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Does the Pill Work as a PMDD Treatment?

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Updated May 13, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Does the Pill Work as a PMDD Treatment?

First, it's important to know that premenstrual syndrome (PMS) refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle.

Premenstrual dysphoric disorder (PMDD), a severe form of PMS, is a condition that adversely affects the psychological well-being and social interactions of some 3-5% of women of reproductive age. Hormonal birth control methods, including extended cycle pills, have been shown to offer some relief and may work as either PMS or PMDD treatment.

Answer:

Hormonal contraception (like the Pill) tends to be a very popular contraceptive choice for many women, yet women may be using this type of birth control and not even be aware of its noncontraceptive benefits. Various hormonal contraceptives have shown some ability to diminish PMDD symptoms as well as provide some PMS relief. Please keep in mind that women may react differently to certain contraceptive methods, so this information is intended to be a general overview. Also, it is important to point out that the chief reason to use hormonal birth control is for contraception (to prevent an unintended pregnancy) -- possible noncontraceptive benefits of birth control can be considered when determining which hormonal method to ultimately use.

The following is a list of various prescription birth control methods that have been shown to be effective as PMS and PMDD treatments:

  • Certain combination birth control pills can offer some relief for PMDD symptoms. In randomized controlled trials, the only combination pills that have shown improvement in PMDD symptoms are pills that consisted of a combination of ethinyl estradiol and drospirenone (like Yaz, Ocella, and Beyaz). These pills have been shown to offer relief from both physical and psychological PMDD symptoms with improvement in health-related quality of life. For women who choose the Pill for contraception, Yaz is the only birth control FDA-approved to treat PMDD.

  • Combination pills consisting of ethinyl estradiol and drospirenone have also been shown to decrease premenstrual mood deterioration in reproductive-aged women receiving treatment for depression.


  • Because extended cycle pills can reduce your number of periods to 4 times a year (Seasonique) or suppress menstruation altogether (Lybrel), these pills may offer some PMS relief. Women on cyclic hormonal contraception (21 day active pills/7 day placebo) may experience premenstrual symptoms as well as distressing symptoms (including pelvic pain, headaches, breast tenderness, and bloating) during the hormone-free interval. Extending the usual 21-day cycle of contraceptive pills was shown to reduce pelvic pain and headaches while improving overall mood.


  • Extended use of the contraceptive patch and the contraceptive ring affords similar benefits (because you are reducing monthly periods). Such regimens are one way to avoid menstrual-related symptoms.

Sources:

Coffee AL, Kuehl TJ, Willis S, Sulak PJ. "Oral contraceptives and premenstrual symptoms: Comparison of a 21/7 and extended regimen." AJOG 2006;156:1311–9. Accessed via private subscription.

Joffe H, Cohen LS, Harlow BL. "Impact of oral contraceptive pill use on premenstrual mood: Predictors of improvement and deterioration." Am J Obstet Gynecol 2003;189:1523–30. Accessed via private subscription.

Joffe H, Petrillo LF, Viguera AC, Gottshcall H, Soares CN, Hall JE, et al. "Treatment of premenstrual worsening of depression with adjunctive oral contraceptive pills: A preliminary report." J Clin Psychiatry 2007;68:1954–62. Accessed via private subscription.

Pearlstein TB, Bachmann GA, Zacur HA, Yonkers KA. "Treatment of premenstrual dysphoric disorder with a new drospirenone-containing oral contraceptive formulation." Contraception 2005;72:414–21. Accessed via private subscription.

Yonkers KA, Brown C, Pearlstein TB, Foegh M, Sampson-Landers C, Rapkin A. "Efficacy of a new low dose oral contraceptive with drospirenone in premenstrual dysphoric disorder." Obstet Gynecol 2005;106:492–501. Accessed via private subscription.

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