PMDD worsening in perimenopause: what to do when symptoms intensify

Premenstrual dysphoric disorder often gets worse before improving in perimenopause. SSRIs, ovulation suppression, and HRT have different best-fit profiles.

1 min readReviewed May 2026

By Sarah Editor, MA Journalism, Certified Menopause Coach · Medically reviewed by Jane Smith, MD, MD, NAMS-certified · menopause nams

LicensedCA +2 moreVerify credentials →

Last medically reviewed: 5/15/2026 · Last updated: 5/15/2026 · Next review due: May 2027

Disclosure: Jane Smith, MD declares no financial relationship with the telehealth providers featured in this content.

Affiliate link Advertiser Disclosure: This site is reader-supported. We may earn an affiliate commission when you sign up for a service through links on our site. This does not influence our editorial recommendations or medical reviews. Read our full disclosure.

Premenstrual dysphoric disorder often gets worse before improving in perimenopause. SSRIs, ovulation suppression, and HRT have different best-fit profiles.

How we work — three pages, three answers