What PMS and PMDD Actually Are
- PMS: Occurs during the luteal phase (after ovulation, before your period). Common symptoms include irritability, mood swings, headaches, cramps, and breast tenderness.
- PMDD: A more severe form of PMS with debilitating mood symptoms that impair daily functioning.
- Important: PMS should not be normalized — symptoms almost always indicate an underlying imbalance.
Root Causes of PMS & PMDD
- Blood sugar instability (increased insulin resistance during the luteal phase)
- Inflammation
- Hormonal imbalances (estrogen, progesterone, LH, FSH)
- Poor-quality or absent ovulation
- Gut and detox pathway dysfunction
- Chronic stress and elevated cortisol
How to Eat During the Luteal Phase
- Your body needs more calories, rest, and nutrients after ovulation
- Aim for a 1:1 ratio of protein to carbohydrates
- Increase carbohydrates, but choose high-quality sources:
- Seed breads
- Protein pastas
- Brown rice and wild rice
- Always pair carbohydrates with protein
- Avoid large amounts of sugar, which fuel inflammation and worsen mood symptoms
Anti-Inflammatory Foods That Reduce PMS Symptoms
Omega-3–rich foods:
- Fish (2–3x/week)
- Chia seeds
- Flax seeds
Leafy greens for antioxidants:
- Kale
- Arugula
- Spinach
Turmeric for inflammation reduction (cook with it or add to drinks)
Why Blood Sugar Matters for Mood
- Blood sugar spikes increase inflammation
- Inflammation disrupts neurotransmitters in the brain
- This worsens irritability, anxiety, and depression in the luteal phase
- Tip: Continuous glucose monitoring can be helpful during this phase
Hormone Testing for PMS & PMDD
- Test hormones during the luteal phase (typically ~7 days after ovulation)
- Key hormones to check: estrogen, progesterone, LH, FSH
- Consider testing on your worst symptom day if symptoms spike before your period
- Mapping hormone patterns helps identify crashes, imbalances, and estrogen dominance
Common Hormone Imbalances Linked to PMS
- Low progesterone
- High estrogen (estrogen dominance)
- Rapid estrogen drops before menstruation
- Anovulation (periods without ovulation)
Supplements for PMS & PMDD (Based on Labs)
- Vitex (chasteberry): supports hormone production
- Omega-3s: ~1,000 mg daily if not eating enough fish
- Magnesium: supports mood and muscle relaxation
- L-theanine and GABA: for mood and anxiety support (taken at night)
- Adaptogens: Ashwagandha, Rhodiola (stress-related PMS)
- DIM or calcium d-glucarate: for estrogen metabolism (only if estrogen is high)
Note: Supplements should be chosen based on your specific hormone profile. Do not take estrogen-lowering supplements if estrogen is already low.
Medical Treatment Options (When Needed)
- Bioidentical progesterone during the luteal phase for low progesterone
- Bioidentical estradiol for estrogen crashes or severe luteal symptoms
- “Bridge dosing” to prevent sudden hormone drops before your period
- SSRIs/SNRIs (e.g., sertraline/Zoloft) as needed during the luteal phase
Lifestyle Factors That Matter
- Adequate calories and protein to support hormone production
- Exercise to help metabolize hormones (higher intensity okay if well-fueled)
- Daily bowel movements to support estrogen detoxification
- Stress reduction to lower cortisol and improve mood regulation
Real Patient Case Highlight
A patient with severe rage and PMS symptoms was found to be:
- Not ovulating
- Estrogen dominant
- Insulin resistant
After blood sugar regulation, cyclic progesterone, and nutrition changes, she resumed ovulation, normalized her luteal phase, and felt like herself again.
Key Takeaways
- PMS and PMDD are not normal and should not be dismissed
- Luteal-phase symptoms are signals of deeper hormonal, metabolic, or inflammatory issues
- Targeted nutrition, hormone testing, supplements, and medical therapy can dramatically improve symptoms
- Feeling amazing every day is possible with the right support
Next Steps
If you experience PMS, PMDD, migraines, mood swings, or luteal-phase discomfort, schedule a consultation with Dr. Sarah and her team. They provide a root-cause, personalized approach to hormone health.