PMDD and Perimenopause
Navigating Hormonal Shifts Naturally
Experiencing PMDD during perimenopause can feel like stepping onto a moving tightrope. The familiar patterns of premenstrual emotional intensity, fatigue, and physical discomfort can intensify—or shift in unexpected ways—as the body transitions toward menopause. As someone who has lived with PMDD, and as a naturopath, trauma-informed emotional healing practitioner, and Family Constellations facilitator, I understand how isolating it can feel when your cycles change but the emotional and physical challenges remain.
While PMDD is often associated with the reproductive years, hormonal fluctuations during perimenopause can trigger similar or even heightened symptoms. Progesterone declines and estrogen swings can exacerbate mood swings, irritability, anxiety, insomnia, and energy fluctuations. Recognising this connection is the first step toward creating a plan that supports both your hormones and your nervous system.
Understanding the Hormonal Landscape
Perimenopause is marked by erratic cycles and changing hormone levels. For women with a history of PMDD, the body’s heightened sensitivity to hormonal shifts doesn’t disappear—it can be amplified. Even small fluctuations can trigger emotional dysregulation, tension, and physical discomfort.
One client, a woman in her mid-forties, reported that her premenstrual rage had always been intense. As she entered perimenopause, the episodes began lasting longer and included new symptoms like sudden fatigue and hot flashes. By approaching her care holistically—tracking her cycle, supporting her nervous system, and introducing targeted herbal medicine—she began to feel steadier and more in control of her emotional landscape.
Natural Strategies for Managing PMDD in Perimenopause
1. Cycle-Aware Nutrition
Nutrition remains a cornerstone of hormonal and nervous system support. Plant-rich proteins, magnesium-rich foods, and anti-inflammatory nutrients can stabilise mood swings and reduce physical discomfort. Incorporating foods like lentils, quinoa, leafy greens, nuts, and seeds helps regulate blood sugar and neurotransmitter balance, which are crucial for women navigating PMDD and perimenopause simultaneously.
2. Herbal and Nutritional Support
Certain herbal interventions can be particularly helpful during this transitional phase. Vitex (Chaste Tree Berry) can support progesterone balance, while adaptogens like Ashwagandha or Holy Basil help the body manage stress and stabilise mood. Magnesium and omega-3s remain essential for nervous system resilience, sleep quality, and inflammation reduction.
3. Mind-Body Practices
Gentle yoga, meditation, and breathwork are powerful tools for regulating the nervous system. In perimenopause, when sleep and emotional regulation can be disrupted, these practices help the body stay grounded. One client began a nightly practice of restorative yoga and guided meditation, which significantly reduced her luteal-phase anxiety and allowed her to sleep more consistently despite hormonal fluctuations.
4. Acupuncture and Energy-Based Therapies
Acupuncture can help harmonise the nervous system and support hormonal balance during perimenopause. Many women with PMDD find that combining acupuncture with gentle energy work or trauma-informed emotional healing helps them release premenstrual tension and navigate perimenopausal shifts with greater ease.
5. Emotional Self-Care
Hormonal shifts often trigger emotional sensitivity. Tools such as journaling, grounding exercises, and self-compassion practices can reduce the impact of mood swings. Accepting that perimenopause may change how PMDD presents allows women to respond with curiosity rather than self-criticism, which in itself is incredibly healing.
Navigating Change with Awareness
The transition into perimenopause is not about losing control—it’s about understanding new patterns and creating support systems that address your mind, body, and emotions. For women with PMDD, natural, integrative strategies that combine nutrition, herbal medicine, nervous system support, and trauma-informed care offer the most sustainable path toward stability.
As I often tell clients: hormonal shifts don’t have to mean emotional chaos. With awareness, gentle self-care, and personalised strategies, it’s possible to navigate this phase with greater balance, clarity, and ease.
Camilla Brinkworth is a naturopath, trauma-informed emotional healing practitioner, and Family Constellations facilitator specialising in PMDD. Through PMDD Naturopath and Camilla Clare Holistic Health, she supports women globally to navigate PMDD and perimenopause using integrative naturopathy, plant-rich nutrition, herbal medicine, nervous system regulation, and mind-body therapies.