Contraception Choices and PMDD: Finding What Works for Your Body
by Camilla Brinkworth, Naturopath, PMDD Specialist & Founder of PMDD Naturopath and Camilla Clare Holistic Health
Contraception is one of the most complex topics for women living with PMDD. Many come to me after years of trying different birth-control methods — pills, implants, intra-uterine devices — only to find that their emotional symptoms have worsened rather than improved.
It’s a deeply personal decision, but for women with PMDD, it’s also a clinical one. Our hormonal and neurotransmitter systems are already highly sensitive, so even small shifts in oestrogen or progesterone can have a dramatic impact on mood, energy, and stability. Understanding how different contraceptive methods influence these pathways is essential for making informed, compassionate choices about your body.
Hormonal Contraceptives and PMDD
Hormonal contraceptives — whether taken as pills, patches, injections, or implants — work by suppressing ovulation and altering the natural hormone cycle. For some women, this can bring short-term relief by flattening hormonal fluctuations. But for others, especially those with PMDD, these artificial hormones can worsen mood symptoms by disrupting the brain’s sensitivity to serotonin, GABA, and dopamine.
I often see clients who say, “I felt calm for a few weeks on the pill, and then everything unravelled — my anxiety, my sleep, my libido.”
This is because synthetic progestins (the lab-made versions of progesterone) do not act in the body the same way as natural progesterone. They often have a different neurological profile, binding to receptors that can cause irritability, anxiety, or depression.
Common experiences reported by women with PMDD on hormonal contraceptives include:
Emotional flatness or mood swings
Low libido
Fatigue or brain fog
Worsened premenstrual anxiety once the body adapts to the hormones
That said, some women do find temporary relief using continuous hormonal contraception (e.g., skipping the placebo week) because it suppresses ovulation and avoids the luteal phase entirely. The key is that responses are individual — and any decision should be made with awareness of the potential neurological effects.
Intra-Uterine Devices (IUDs): Copper vs Hormonal
There are two main types of IUDs — copper and hormonal (levonorgestrel-releasing) — and both come with their own considerations for women with PMDD.
Copper IUDs don’t contain hormones, which can be appealing for those wanting to avoid systemic effects. However, they can sometimes increase period pain or bleeding — an issue for women already prone to inflammation or fatigue during menstruation.
Hormonal IUDs release small amounts of progestin directly into the uterus. While marketed as “local,” systemic absorption still occurs. For some women with PMDD, this subtle but continuous hormonal exposure can trigger mood changes, irritability, or anxiety.
In my practice, I’ve seen mixed results. One client described her hormonal IUD as “liberating,” while another said it made her feel “numb and disconnected.” This variation reinforces the need for individualised care — what works beautifully for one woman may feel unbearable for another.
Natural Fertility Awareness Methods
For women who want to avoid synthetic hormones altogether, fertility awareness-based methods (FAM) can be an empowering alternative. These involve tracking cervical mucus, basal body temperature, and cycle length to identify fertile days.
While this approach requires diligence, it also offers something profoundly healing for women with PMDD: a renewed connection with their body’s rhythm.
Tracking your cycle can help you anticipate your luteal-phase sensitivity and plan accordingly — not just for fertility, but for self-care, work, and relationships. Many of my clients find this process deeply grounding once they understand their unique hormonal patterns.
For contraception, FAM can be combined with barrier methods such as condoms or diaphragms, providing both safety and autonomy without hormonal interference.
Why Some Birth Control Methods Worsen PMDD
The link between PMDD and contraceptives lies in the brain. PMDD is not caused by abnormal hormone levels, but by the brain’s altered response to normal hormonal fluctuations. When external hormones are introduced — especially synthetic ones — they can intensify this sensitivity by affecting:
GABA receptors, which influence calmness and anxiety.
Serotonin receptors, critical for emotional stability.
Dopamine pathways, affecting motivation and mood.
This is why some women feel dramatically worse on hormonal contraception: the brain’s delicate hormonal-neurotransmitter balance is disrupted further rather than stabilised.
Naturopathic Approaches for Cycle Regulation
If your goal is to regulate your cycle naturally, there are evidence-based naturopathic strategies that can make a real difference:
Nutritional support: magnesium, B6, and Ahiflower® omega-3s to reduce inflammation and stabilise mood.
Liver support: herbs like milk thistle, turmeric, and dandelion root to enhance hormone metabolism and clearance.
Adaptogens: herbs such as ashwagandha or rhodiola to support stress resilience and hormonal balance.
Stress regulation: gentle exercise, Yoga Nidra, and trauma-informed nervous system work to reduce HPA-axis overactivation.
When the body is well nourished and the nervous system regulated, hormonal fluctuations become less destabilising — and contraception decisions can be made from a place of clarity rather than desperation.
Final Thoughts
Choosing contraception with PMDD can feel overwhelming, but the most important thing is that it’s informed, individualised, and compassionate. There’s no one-size-fits-all answer — what matters is how your body and mind respond.
If you’re exploring contraception options and finding your symptoms worsening, it may be time to look deeper. At PMDD Naturopath, I support women to understand their cycles, balance hormones naturally, and address emotional and nervous system regulation so that hormonal changes no longer feel unbearable.
Author Bio
Camilla Brinkworth is a naturopath, nutritionist, and Family Constellations facilitator specialising in PMDD and women’s hormonal health. Having personally healed from PMDD, she now supports women worldwide through her clinics — PMDD Naturopath and Camilla Clare Holistic Health — combining natural medicine, trauma-informed care, and plant-based nutrition.