PMDD guide

PMDD treatment online

For adults 18 to 49 with regular periods whose mood symptoms come in the week before the period and get better soon after it starts. You rate your symptoms every day for 2 cycles first.

Start online

Start a $59 online review for PMDD.

Many people feel moody, tense, or sad in the week before their period. When it is bad enough to hurt your work, school, or relationships, it may be PMDD. PMDD stands for premenstrual dysphoric disorder. A daily pill called sertraline (Zoloft) is approved by the FDA to treat it. Talk therapy and regular exercise can help too. A physician reviews your answers and your daily ratings and, if it fits, prescribes sertraline with check-ins to keep it safe. We do not send a prescription automatically.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Already in ongoing care with us for this? Check-ins are $39 (your first one is free).

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

Big mood swings, or feeling very sensitive, in the week before your period
Feeling angry, cranky, down, hopeless, tense, or anxious before your period
Less interest in things, trouble focusing, low energy, food cravings, or sleep changes
Sore breasts, bloating, or aches, with symptoms that lift a few days after your period starts

May fit online care

Adults 18 and older
You are 18 to 49 and your periods come about every 21 to 35 days
Your symptoms start in the week before your period and are mild or gone in the week after it
You have at least 5 symptoms, at least one about mood, and they hurt your work, school, or relationships
You have rated your symptoms every day for at least 2 cycles and can upload it

Look for another care setting

Thoughts that you would be better off dead, or of hurting yourself in any way (call or text 988, or call 911).
Low mood or worry that lasts all month, not just before your period (use our anxiety and depression visit instead).
Periods that are not regular, have stopped, or are changing as you get older.
Pregnancy, possible pregnancy, or breastfeeding.
Narrow-angle glaucoma that is not treated.
An allergy to sertraline (Zoloft).
Mania, hypomania, bipolar disorder, or psychosis, or a mood stabilizer like lithium.
Liver disease.
A blood thinner, like warfarin or apixaban, or phenytoin.
Long QT syndrome, or a medicine that can change your heart rhythm (QT).
An MAOI, linezolid, methylene blue, or pimozide.
Heavy drinking or drug use.

What to have ready

Your daily ratings for at least 2 cycles, from a period app or a paper chart
The dates of your last periods
Every medicine, vitamin, and supplement you take
The birth control you use, if any

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

Why do I need to track my symptoms first?

PMDD is found by how your symptoms follow your cycle, so your doctor needs daily ratings for at least 2 cycles before the first prescription. If you have not tracked yet, our questions show you how before you pay, and you are not charged.

How does the medicine work with check-ins?

You take one 50 mg pill each day. Your first supply lasts 14 days. If you are 18 to 24, we check in after 1 week. Everyone has a check-in at 2 weeks, and that first check-in is free. Then you get a 30-day supply and check in each month. Your doctor may raise the dose one step per cycle, up to the label limit.

What if I have thoughts of hurting myself?

Please call or text 988, or text HOME to 741741, now. Call 911 if you are in danger. This visit does not prescribe while those thoughts are present.

What if my low mood lasts all month?

Then it may not be PMDD. Please use our anxiety and depression visit instead.

Can a birth control pill help?

One type of birth control pill, with drospirenone, is FDA-approved for PMDD in people who want to use the pill for birth control. You can ask for it in our combined birth control visit.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Birth control Bacterial vaginosis Combined birth control Delay your period Morning-after pill Heavy menstrual bleeding