PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

 Basic information

description

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). Symptoms of PMDD interfere with daily activities, and can cause problems with personal relationships. PMDD is also called late-luteal dysphoric disorder.

FREQUENT SIGNS & SYMPTOMS

• The symptoms occur 5 to 14 days before, and go away a few days after, the start of menstruation.
• Symptoms vary for every woman, and vary at times in the same woman. Most of the symptoms involve emotional or behavioral factors. Symptoms may include:
  • Being irritable or angry.
  • Feeling depressed, sad, and hopeless.
  • Feelings of tension, anxiety, or panic.
  • Mood swings marked by periods of crying.
  • Lack of interest in daily activities and relationships.
  • Trouble paying attention and unable to concentrate.
  • Fatigue or lack of energy.
  • Food cravings or overeating.
  • Trouble sleeping.
  • Feeling out of control.
  • Physical symptoms, such as bloating, breast tenderness, headaches, diarrhea, and joint or muscle pain.

causes

No single cause has been found. Some studies suggest it may be an abnormal response to normal hormonal changes. Genetic factors are likely involved. Research into the cause is ongoing.

risk increases with

• Women with a personal or family history of mood disorders, such as depression or postpartum depression.
• Stressful life events.

PREVENTIVE MEASURES

None known.

expected outcomes

Treatment can help reduce some PMDD symptoms. Treatment may be needed for at least a year. There are a variety of treatment options. It is important to find what works for you.

possible complications

The symptoms may get worse over time and last until menopause (when menses ceases).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam (including a pelvic exam). Questions will be asked about your symptoms and lifestyle. To aid in the diagnosis, you may be asked to keep a symptom diary for two or more months. List the dates of your period and which symptoms you have (and their severity) on the days before and after your period.
• Treatment options for PMDD include lifestyle changes, counseling, drugs, and use of alternative therapies. No single treatment works for every woman.
• Lifestyle changes include diet changes, stopping smoking, aerobic exercise, and steps to reduce stress.
• Counseling may help a woman find ways to cope with the PMDD symptoms.
• Biofeedback, acupuncture, and massage may help some women. Relaxation techniques may be used as treatment for stress. Phototherapy (treatment with light) may help in some cases.
• Join a support group. Talking about your PMDD symptoms with others can help.
• To learn more, do an Internet search or visit a library.

medications

• Antidepressant drugs may be prescribed. These help the symptoms of PMDD.
• Other drugs may be prescribed for specific symptoms such as headaches, anxiety, pain, and bloating.
• Vitamins and supplements may be recommended.

activity

Do aerobic exercise (20 to 30 minutes) daily, or at least three times per week.

diet

• Eat a healthy diet. Try eating frequent, small meals.
• Reduce or eliminate salt, caffeine, sugar, and alcohol.

 notify our office if

• You or a family member has symptoms of PMDD.
• Symptoms get worse or new ones develop despite treatment.

Special Notes: