Premenstrual Syndrome PMS D

Premenstrual Syndrome PMS D (Depression): Overview

Many Holistic doctors categorize PMS into four types – A, C, D and H – which were originally identified by Dr. Guy Abraham, M.D. 'Type D' or 'PMS-D' ("Depression") is the least common and is relatively rare in its pure form.  Its key symptom is depression due to an underactive thyroid and low serotonin levels.

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Causes and Development

The depression in PMS-D patients is usually associated with low levels of biogenic amines in the synaptic vesicles of the Central Nervous System, most likely due to increased MAO-A levels as a result of decreased peripheral estrogen.  This is in contrast to PMS-A, which has elevated levels.  The decreased ovarian estrogen output during the luteal phase has been attributed to a stress-induced increase in adrenal androgens and/or progesterone.

Signs and Symptoms

Symptoms of PMS-D include:

  • Emotional changes, most commonly depression
  • Forgetfulness
  • Insomnia
  • Confusion
  • Teariness
  • High blood pressure
  • Problems with eyesight

Treatment and Prevention

Supplementing with kelp, spirulina, and potassium oxide (K2O) can help relieve symptoms.  The patient should also avoid sugar, red meat, salt, cheese and alcohol and try and eat potassium-rich foods such as bananas.  Other potentially useful dietary supplements include:

References and Further Information

See also:

Premenstrual Syndrome (PMS)
PMS-A (Anxiety)
PMS-C (Craving)
PMS-H (Headache)

Signs, symptoms & indicators of Premenstrual Syndrome PMS D (Depression):

Symptoms - Mind - Emotional

Symptoms - Mind - General

Symptoms - Reproductive - Female Cycle

Pre/menstrual depression

PMS type D is characterized chiefly by depression.

Symptoms - Sleep

Conditions that suggest Premenstrual Syndrome PMS D (Depression):


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Premenstrual Syndrome PMS D (Depression) suggests the following may be present:


Recommendations for Premenstrual Syndrome PMS D (Depression):

Amino Acid / Protein


Not recommended
Natural Progesterone

In patients with PMS Type D, progesterone levels may be elevated.  You should have your hormone levels checked prior to any hormone therapy: using progesterone cream may only make symptoms worse.



Lead blocks the binding of estrogen to receptor sites and but has no effect on progesterone.  A chronic magnesium deficiency may be a contributing factor as it results in increased lead absorption and retention, while decreasing resistance to stress.  Hair mineral analysis has shown that, in general, PMS patients have higher heavy metal levels and lower magnesium levels than non-PMS controls.  Menstrual cramps, irritability, fatigue, depression and water retention have been lessened with magnesium, usually given along with calcium and often with vitamin B6.  Magnesium is often at its lowest level during menstruation.  Supplementing magnesium in the same amount (or more) as calcium (about 500-1,000mg daily) is currently recommended for premenstrual problems.


Vitamin B6 (Pyridoxine)

In one study, women received 50mg per day of vitamin B6 or a placebo for 3 months.  Symptoms amongst these women included depression, irritability, tiredness, headache, breast tenderness and swollen abdomen/hands.  At this dose depression, irritability and tiredness were the only symptoms to respond and they were reduced by 50%. [Gynecol Obstet Invest 1997;43(2): 120-124]

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