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Premenstrual Dysphoric Disorder
By, Joe Briggs
What is Premenstrual Dysphoric Disorder?
PMDDSevere PMS (Premenstrual Syndrome)Depression, tension and irritability are
common.
Causes of PMDDThe Causes are NOT KNOWN.Hormones play some sort of
role.Symptoms Disappear if
ovaries are removed.Ovarian function
may affect changes in brain chemistry.
Incidence of PMDDOccurs in in 8% of woman who are having their
menstrual cycle.May have a genetic disposition. Daughters of mothers with PMDD are likely to
have the disorder as well.93% of Identical twins will
both have PMDD.44% of Fraternal twins will
both have PMDD.
Risk FactorsAnxietyMajor DepressionSeasonal affective disorderAlcohol abuseOverweightSedentary lifestyleFamily History
SymptomsSimilar to PMS, more severe.Occur during the week before menstrual
bleeding.Examples (5 or more must be present):
Disinterest in ADL’s Fatigue or low energy Suicidal thoughts Binge eating Panic attacks Headaches and/or joint or muscle pain Persistent irritability Sleeplessness Trouble concentrating
Do I have PMDD ?No physical exam or lab test can diagnose
PMDD.Psychiatric evaluation is used to rule out other
conditions.Keep a calendar or diary of symptoms when
they occurred to help with a diagnosis and best course of treatment.
Treatment of PMDDA healthy lifestyle is the first step to managing
PMDD. Eat a Balanced Diet Get sufficient sleep Exercise Keep a track of your symptoms
Other Treatments: Birth control Pills Diuretics Nutritional supplements Antidepressants CBT (Congenital behavioral Therapy)
ComplicationsADL’sWorse in second half of menstrual cycleSuicidal ThoughtsHarder to resist cravingsMeds will most likely need to be adjusted
Expectations
After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels
References Vigod SN. Understanding and treating premenstrual
dysphoric disorder: an update for the women's health practitioner. Obstet Gynecol Clin North Am. 2009;36:907-924, xii. [PubMed]
Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 36