Description
Premenstrual dysphoric disorder (PMDD) is a condition that affects some women approximately 5 to 10 days prior to their monthly menstrual cycle. Symptoms are similar to premenstrual syndrome (PMS) but are much more severe. They include depressive symptoms, anxiety and irritability in addition to physical symptoms such as breast tenderness, menstrual cramps, bloating and headaches. PMDD affects approximately 3-8% of women during the years that they are menstruating. The cause of PMDD is unknown but is more common in women with underlying depression and anxiety disorders.
Symptoms
Symptoms typically occur 5 to 10 days before a menstrual cycle and resolve a few days after the period has started. Symptoms may include fatigue, anxiety, panic attacks, mood swings, depression, trouble concentrating, trouble sleeping, food cravings as well as physical symptoms including breast tenderness, menstrual cramps, bloating and headaches.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. There are no definitive tests to establish the diagnosis. Sometimes a mental health evaluation is recommended to determine if other conditions exist and to help guide treatment.
Tests:
Complete blood count (CBC)
Specialists:
Family Practice
Workup:
A history and physical exam will be performed. There are no definitive tests to establish the diagnosis. Sometimes a mental health evaluation is recommended to determine if other conditions exist and to help guide treatment.
Tests:
Complete blood count (CBC)
Specialists:
Family Practice
Treatment
Exercise and diet changes (avoiding simple sugars, caffeine, and alcohol) may help relieve symptoms. Nonsteroidal anti-inflammatory medications - NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn) are prescribed for pain. Of the drug therapies, SSRI antidepressants are considered the most effective therapy. Birth control pills may decrease PMS symptoms but are not effective in all patients. Cognitive behavioral therapy is also an option.