PMDD - Premenstrual Dysphoric Disorder



I.	The Phases of the Menstrual Cycle


II.	About Your Period


III.	Symptoms Related to Your Cycle


>	PMS - Premenstrual Syndrome
>	PMDD - Premenstrual Dysphoric Disorder


IV.	Managing Your Cycle


V.	Contraception and Your Cycle


VI.	Glossary

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Premenstrual Dysphoric Disorder (PMDD) >n. A disorder characterized by a collection of symptoms that regularly occur during the last week of the luteal phase in most menstrual cycles during the past year, and remit within a few days of the onset of the menses.

Understanding PMDD

Symptoms of PMDD can be a very serious concern, and you may want to discuss them with your doctor or health care professional.

When compared with PMS, Premenstrual Dysphoric Disorder (PMDD) is a more severe disorder associated with the menstrual cycle and is characterized by a very specific pattern of symptoms. The symptoms of PMDD must occur during the last week of the luteal phase in the majority of menstrual cycles over the course of a year and disappear during menstruation.^{47. American Psychiatric Association, p. 715 A}

PMDD symptom severity can be compared to a Major Depressive Episode.^{47. American Psychiatric Association, p. 715 C} The symptoms must be debilitating enough to interfere with a woman’s ability to carry on with social or job-related activities. The symptoms may also be accompanied by suicidal thoughts.^{47. American Psychiatric Association, p. 715 B, C}

Because of its impact on women, the American Psychiatric Association has defined PMDD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV™). In order to be diagnosed with PMDD, a woman must have five (or more) of the following symptoms with at least one of the symptoms being one of the first four.^{47. American Psychiatric Association, p. 715}

Feeling sad, hopeless, or worthless^{47. American Psychiatric Association, p. 715 B}
Feeling tense, anxious, or "on edge"^{47. American Psychiatric Association, p. 715 B}
Mood swings interspersed with frequent tearfulness^{47. American Psychiatric Association, p. 715 B}
Persistent irritability, anger, and increased interpersonal conflict^{47. American Psychiatric Association, p. 715 B}
Decreased interest in usual activities^{47. American Psychiatric Association, p. 715 B}
Difficulty concentrating^{47. American Psychiatric Association, p. 715 B}
Feeling fatigued, lethargic, or lacking in energy^{47. American Psychiatric Association, p. 715 B}
Changes in appetite (may be associated with binge eating or craving certain foods)^{47. American Psychiatric Association, p. 715 B}
Inability to sleep or sleeping excessively^{47. American Psychiatric Association, p. 715 B}
Having a subjective feeling of being overwhelmed or out of control^{47. American Psychiatric Association, p. 715 B}
Other physical symptoms such as breast tenderness or swelling, headaches, sensations of bloating or weight gain with feelings of tightness in clothing, shoes, or rings. Joint or muscle pain may also be present.^{47. American Psychiatric Association, p. 715 B}

If you have menstrual symptoms that interrupt your daily life, and recur consistently and predictably every month^{47. American Psychiatric Association, p. 715 B}, you may want to discuss them with your doctor or health care professional. Use the Annual Visit Checklist to help facilitate a discussion.