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Premenstrual dysphoric disorder - Symptom

Alternative Names

PMDD; Severe PMS

Symptoms:

The symptoms of PMDD are similar to those of PMS. However, they are generally more severe and debilitating and include a least one mood-related symptom. Symptoms occur during the week just before menstrual bleeding and usually improve within a few days after the period starts.

Five or more of the following symptoms must be present to diagnose PMDD, including one mood-related symptom:

  • Disinterest in daily activities and relationships
  • Fatigue or low energy
  • Feeling of sadness or hopelessness, possible suicidal thoughts
  • Feelings of tension or anxiety
  • Feeling out of control
  • Food cravings or binge eating
  • Mood swings marked by periods of teariness
  • Panic attack
  • Persistent irritability or anger that affects other people
  • Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain
  • Problems sleeping
  • Trouble concentrating

Signs and tests:

No physical examination or lab tests can diagnose PMDD. A complete history, physical examination (including a pelvic exam), and psychiatric evaluation should be done to rule out other conditions.

Keeping a calendar or diary of symptoms can help women identify the most troublesome symptoms and the times when they are likely to occur. This information may help the health care provider diagnose PMDD and determine the best treatment.

  • Reviewed last on: 12/22/2010
  • Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Vigod SN. Understanding and treating premenstrual dysphoric disorder: an update for the women's health practitioner. Obstet Gynecol Clin North Am. 2009;36:907-924, xii.

Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 36.

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