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Psychiatr Clin North Am. 2017 Jun;40(2):201-216. doi: 10.1016/j.psc.2017.01.002. Epub 2017 Mar 1.

Premenstrual Dysphoric Disorder.

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Department of Psychiatry, Rhode Island Hospital and Miriam Hospital, 593 Eddy Street, Providence, RI 02903, USA. Electronic address:
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Women's Behavioral Medicine, Women's Medicine Collaborative, Miriam Hospital, 146 West River Street, Providence, RI 02904, USA.


Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.


Antidepressant; Etiology; Oral contraceptive; Premenstrual dysphoric disorder; Premenstrual syndrome; Treatment

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