PMS Type D

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Other names for PMS Type D

Depressive PMS
Low mood PMS
Estrogen-deficient PMS

Synopsis of PMS Type D

PMS Type D is defined by depressive symptoms in the luteal phase of the menstrual cycle, including sadness, hopelessness, withdrawal, forgetfulness, and sometimes tearfulness or suicidal ideation. This type is often linked to low estrogen levels and reduced serotonin activity. The symptoms can mimic major depressive disorder but differ in that they are cyclical and resolve shortly after menstruation begins. Type D may overlap with PMDD (Premenstrual Dysphoric Disorder) in more severe cases and is often the most emotionally challenging form of PMS.

Types:
This type may also present with cognitive fog, social isolation, low motivation, and reduced libido. Individuals may experience overlap with other PMS types (e.g., anxiety from Type A or cravings from Type C).

Common Causes:

  • Estrogen deficiency in the luteal phase

  • Reduced serotonin production or receptor sensitivity

  • Nutrient deficiencies, especially B vitamins, magnesium, and omega-3s

  • Thyroid imbalances or adrenal fatigue

  • High-stress lifestyle or poor sleep hygiene

Severity Causes:

  • History of mood disorders or postpartum depression

  • Rapid hormonal fluctuations during perimenopause

  • Chronic inflammation or oxidative stress

  • Unaddressed stress and trauma

  • Lack of exercise or exposure to natural light

When to See a Doctor:

  • Depressive symptoms that interfere with daily functioning

  • Feelings of hopelessness, worthlessness, or suicidal thoughts

  • Symptoms persisting outside the luteal phase

  • No response to natural or lifestyle interventions after several cycles

  • Coexisting anxiety, insomnia, or hormonal conditions

Natural remedies for PMS Type D

Omega-3 fatty acids: EPA and DHA help reduce inflammation and improve serotonin signaling, which can lift mood and reduce depression-related PMS symptoms.

Vitamin B6: Essential for the synthesis of neurotransmitters like serotonin and dopamine. Supplementing may reduce low mood, confusion, and mental fatigue.

Magnesium: Calms the nervous system and helps regulate serotonin. Often used with B6 to improve emotional stability and reduce irritability or sadness.

SAMe (S-adenosylmethionine): A compound naturally found in the body that supports mood regulation and methylation. Has shown benefits in managing PMS-related depressive symptoms.

St. John’s Wort: A traditional herb used to relieve mild to moderate depression. May help support mood and emotional well-being when taken cyclically, though it interacts with many medications.

Ashwagandha: An adaptogen that supports adrenal and thyroid balance, helps modulate cortisol, and reduces feelings of overwhelm or emotional crash.

Rhodiola: Enhances resilience to emotional and physical stress while supporting neurotransmitter activity, making it helpful for fatigue and depressive PMS patterns.

Light therapy: Daily exposure to bright light, especially in the morning, improves circadian rhythm and mood. Especially useful in fall/winter months or with coexisting seasonal affective disorder.