Lexapro For PMDD: What Are The Benefits?

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Geoffrey C. Whittaker

Published 10/25/2022

Updated 10/26/2022

Premenstrual dysphoric disorder, or PMDD, is a frustrating condition. And if you’ve recently been diagnosed with it or are struggling to manage it, a healthcare professional might have mentioned Lexapro® for PMDD as a potential treatment. 

Treating PMDD is like treating any other mental health condition: it may take time to see results, it may take a combination of treatments and it may take more than one try to find the right combination for your needs. 

But if you’re wondering if Lexapro could be one of those potential treatments, the answer is yes.

Lexapro has a lot to offer in the way of mood disorder treatment, and there are many reasons a healthcare provider might suggest it for PMDD. 

But whether it’s right for you or not is another matter. To figure that out, you’ll need to know a few things.

Let’s start with the essential info.

Premenstrual dysphoric disorder, or PMDD, is a relatively new diagnostic term, but the simplest way to understand it is as a specific name for the most severe of premenstrual symptoms. 

PMDD essentially represents a collection of physical symptoms, depressive symptoms and anxiety symptoms that are interlinked with your menstrual cycle. 

The symptoms of PMDD can be both physical and emotional/psychological, and for a diagnosis, you’ll typically have several of the following symptoms:

  • Depressed mood

  • Hopelessness

  • Anxiety

  • Irritability

  • Decreased interest in activities

  • Difficult concentrating

  • Fatigue

  • Changes in appetite

  • Sleep issues

  • Feeling overwhelmed or out of control

  • Breast tenderness or swelling

  • Headaches

  • Bloating

  • Weight gain

  • Joint or muscle pain

These symptoms are generally strong enough to interfere with your professional and social function. 

Crucially, PMDD is the diagnosis you receive when your symptoms are related to your cycle.

Where Lexapro enters the equation is that while it’s not approved by the Food and Drug Administration to treat PMDD specifically, it is sometimes prescribed in an off-label capacity to help treat it.

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First off, what is Lexapro? Well, it’s a selective serotonin reuptake inhibitor, or SSRI — an antidepressant medication that, when taken as directed, can help treat some symptoms of depression, anxiety and other mental illnesses by helping your brain to better regulate its supply of serotonin.

Serotonin is a neurotransmitter that is believed to play a role in one’s mood. Our brains produce it, but also reabsorb its supply from time to time. 

Unfortunately, some peoples’ brains absorb too much, which is believed to contribute in some part to mood disorders like depression and PMDD.

In this capacity, Lexapro may reduce the symptoms associated with PMDD, similarly to other SSRIs.

One study that looked at escitalopram for PMDD found that it provided an 80 percent reduction in one of the most commonly reported symptoms: irritability and mood changes. 

Treatment was administered during the luteal phase, which is the period of a woman’s cycle between egg release and menstruation. 

The 80 percent response was also more than double the response in placebo patients, and while it did add some adverse effects like nausea to the variables, it was seen overall as effective.

That study we mentioned in the last section is the only one of substance we’ve found to date, but thankfully, it was somewhat comprehensive. 

The more than 150 women who were part of the study were divided into three groups: a placebo group, as well as escitalopram groups at 10mg and 20mg daily doses.

The 20mg group saw those great results, while the second group did not. 

In fact, the study’s authors went so far as to call 20mg a “clearly superior” dosage for treating PMDD.

For the record, 20mg is, in most cases, the maximum recommended dose of Lexapro — people with major depressive disorder tend to be started with 10mg and moved up in dosage as necessary, while in the treatment of generalized anxiety disorder, 10mg is actually considered the maximum effective dosage for safety purposes.

And those safety considerations are important because, without them, you run the risk of problems.

It’s important to understand that, while daily dosing of Lexapro may be an effective treatment for some PMDD symptoms, it’s technically not approved by the FDA for PMDD treatment. 

Lexapro may increase your risk of any of the following common side effects:

  • Fatigue

  • Dry mouth

  • Diarrhea

  • Constipation

  • Indigestion

  • Abdominal pain

  • Flu-like symptoms

  • Insomnia

  • Dizziness

  • Sweating

  • Sexual performance and libido issues

Serious side effects may include increased suicidal thoughts, abnormal bleeding, eye pain and vision problems, as well as an increase in your risk of experiencing serotonin syndrome, which may be deadly.

Also, you should generally avoid suddenly stopping this prescription medication, as sudden discontinuation could cause irritability, sweating, dizziness, nausea, shaking and anxiety.

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If you have PMDD or even a history of depression and you’re considering Lexapro as a treatment, talk to a healthcare provider about it for personalized medical advice. 

They’ll be able to answer questions about Lexapro use with medical disorders like PMDD, as well as things like additional risks, side effects and drug interactions.

If they decide Lexapro (or its generic, escitalopram) might be helpful to you, they’ll be able to write you a prescription for this medication

Whether you have questions that we haven’t answered or not, a healthcare professional is going to help you make the best decisions, which may include Lexapro or another medication

Your tailored treatment plan may require some time to fine-tune and may also include therapy or lifestyle changes, so the sooner you get started, the sooner you’re likely to see the results you want. 

Not sure where to find that kind of support? Our online therapy platform can help connect you with mental health professionals and find the right one for your needs. 

And you can talk to a healthcare provider about Lexapro, PMDD and whatever else is on your mind right now through our mental health resources. 

Whether it’s us or not, start that conversation today. PMDD is serious, and you’re worth it.

5 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. FDA. (n.d.). HIGHLIGHTS OF PRESCRIBING INFORMATION Lexapro. Accessdata. Retrieved September 7, 2022, from HIGHLIGHTS OF PRESCRIBING INFORMATION.,021323s053lbl.pdf.
  2. Eriksson E, Ekman A, Sinclair S, Sörvik K, Ysander C, Mattson UB, Nissbrandt H. Escitalopram administered in the luteal phase exerts a marked and dose-dependent effect in premenstrual dysphoric disorder. J Clin Psychopharmacol. 2008 Apr;28(2):195-202. doi: 10.1097/JCP.0b013e3181678a28. PMID: 18344730.
  3. Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  4. Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2022 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  5. Serotonin Syndrome: What It Is, Causes, Symptoms & Treatment. (2022, March 24). Cleveland Clinic.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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