Can the ExoMind help Premenstrual Dysphoric Disorder (PMDD)?

Michel J Lazar, MD, MHA, FACC

When referring to the BTL ExoMind TMS device, we’re talking about a Transcranial Magnetic Stimulation (TMS) platform that applies non-invasive, targeted magnetic pulses to modulate brain activity. This technology has compelling potential in helping patients with Premenstrual Dysphoric Disorder (PMDD). To be clear - the ExoMind and TMS in general has is FDA approved for the treatment of Major Depressive Disorder- that means it was found to be both safe and effective. Outside this one diagnosis, the machine remains equally safe but the results, while promising, and not an FDA approved "treatment." Like most medical devices and medications, once a device is approved for one indication, physicians can use it to help in other areas as they see fit.

Here’s how the BTL ExoMind TMS system may help:

1. Targets Mood-Regulating Brain Regions

PMDD is associated with heightened emotional sensitivity to hormonal changes, especially in the prefrontal cortex and limbic system (e.g., amygdala, anterior cingulate). The BTL ExoMind device can deliver precise stimulation to these areas, promoting neural stabilization and improved mood regulation.

2. Modulates Serotonergic Activity

TMS has been shown to enhance serotonin transmission, which is often dysregulated in PMDD. This is a similar mechanism to SSRIs, but without systemic side effects — making it attractive for women sensitive to medications or seeking non-pharmacologic options.

3. Reduces Treatment-Resistant Symptoms

PMDD often resists standard treatments. ExoMind’s deep TMS capabilities may provide relief where lifestyle, medication, and hormone therapies have fallen short — particularly for severe mood swings, irritability, or depressive episodes during the luteal phase.

4. Non-Hormonal and Non-Systemic

This is particularly relevant for women:

  • Who want to avoid hormonal birth control,
  • Who are undergoing fertility treatment,
  • Or who are perimenopausal and experiencing PMDD-like mood instability.

What We’d Offer at Hush Medical Spa

If integrating a patient with PMDD and ExoMind into our treatment offerings:

  • We’d track symptom scores across cycles (e.g., DRSP — Daily Record of Severity of Problems) before and during treatment.
  • Possibly combine with our Vitality Memberships and hormonal optimization (like bioidentical progesterone, estrogen detox support, or cycle syncing) for a synergistic effect.

Ideal Candidates

  • Women with diagnosed PMDD confirmed by 2+ tracked cycles
  • Those who’ve failed or declined SSRIs or hormonal contraceptives
  • Women with cyclical depressive or anxious symptoms that impair function