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Premenstrual Dysphoric Disorder

By, Joe Briggs

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What is Premenstrual Dysphoric Disorder?

PMDDSevere PMS (Premenstrual Syndrome)Depression, tension and irritability are

common.

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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.

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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.

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Risk FactorsAnxietyMajor DepressionSeasonal affective disorderAlcohol abuseOverweightSedentary lifestyleFamily History

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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

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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.

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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)

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ComplicationsADL’sWorse in second half of menstrual cycleSuicidal ThoughtsHarder to resist cravingsMeds will most likely need to be adjusted

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Expectations

After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels

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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


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