When I was first diagnosed with PMDD, I’ll be honest: vodka worked better than most of the medication I was given. It calmed the edge, made my thoughts softer, and helped me survive the afternoon.

I remember vividly that every luteal phase (usually Day 22) leaning on the lounge room, with a massage ball behind my shoulder, and a double vodka. My right eye usually closed from the migraine I could feel building, and the blanket of soul-destroying thoughts telling me what a piece of garbage I am. Vodka was the only thing in that moment that took the edge off all of that pain. 

Over the years, I’ve had clients come to me confused, sometimes scared, asking, “Why do I crave alcohol so badly in the luteal phase? Do I have a drinking problem?” 

What’s Actually Happening in Your Brain

PMDD is not a hormonal imbalance. Your estrogen and progesterone levels are normal. The issue is that your brain responds differently to normal hormonal changes. Specifically, your GABA system, which normally keeps your brain calm and balanced, doesn’t adjust properly in the luteal phase.

Allopregnanolone, a metabolite of progesterone, usually helps regulate this system. In PMDD, the receptors are overly sensitive or misfiring. The result? Anxiety, irritability, mood swings — that raw, emotionally exposed feeling we call an episode.

Alcohol interacts with GABA receptors in the brain, temporarily mimicking the calming effect that your brain isn’t producing on its own. That’s why a drink can feel like it works in the moment. It’s literally giving your nervous system a little softening, a pause, a break. God knows you need it. 

It’s Your Body Trying to Help You Survive

When you find yourself craving a drink during the luteal phase, it’s not about weakness, laziness, or an addiction problem. It’s your body looking for relief, finding something that works to make that moment liveable. It’s a survival strategy. Think of it like your nervous system saying: “I need help calming down right now, and alcohol happens to do that.”

That’s why it can feel confusing. You might follow your cravings and feel better briefly, but later feel guilty or worried. Understanding the biology behind it — that your GABA system is dysregulated — takes the shame out of it.

What You Can Do Instead

Finding the right medication protocol is the key and, of course, working with a PMDD-aware clinician can help you navigate episodes and cravings safely, finding approaches that fit your unique pattern.

PMDD is not about broken hormones. Your brain is simply responding differently to normal hormonal changes. Alcohol may feel like it works because it temporarily fixes the very system that is struggling, but it’s not a long-term solution. Your cravings are not a moral failing — they’re your body trying to help you survive the luteal phase. Understanding that is the first step toward self-compassion and smarter coping strategies.

If you need help, I'm here. 

• Raffi ER & Freeman MP. The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces. MGH Center for Women’s Mental Health; 2017. 

• Epperson CN, et al. Allopregnanolone and GABAergic function in PMDD. J Psychiatry Neurosci. 2012;37(1):9–17. 

• GABA and alcohol: National Institute on Alcohol Abuse and Alcoholism.