PMDD is triggered by the changes of normally fluctuating hormones in a woman’s body during the luteal phase of the menstrual cycle.  In most cases, it is the fluctuation of the hormones, not the levels of the hormones themselves, that trigger the symptoms of PMDD. The two hormones that the get the most attention for these the fluctuations are estrogen and progesterone.  Some doctors prescribe progesterone cream (over-the-counter and prescribed) for PMDD symptoms, but the clinical trials that we have do not show that progesterone creams are more effective than placebo (sugar pill)  for treating PMDD.  In fact, some women feel worse after using progesterone creams for PMDD.  Additionally, over-the-counter progesterone creams contain other ingredients that the body can react to and it is almost impossible to determine how much progesterone is in one “dose” since they are not well-regulated.  If you think your symptoms could be related to another hormonal or gynecological condition, talk to your doctor about laboratory tests and treatment options that might be appropriate for you.
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-Gioia Guerrieri, DO, February 25, 2019