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PMDD – Premenstrual Dysphoric Disorder

October 20, 2020

Our Naturopath and Acupuncturist, Genya Fleischer, has written the following blog on PMDD, including symptoms, Natural management strategies and a delicious recipe. Enjoy!

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that includes physical and  emotional symptoms that usually  start 7-10 days before menstruation and resolve with the onset of menstruation. PMDD causes extreme mood shifts that can disrupt work and damage relationships.  

 Physical symptoms of PMDD:

  • acne
  • bloating, constipation, diarrhoea, nausea, vomiting (can be one or all the above)
  • poor libido
  • breast  engorgement
  • cramps
  •  muscular/joint pain
  • headache
  • heart palpitations
  • appetite changes
  • painful periods
  • back pain
  • change of appetite 

Emotional symptoms of PMDD :

  • agitation, nervousness, irritability, hopelessness
  • crying
  • anger
  • forgetfulness
  • loss of control
  • apathy
  • mood swings
  • depression, sadness
  • insomnia
  • panic attacks
  • suicidal thoughts, self-harm

Generally, PMDD  is considered if you experience at least five of these  symptoms starting seven to ten days before your period.

 The cause for PMDD

The reasons for PMDD are not clear, but it is likely to be a response to the hormonal changes ( oestrogen , progesterone ) which take place during  the cycle.  This can affect the level of serotonin, a neurotransmitter that stabilises mood.


There’s no single treatment for PMDD. You may need to modify one or more of the suggested points as well as consider medical treatment.

  1. Add fish oil to your diet (omega-3)  

Research shows that adding omega-3 fatty acids to your diet reduces the following symptoms: Depression, Nervousness, bloating, headaches, sore breasts.

It is suggested to eat lots of wild salmon and to take Omega 3 supplement (or krill oil)

2. Ensure regular bowel motions

Regular bowel  motions (1-3 times daily) help to eliminate excess oestrogen which is one of the main reasons for PMDD.

The best ways to enhance elimination is by

  Magnesium is taken for mood and physical symptoms of PMS and PMDD

  • having more vegies/fruit/nuts/seeds
  • taking magnesium supplement
  • adding probiotics to your food intake (supplements, fermented vegies, fermented milk)
  • drink more fluid
  • have apple cider vinegar before each meal

3. Take B complex and Magnesium supplement It was shown that B vitamins (specifically B6, B1 and B2) reduce the symptoms of PMDD.

It was  found that women who experienced PMS had a lower magnesium concentration in their red blood cells than women who did not experience PMDD.

4. Meditation and Relaxation

Practicing meditation on a regular basis was found to change the structure of the brain and help reduce stress, anger, depression and anxiety.

 There’s evidence that a mindfulness practice reduces PMS symptoms.[

5. Regular EXERCISE  

Getting out and getting moving will increase your circulation, elevate your mood, and help you sweat out some of that bloat .

This doesn’t have to be an intense workout in a gym. Taking a quick 30-minute walk around your neighbourhood everyday can help to boost your mood.

6. Eating  TO STABILISE your mood.

Eating the right foods is critical to managing PMS. It’s unclear how diet impacts PMDD, but eating healthy may help minimize uncomfortable symptoms that make you feel worse.

For example, salty foods increase bloating. Foods high in sugar may cause drastic blood sugar fluctuations, which may worsen fatigue and mood swings. Meat and high-fat foods increase prostaglandin levels, which could increase the severity of menstrual cramps.

  • Eat small, frequent meals to  REDUCE bloating and stomach upset.
  • Eat plenty of fruits and vegetables.
  • Choose complex carbs such as whole grains over processed carbs.
  • Avoid salt and salty snacks.
  • Avoid caffeine.
  • Avoid alcohol.
  • Eat high-protein foods to help increase tryptophan levels.


Teriyaki Salmon with Broccoli Sesame Noodles

A garlicky teriyaki salmon on a bed of sesame broccoli soba noodles

Servings: 2


Salmon Marinade

  • 2 Tablespoon Soy sauce
  • 1 Tablespoon Oyster sauce
  • 1 Teaspoon Sesame oil
  • 2 Teaspoon Honey
  • 4 Cloves Garlic  crushed

Teriyaki Salmon Soba

  • 200 Grams Soba Noodles
  • 1 Small head Broccoli Cut into florets
  • Sesame seeds For garnish
  • 2 Fillets Salmon

Sesame Sauce

  • 2 Tablespoons Tahini
  • 1 Tablespoon Ponzu
  • 1 Tablespoon White miso
  • 1 Teaspoon Rice Vinegar
  • 1 Teaspoon Mirin
  • 1/2 Tablespoon Sesame oil
  • 1/2 Tablespoon Vegetable oil
  • 3 Tablespoons Sake


  • Mix all ingredients for salmon marinade.
  • Place salmon in shallow bowl and pour in marinade. Let marinate for at least 20 minutes
  • Preheat oven to  180 c
  • Meanwhile, bring water to boil in a medium pot
  • When water boils, put in soba noodles and broccoli and cook for 4-5 minutes.
  • While noodles cook, put all ingredients for sesame sauce in a bowl and whisk.
  • Thoroughly drain noodles and broccoli and rinse with cold water.
  • Pour in sesame sauce into soba noodles and mix.
  • Transfer marinated salmon to baking sheet (line with foil for less mess). Bake in preheated oven for 10 minutes. (See note #1)
  • Serve salmon on top of soba noodles and sprinkle with sesame seeds.


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