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Premenstrual Dysphoric Disorder (PMDD)

Severe luteal-phase mood and physical symptoms causing functional impairment

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder is a cyclical mood disorder characterized by emotional, cognitive, and physical symptoms in the week before menses, with rapid resolution after menstruation begins. Symptoms must occur in most cycles of the past year and cause clinically significant impairment.

Core symptoms include irritability, mood swings, depressed mood, anxiety, decreased interest, difficulty concentrating, fatigue, appetite changes, sleep disturbance, and physical symptoms such as breast tenderness or bloating. PMDD is distinct from premenstrual exacerbation of an underlying mood disorder.

Treatment includes selective serotonin reuptake inhibitors (luteal-phase or continuous), combined oral contraceptives containing drospirenone, GnRH agonists in refractory cases, cognitive-behavioral therapy, and lifestyle interventions including exercise and limiting alcohol and caffeine.

Symptoms

Severe irritability, anger, or interpersonal conflict
Marked depressed mood, hopelessness, anxiety
Decreased interest, concentration problems, fatigue
Appetite or sleep changes, feeling overwhelmed
Breast tenderness, bloating, joint or muscle pain

Risk Factors

Personal or family history of mood or anxiety disorders
Trauma or chronic stress
Smoking and obesity in some studies
Genetic sensitivity to ovarian hormone changes

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe symptoms interfering with work, school, relationships
  • Suicidal ideation or self-harm thoughts (urgent)
  • Symptoms unresponsive to lifestyle measures
  • When considering hormonal contraception or SSRI for PMDD
  • Need for specialist evaluation in refractory cases

Treatment Methods

01
Prospective symptom diary across two cycles for diagnosis
02
SSRIs (fluoxetine, sertraline, escitalopram) luteal or continuous
03
Combined oral contraceptive with drospirenone
04
GnRH agonists with add-back in refractory cases
05
Cognitive-behavioral therapy and stress management
06
Exercise, sleep hygiene, calcium and vitamin B6 supplementation
07
Multidisciplinary care with psychiatry and gynecology

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.