An Introduction to PMDD
Hi everyone!
Premenstrual dysphoric disorder (PMDD) is a critical area of concern in women's health, necessitating a nuanced understanding and approach from reproductive and women's health providers. PMDD significantly impacts a woman’s mental well-being and quality of life, yet is often misunderstood, underdiagnosed, and undertreated.
PMDD is a severe form of premenstrual syndrome (PMS) characterized by intense emotional and physical symptoms that disrupt daily functioning. Affecting 3-8% of menstruating women, PMDD manifests in the luteal phase of the menstrual cycle, typically starting 7-10 days before the start of menstruation and subsiding within a few days of its onset.Symptoms include severe mood swings, irritability, depression, anxiety, and physical complaints such as bloating, fatigue, and breast tenderness. While the medical field does not yet understand the exact etiology of PMDD, there are a few working hypotheses involving an abnormal response to the drop in progesterone during the luteal phase and serotonin dysregulation. Effective management of PMDD often requires a multidisciplinary approach, including lifestyle modifications, psychotherapy,and pharmacological treatments such as SSRIs or hormonal therapies with oral contraceptives. In severe cases, women may experience suicidal thoughts or suicide attempts only in the luteal phase. For these cases that do not respond to typical pharmacologic treatment strategies, inducing a medical menopause or surgical intervention may be needed to achieve symptom remission and keep the patient safe.
For reproductive and women's health providers, early identification and intervention are key in managing PMDD. Establishing a thorough clinical history, using validated screening tools, and maintaining a holistic approach to treatment can significantly improve outcomes for affected women. By addressing this condition with empathy and expertise, we can help mitigate its impact and enhance the overall well-being of our patients.
I discuss this more in my Foundations Pathway of Repro Psych Academy, launching October 1st.
Save your seat now!
