Accurately diagnosed PMDD should see significant improvement with cycle suppression with a GnRHa.

In trials, GnRH analogs appear to offer a significantly superior therapeutic effect compared with vitamin B6, progesterone, and progestogens. This effect appears comparable with that seen for SSRIs (selective serotonin reuptake inhibitors). Data demonstrated a clinical and significant beneficial effect over placebo.

While there is some evidence to suggest that side effects can be reduced by ‘add-back' therapy with no demonstrable effect on efficacy, further trials are needed.