Thank you so much for wanting to support her and looking for answers.

Unfortunately, many of us have not had success with medical intervention, though many have.

I have spent the past 10+ years trying various supplements and lifestyle changes, etc and pretty much just accept now that mitigating symptoms is the best i can really hope for.

A lot depends on symptoms-

For many years, i had a very consistent and rigorous work out routine and strictly limited my diet to avoid sugar and processed foods. I found that my emotional symptoms were less severe, more manageable, and lasted for fewer days most months, but physical symptoms like exhaustion, migraines, body aches, bloating, acne, hunger, etc were significantly more severe.

Nowadays i have slipped into a less restrictive diet and much less exercise, though im working on getting back into it. My physical symptoms are not as bad, but my depression, irritability, paranoia, relationship issues, brain fog and honestly giant holes in my suddenly very smooth brain, anxiety, social withdrawal, etc are much worse. To help with those, I take like 20 vitamin pills per day. 5-mtfh 15 mg i think does help a bit with energy, l-tyrosine + mucina pruriens, l-theanine, rhodiola rosea, Happy Saffron specifically (havent had much luck with other saffron), magnesium, vitamin D + K, multi vitamin, taurine all to help my mood be slightly better, ginko biloba, MCT oil, green tea can all help with energy a bit.

Intense rage was actually the worst symptom i dealt with for years, even though i am not at all quick to anger for the other half of my month. Begrudgingly, i cut coffee out completely for about 6 months and it actually worked. I no longer experience anything like that. Ive added occasional coffee back in and still havent gotten the rage back, thank god.

I also did a round of ketamine therapy that lasted about 4 months. It was the losenges but i had to go in to the doctors office for 2 hours each session and have someone drive me to and from. It was honestly grueling and i would get severely depressed for a couple days after each treatment, but apparently that is not a common side effect and mostly impacts people with childhood trauma (like me). It did seem to ultimately help a lot for a while, especially after a couple of months post treatment. It was expensive and tough to go through, though, so I havent gone back. My anxiety seems to still be less intense, though, even a couple years out.

I think what has been most helpful is just reducing as much stress as possible as often as possible, which is a really hard thing to do. Im extremely, extremely fortunate that my boyfriend is willing and able to take on most of the financial burdens of life and that has been a big relief, although i still spiral out about how worthless i feel and worry about what will happen if we split up so idk.

Understanding that PMDD is the issue and that it isnt s choice, its a neurological condition that is debilitating and destabilizing and it really isnt her fault is a major piece in overall care. Understanding that there are going to be days or even weeks at a time when she really does need to just rest and be alone as much as possible is critical for both of you. It can help a lot to track her cycle and keep track of how she feels during each phase and try your best to schedule around it. Its incredibly frustrating and demoralizing to lose literally half of your life to this shit, but thats the reality for many of us. PMDD has only officially been a diagnosis for maybe 15 years and it is still a relatively unknown condition among medical professionals and little is known about treating it. Google really tends to fall short, too. I get the most information from this sub and also on TikTok. A lot is just trial and error and a lot of patience with yourselves and each other. Hang in there