Definition

Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:

• Depression
• Irritability
• Tension

PMS affects about 75% of women. PMDD affects 2%-10% of all women during their reproductive years. With treatment, the condition can be managed. Some women no longer have any symptoms once PMDD has been diagnosed and treated.

Causes

The factors that cause PMDD are not known. Some possible causes of PMDD include:

• Hormonal changes caused by high hormones in latter half of a normal (ovulatory) menstrual cycle
• Traumatic life events
• Stress

Microscopic View of Hormone Receptor

Menstruation causes many hormone changes which may play a role in PMDD.

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Risk Factors

The following factors increase your chance of developing PMDD:

• Family history of PMDD
• Family history of severe PMS
• Stress
• Suffering from major depression]]>
• Suffering from ]]>seasonal affective disorder (SAD)]]>

Symptoms

Symptoms include:

• Extreme sadness
• Frequent crying
• Irritability
• Feelings of anxiousness or nervousness]]>
• Unusually strong cravings for certain foods
• Difficulty concentrating or paying attention
• ]]>Insomnia]]>
• Panic attacks
• Mood swings
• Fatigue or lack of energy
• Physical symptoms include sore breasts, headaches, joint or muscle pain, swelling, and bloating

To be properly diagnosed with PMDD, usually at least five symptoms need to be present. Symptoms typically begin 10-14 days prior to the start of menstruation. They begin to decrease once menstruation begins. Symptoms that occur at other times during the cycle suggest other underlying mood or anxiety disorders.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will ask detailed questions about your symptoms and when they occur.

You may also be asked to keep a chart or record of your symptoms. Record when they occur and the severity of each. Your doctor will compare your symptoms to days of your menstrual cycle. This will help to determine if you suffer from PMDD.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Prevention

To help reduce your chance of getting PMDD, take the following steps:

• Get plenty of exercise and rest
• Eat a well-balanced diet
• Manage stress]]>