Understanding PMDD: Insights from Sarah Vickers
We've asked Sarah Vickers all about Premenstrual Dysphoric Disorder (PMDD). Sarah is a a holistic health advocate with a background in nursing and holistic wellness. Sarah Vickers is passionate about helping women reconnect with their bodies through natural, mindful practices. She believes true well-being comes from returning to nature’s basics, offering personalised support to guide clients toward balanced health, especially in managing conditions like PMDD.
Listen to Sarah explain PMDD here:
What is PMDD?
Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects women during the luteal phase of their menstrual cycle. This phase, typically occurring a week (or sometimes two weeks) before menstruation, can bring on intense physical, emotional, and behavioural symptoms.
Common PMDD Symptoms
Women with PMDD often experience extreme mood fluctuations. These can include severe irritability, anger, and even rage, while others may struggle with feelings of depression and hopelessness. Fatigue is another frequent complaint, with many women feeling utterly exhausted even before their period begins.
Physically, symptoms may include significant bloating, abdominal distension, and breast tenderness. Some women also experience migraines and insomnia, with disrupted sleep patterns sometimes lasting from mid-cycle until menstruation begins.
Root Causes of PMDD
The causes of PMDD are complex and individual. Many factors contribute to hormonal imbalances, with some of the most obvious being toxic exposure. This includes exposure to microplastics, environmental toxins, the things that we dress ourselves in, chemicals in food and drink, alcohol, medication use, and even trauma. Lifestyle factors like diet, mindset, and stress levels can also play a critical role.
Sarah Vickers highlights stress as one of the most significant drivers of hormonal disruption. When the body is under stress, it may not ovulate, resulting in insufficient progesterone levels. This hormonal imbalance often leads to mood swings and emotional difficulties, common hallmarks of PMDD.
From a clinical perspective, Sarah suggests that an imbalanced gut microbiome is often at the core of many hormonal issues. A disrupted gut can affect everything from immune function to hormonal regulation. Poor nutrition, specifically during the luteal phase, also plays a role. The body demands more carbohydrates during this time to support progesterone production, and if you're fasting or not eating enough, it can worsen PMDD symptoms.
Supporting Your System Through PMDD
The first step in managing PMDD is identifying sources of stress—whether mental, emotional, spiritual, or physical. Vickers emphasizes the importance of tailoring your exercise routine to the different phases of your cycle. During the luteal phase, restorative practices like yoga, tai chi, or gentle walking are more supportive than intense workouts, as they help calm the nervous system.
Nutrition is also essential. Supplements like magnesium, vitamin B6, and adaptogenic herbs such as rhodiola, ashwagandha, and rhamania can support the brain and adrenal glands, helping to ensure progesterone production. These herbs signal the body that it’s safe, reducing the stress that inhibits ovulation.
One of the most powerful, yet often overlooked, tools for managing PMDD is nervous system work. Simple breathwork—taking five to ten minutes each morning and evening to connect to your breath—can drastically change how your body handles stress. By activating the parasympathetic nervous system (the rest-and-digest state), the body feels calmer and safer, which is crucial for healthy ovulation.
Additionally, calming herbal teas like raspberry leaf, nettle, and ginseng offer gentle support to the system, helping to soothe both mind and body. 
PMDD can be challenging to manage, but understanding its root causes and incorporating stress-reducing practices can make a significant difference. Whether through dietary adjustments, gentle exercise, or herbal support, small daily changes can help create a more balanced, healthier menstrual cycle. By addressing stressors, improving gut health, and being mindful of lifestyle factors, you can better support your body through the luteal phase.
Sarah is a registered nurse and integrative health practitioner. If you want to find out out more about Sarah Vickers head over to her Instagram @svholistic or her website www.svholistic.com.
