Treatments your clinician may suggest

• SSRIs/SNRIs (either continuous daily, or luteal-phase if your cycles are still predictable). These are first-line and have solid evidence for PMDD. Lippincott Journals+1

• Hormonal options if appropriate: combined hormonal contraception or (in select cases) transdermal estradiol with cyclic progestogen. Evidence exists but is mixed/low-quality Lippincott Journals+2PMC+2

Supplements with the best (still modest) evidence

(Check meds/allergies with your clinician first.)

• Magnesium (glycinate or citrate): 200–360 mg elemental/day. Mixed but promising data for mood/anxiety; gentle on sleep. Avoid if you have significant kidney disease. PMC+1

• Vitamin B6 (pyridoxine): if used, keep ≤50 mg/day and short-term unless supervised—higher chronic doses can cause neuropathy. Evidence is mixed; some find it helps irritability/cravings. NCBI+1

• Chasteberry (Vitex agnus-castus): some RCTs suggest benefit for PMS/PMDD; it can interact with hormonal meds. Talk to your clinician first. PubMed+2Women's Mental Health+2

Jess Sea's personal theories:

If you're interested in an article based on WHY I think these methods work, contact me. I'm willing to write one if the demand is there for it.

Magnesium Glycinate

B12 

Folate

DAO Enzymes

Camu Camu (vitamin c) 

Sour Sop Leaf

Black Seed Oil

Low inflammatory- low histamine diet

 Non-pill tools that help in perimenopause

Sleep routine: fixed wake time, dim wind-down, earlier caffeine cut-off or elimination if possible; perimenopause hot-flash nights benefit from a cooler room/fan. (Poor sleep amplifies mood changes.)

• Steady meals: aim for protein + complex carb each meal; keep snacks simple (yogurt + fruit, nuts). Avoid big sugar/alcohol spikes in the late luteal days.

• Gentle movement: even 10 minutes (walk, stretch, light strength) can nudge mood, help clear your head and ready your mind for sleep.

• Low-stim environment: warmer lamplight (yellow bulbs), fewer notifications, quieter spaces during “red” days. If social media is an anxiety trigger for you, avoid it. Replace the habit with reading, crafting etc.

Safety notes

• New/worsening depression outside the premenstrual window, or any suicidal thoughts → seek urgent help and share your safety plan.

• Supplements can interact with meds (e.g., Vitex with hormones). Run your full list by your clinician/pharmacist. Lippincott Journals