake inhibitors).
But a new TikTok trend is positing that the biggest culprit in PMDD is not necessarily our neurotransmitters: it could be histamine.
Histamine is a part of our immune system. It's a hormone released by mast cells in response to infection or allergens.
Dr. Lara Briden writes in her Period Repair Manual:
Histamine intolerance is often worse just before the period because estrogen increases histamine and vice versa. Progesterone, on the other hand, decreases histamine, which is one way that progesterone relieves PMS.
In other words, she posits that women who experience severe PMS have a hormonal imbalance, whereby post-ovulatory estrogen levels are HIGH relative to progesterone. Without the calming benefits of progesterone, estrogen reinforces the production of histamine which then increases estrogen.
So what should we do? Dr. Briden really likes progesterone therapies.
But getting a doctor who is willing to prescribe progesterone is not always within reach for women– so instead, social media has come up with a more "downstream" approach: blocking histamines.
Women all over the internet have been taking Pepcid AC—a heartburn treatment that works by blocking histamines and stomach acids—and touting life-changing results.
Here's a video from Dr. Rubin (an allergist I like to follow!) responding to one of the more viral video examples:
This basically sums up what every doctor will say at this point:
Could it help? Maybe. We don't know. We haven't studied it. But could it hurt? Signs also point to "no." Because taking Pepcid AC or another H2 inhibitor is relatively harmless.
I'd love to hear your thoughts about whether you've tried this. And if you have a loved one suffering from PMDD, perhaps you can share if they are looking for ideas.
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