PMS and PMDD - AUD Lecture

Question 1

PMS

Answer 1

must have at least one symptom and 3menstrual cycles

Question 2

PMDD

Answer 2

included in the DSM-5 (health disorders)
must have at least 5 total symptoms, with at least one in two different criteria for 2 consecutive months

Question 3

Similarities of PMDD and PMS

Answer 3

onset - 5-7 days prior to menses
symptoms end - start of follicular phase
some level of impairment to daily activity
no definitive diagnostic test

Question 4

PMDD diagnostic symptoms

Answer 4

At least one from this list
affective lability
irritability, anger or interpersonal conflict
depressed mood
anxiety

At least one from this list
decreased interest in usual activities
difficulty in concentration
easily fatigued
changed appetite
hypersomnia or insomnia
feeling overwhelmed
physical symptoms

Question 5

Common somatic symptoms of PMS and PMDD

Answer 5

abdominal bloating
breast swelling and tenderness
muscle pain
edema
weight gain
fatigue
dizziness
constipation or diarrhea
migraines
appetite change
acne

Question 6

Common affective symptoms of PMS and PMDD

Answer 6

Angry outbursts
anxiety
depression
confusion
difficulty concentrating
social withdrawal
forgetfulness
sadness
tension
tearfulness
restlessness
loneliness
food craving
change in libido

Question 7

Pathophysiology

Answer 7

reduced levels of serotonin, GABA, allopregnanolone
Fluctuation in estrogen and progesterone

Question 8

Non-pharmacologic treatment

Answer 8

Limit sodium, caffeine, and alcohol consumption
Aerobic exervise
relaxation techniques
structured sleep schedule
calcium
magnesium
vitamin B,D,E

Question 9

PMS/PMDD treatment overview

Answer 9

First line - SSRIs, NSAIDs, spironolactone
Second line - Venlafaxine, duloxetine, clomipramine, alprazolam, cocs
Last line - GnRh agonists, surgery
Complementary therapy - Ginkgo, st johns wort (not commonly used at all)

Question 10

Medication summary

Answer 10

SSRIs- Mood/ emotional and physical symptoms, psychosocial functioning, work performance and over all quality of life

Spironolactone - breast tenderness, bloating, and negative mood

COCs - physical symptoms, social functioning and productivity

alprazolam - premenstrual depression, tension, anxiety, irritability, hostility, social withdrawal