Premenstrual dysphoric disorder

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Depression and the menstrual cycle

Overview

Symptoms

Treatment

Prevention

Premenstrual dysphoric disorder

Alternative Names:

PMDD

Treatment:

Women with PMDD may be helped by the following:

Regular exercise 3-5 times per week
Adequate rest
A balanced diet (with increased whole grains, vegetables, fruit, and decreased or no salt, sugar, alcohol, and caffeine)

In addition, it is important to keep a diary or calendar to record the type, severity, and duration of symptoms.

Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa).

SSRIs can relieve physical symptoms, irritability, and tension. In fact, SSRIs appear to relieve PMS-related depression much faster than major depression. Women with PMDD, but without major depression, need only take SSRIs during the 14-day premenstrual period. This approach, called intermittent treatment, causes fewer side effects than when SSRIs are used to treat major depression.

Nutritional supplements -- such as Vitamin B-6, calcium, and magnesium -- may be recommended. Pain relievers such as aspirin or ibuprofen may be prescribed for headache, backache, menstrual cramping and breast tenderness. Diuretics may be useful for women who experience significant weight gain due to fluid retention.

Expectations (prognosis):

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

Complications:

PMDD symptoms may become severe enough that they interfere with a woman's daily life. Women with depression may have worse symptoms during the second half of their cycle and may require medication adjustments.

As many as 10% of women who report PMS symptoms, particularly those with PMDD, have had suicidal thoughts. The incidence of suicide in women with depression is significantly higher during the latter half of the menstrual cycle.

PMDD may be associated with eating disorders and smoking.

Calling your health care provider:

Call 911 immediately if you are having suicidal thoughts.

Call for an appointment with your health care provider if:

PMS symptoms do not improve with self-treatment
PMS symptoms are interfering with your daily life

Review Date: 10/25/2004
Reviewed By: Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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