Psychoneuroendocrinology - Disorders - Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder is a mood disorder which occurs recurrently in the late luteal phase of the menstrual cycle and remits within the first day or two after the onset of menstruation. Symptoms include depression, irritability, anxiety, insomnia, bloating, breast tenderness, cramping, and headaches. About 5-9% of women of child-bearing age meet the DSM-IV criteria for PMDD. In some women, end-of-cycle worsening actually represents "menstrual magnification" of an underlying mood disorder.

Premenstrual dysphoric disorder can be treated cyclically with hormonal oral contraceptives, or with antidepressants, which may be used continuously or only during the late luteal phase. Selective serotonin reuptake inhibitors, or SSRIs, have been found to be effective in the treatment of PMDD. Physical symptoms can be affected by the intake of caffeine, salt, alcohol, and nicotine, so the use of these substances should be monitored and potentially decreased. Sleep hygiene measures, exercise, relaxation therapy, and cognitive behavioral therapy are all potentially effective non-medication strateg for milder symptoms.