Update on research and treatment of premenstrual dysphoric disorder.
Many women in their reproductive years experience some mood, behavioral. or physical symptoms in the week prior to menses. Variability exists in the level of symptom burden in that some women experience mild symptoms, whereas a small minority experience severe and debilitating symptoms. For an estimated 5%-8% of premenopausal women, work or social functioning are affected by severe premenstrual syndrome. Many women in this group meet diagnostic criteria for premenstrual dysphoric disorder (PMDD). Among women who suffer from PMDD, mood and behavioral symptoms such as irritability, depressed mood, tension, and labile mood dominate. Somatic complaints, including breast tenderness and bloating, also can prove disruptive to women's overall functioning and quality of life. Recent evidence suggests that individual sensitivity to cyclical variations in levels of gonadal hormones may predispose certain women to experience these mood, behavioral, and somatic symptoms. Treatments include: antidepressants of the serotonin reuptake inhibitor class, taken intermittently or throughout the menstrual cycle; medications that suppress ovarian cyclicity; and newer oral contraceptives with novel progestins.
Cunningham
Joanne
J
Department of Psychiatry, Yale University, New Haven, CT 06510, USA. joanne.cunningham@yale.edu
Yonkers
Kimberly Ann
KA
O'Brien
Shaughn
S
Eriksson
Elias
E
D005260:Female; D006801:Humans; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D012919:Social Behavior; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology