Doctor's Notes on Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder (PMDD) is the severe form of premenstrual syndrome (PMS). The signs and symptoms are the same as for PMS, but they are severe enough to interfere with daily living and often need physician-directed treatment. Premenstrual syndrome (also termed PMS) is a syndrome that has monthly cycles of symptom changes in mood and behavior and/or physical functioning. Signs and symptoms of mood changes include
- mood swings,
- insomnia, and/or
Behavior signs and symptoms include
- increased eating,
- cravings for sweets,
- poor concentration and sensitivity to noise changes, and
- alcohol tolerance.
Physical function signs and symptoms include
- heart palpitations,
- weight gain,
- breast swelling and/or tenderness,
- constipation, or
The syndrome usually occurs immediately after an egg is released from the ovary and may last from day 14 through day 28 for a normal menstrual cycle with day one being that her period starts. Some individuals may have signs and symptoms extend into the period. Most women who have PMS have mild enough symptoms that they may treat them at home. When the above symptoms become severe enough to interfere with daily living, the patient has premenstrual dysphoric disorder (PMDD). PMDD may lead to severe depression and suicidal thoughts (a medical emergency).
PMDD is thought to be caused by the complex changing of hormone levels during the luteal phase of the menstrual cycle (for example, the brain chemical serotonin, which has many functions including mood control and sensitivity to pain, is reduced in some women with PMS and PMDD.
What Are the Treatments for Premenstrual Dysphoric Disorder (PMDD)?
The treatments of PMDD are similar to PMS, but the symptoms may need physician-directed treatments over time and emergency intervention if the patient exhibits self-destructive behaviors. However, the following is a list of treatments that may control or reduce symptoms over time:
- Decrease sugar, salt, caffeine, and alcohol intake.
- Exercise regularly.
- Increase protein and carbohydrates.
- Practice stress management.
- Vitamins like B6
- Calcium and magnesium supplements
- Anti-inflammatory medicines like NSAIDs
- Antidepressants: fluoxetine, sertraline, for example
- Diuretics: spironolactone
- Combined estrogen and progesterone birth-control pills can prevent mittelschmerz and thus painful ovulation.
Your ob-gyn may also recommend support groups.
Premenstrual Dysphoric Disorder (PMDD) - Test Your IQ of Women's Health QuizQuestion
Premenstrual dysphoric disorder is a severe form of premenstrual syndrome.See Answer
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PMDD: A Severe Form of PMSPremenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by mood swings, pain, fatigue, bloating, and other symptoms. This is most commonly treated by over the counter medications, but severe PMDD may require antidepressants.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.