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Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). Like PMS, premenstrual dysphoric disorder follows a predictable, cyclic pattern. Symptoms begin in the late luteal phase of the menstrual cycle (after ovulation) and end shortly after menstruation begins.

PubMed Health Glossary
(Source: Wikipedia)

About PMDD

Many women experience abdominal pain or a headache, are tense, sad and irritable or feel bloated and uncomfortable in the days leading up to their period. The medical term for this is "premenstrual syndrome" (PMS), also known as "premenstrual tension" (PMT).

PMS symptoms are usually not very severe, and most women cope well with them. But some women have such severe PMS that they are unable to go about their everyday lives during that time. If that is the case, various treatment options are available.


Premenstrual syndrome is a set of physical and psychological symptoms that start about 7 to 10 days before a woman gets her monthly period (menstruation). Many women experience breast tenderness and abdominal pain. Other symptoms include headaches, back pain and joint or muscle ache. They may also have water retention (bloating) and sleeping problems or digestive problems.

Women who have PMS often feel exhausted, down, irritable and have lower self-esteem in the days leading up to their period. Some might feel like they are losing control over their body and emotions. But sometimes women report that they experience positive changes in the days before menstruation, like having more energy and finding it easier to get things done.

If a woman's PMS is severe and clearly affects her mental health — leading to things like depression or anxiety — some experts refer to it as premenstrual dysphoric disorder (PMDD)... Read more about Premenstrual Dysphoric Disorder

What works? Research summarized

Evidence reviews

Cognitive-behavioral and pharmacological interventions for premenstrual syndrome or premenstrual dysphoric disorder: a meta-analysis

The current meta-analysis investigates the efficacy of psychotherapeutic interventions and psychopharmacotherapy for premenstrual syndrome (PMS) and premenstrual dysphoric disorder. Based on a multiple-phase literature search, controlled trials were selected according to a priori defined inclusion criteria. Data were extracted on the basis of a standardized coding scheme. The standardized weighted mean difference (random effects model) was used as effect size index. Dependent on outcome, 22 included studies obtained small to medium effect sizes for cognitive-behavioral interventions (range: d(+) = 0.24-0.70) and for serotonergic antidepressants (range: d(+) = 0.29-0.58), at post-assessment. Follow-ups were performed only in studies of cognitive-behavioral interventions (range: d(+) = 0.46-0.74). There was no evidence of a publication bias. For both cognitive-behavioral interventions and serotonergic antidepressants, efficacy in treatment of PMS was found to not be satisfactory. Future research should possibly focus more on a combination of both approaches.

The effect of bright light therapy on depression associated with premenstrual dysphoric disorder

The review evaluated the evidence from randomised controlled trials on bright light therapy for the treatment of depression associated with premenstrual dysphoric disorder. The impact of bright light therapy for relief of premenstrual depressive symptoms is uncertain given the limitations of existing trials. The conclusions appear appropriate and reflect the limited available evidence.

Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder: a meta-analysis

The authors concluded that selective serotonin re-uptake inhibitors effectively relieved the symptoms of pre-menstrual syndrome and pre-menstrual dysphoric disorder. Continuous dosing regimens may be more effective than intermittent regimens. The review was in most respects well conducted and the conclusions seemed reliable, though the marked heterogeneity between studies meant that the overall effect size of the intervention is unclear.

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Summaries for consumers

Premenstrual syndrome: Overview

The days leading up to menstrual periods are sometimes a mystery to women too: Out of the blue, women with premenstrual syndrome (PMS) feel depressed, irritable, find it hard to concentrate, or cry easily. There are different ways to cope with these symptoms.

Premenstrual syndrome: Treating PMS symptoms

Some women who have premenstrual syndrome (PMS) have such bad symptoms in the days before their period that it keeps them from doing the things they usually do. But there are different ways of coping with and treating typical symptoms such as pain, breast tenderness and mood swings.Most women who get PMS do not have very severe symptoms, and they have found ways of coping with them – like getting enough rest and avoiding stress around that time of the month. There is a lot of advice out there about how to deal with PMS symptoms, including:regularly getting enough sleep,doing exercise and sports,using relaxation techniques and meditating,not smoking,drinking less alcohol and caffeine,eating food that is low in carbohydrates and/or salt.Most of these things have not been put to the test in high-quality scientific studies. But that does not mean that they cannot help. Women can try them out themselves and see whether making these changes helps relieve their symptoms. If you are going to try one of these things, keeping a diary might help. Observing and recording symptoms and attempted "remedies" over the course of several menstrual cycles can help you find out whether the changes have affected the symptoms.

Selective serotonin reuptake inhibitors (SSRIs) for premenstrual syndrome

Premenstrual syndrome (PMS) is a common cause of physical, psychological and social problems in women of reproductive age. PMS is distinguished from 'normal' premenstrual symptoms by the degree of distress and disruption it causes. Symptoms occur during the period leading up to the menstrual period and are relieved by the onset of menstruation. Common symptoms include irritability, depression, anxiety and lethargy. A clinical diagnosis of PMS requires that the symptoms are confirmed by prospective recording (that is recorded as they occur) for at least two menstrual cycles and that they cause substantial distress or impairment to daily life. It is estimated that approximately one in five women of reproductive age are affected. PMS can severely disrupt a woman's daily life and some women seek medical treatment. Researchers in The Cochrane Collaboration reviewed the evidence about the effectiveness and safety of selective serotonin reuptake inhibitors (SSRIs) for treating PMS. They examined the research up to February 2013.

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Terms to know

Dysphoria is a profound state of unease or dissatisfaction. Dysphoria may accompany depression, anxiety, or agitation. It can also mean someone that is not comfortable in their current body, particularly in cases of gender dysphoria.
A chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. For example, insulin is a hormone made in the pancreas that tells other cells when to use glucose for energy. Synthetic hormones, made for use as medicines, can be the same or different from those made in the body.
Luteal Phase
The period in the menstrual cycle that follows ovulation. The luteal phase begins with ovulation and ends with the onset of menstruation.
Menstruation (Periods)
Periodic discharge of blood and tissue from the uterus. From puberty until menopause, menstruation occurs about every 28 days when a woman is not pregnant.
The release of an egg from an ovary during the menstrual cycle.
Occurring in the time period during the menstrual cycle leading up to the beginning of menstruation. Or relating to the time period in a girl's life prior to her first experience of menstruation.

More about Premenstrual Dysphoric Disorder

Photo of a young adult woman

Also called: Severe premenstrual syndrome

See Also: Premenstrual Syndrome

Other terms to know: See all 6
Dysphoria, Hormones, Luteal Phase

Related articles:
How the Menstrual Cycle Works

Keep up with systematic reviews on Premenstrual Dysphoric Disorder:


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