Premenstrual Dysphoric Disorder

From 2 to 10 percent of women of reproductive age have severe distress and dysfunction caused by premenstrual dysphoric disorder, a severe form of premenstrual syndrome. Premenstrual Dysphoric Disorder is defined as mood and anxiety symptoms that occur with a predictable pattern related to the menstrual cycle. The symptoms may include depressed mood, anxiety, affective lability, irritability, decreased interest in usual activities, difficulty concentrating, low energy, appetite changes, sleep changes, feeling overwhelmed and physical symptoms such as bloating, breast tenderness and headaches.

Read more about Premenstrual Dysphoric Disorder, click here.


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Prevalence and Risk Factors

Although up to 80% of women have at least mild symptoms of PMS, only about 5% have symptoms that impair their functioning and thus meet criteria for Premenstrual Dysphoric Disorder (PMDD).

Women with PMDD are thought to have different receptor sensitivity to hormones rather than a difference in hormone levels compared to women without PMDD.

Symptoms

  • Depressed mood
  • Anxiety
  • Affective lability
  • Irritability
  • Decreased interest in usual activities
  • Difficulty concentrating
  • Low energy
  • Appetite changes
  • Sleep changes
  • Feeling overwhelmed
  • Physical symptoms (bloating, breast tenderness, headaches, etc)

Screening Tools

To assist their doctor in making the diagnosis, patients should track their symptoms across at least 2 consecutive menstrual cycles using a Daily Rating Scale (click here to download).

Other mental health issues can be affected by the menstrual cycle, as well, so it is important to have a full evaluation to rule out any problems other than PMDD that may be occurring.

Treatment Options

In some patients, medications such as SSRI’s or oral contraceptives may be appropriate. Lindner Center of HOPE psychiatrists can prescribe psychiatric medications and/or work with the patient’s OB/GYN if oral contraceptives are under consideration.


More information at Medline Plus, click here.

Read this article to learn more, click here.