Pre- Menstrual Dysphoric Disorder

Question 1

Definition of what issue?
Recurrent variable cluster of troublesome physical and emotional symptoms that develop during the 5 days before the onset of menses and subsides within 4 days after menstruation occurs.

Answer 1

Premenstrual syndrome (PMS)

Question 2

Definition of what issue?
When emotional or mood symptoms predominate along with the physical symptoms and there is a clear functional impairment with work or personal relationships. May be thought of as complicated PMS

Answer 2

Premenstrual dysphoric disorder (PMDD)

Question 3

Premenstrual dysphoric disorder (PMDD)

• Intermittently affects about __% of premenopausal women
• Primarily ______ years of age
• About ___% the symptoms are severe

Answer 3

• 40%
• 25-40 years
• 5-8%

Question 4

Signs and symptoms of what issue?

(1) Bloating
(2) Breast pain
(3) Ankle swelling
(4) A sense of increased weight
(5) Skin disorders
(6) Irritability
(7) Aggressiveness
(8) Depression
(9) Inability to concentrate
(10) Libido change
(11) Lethargy
(12) Food cravings

Answer 4

PMS/PMDD

Question 5

Work up PMDD

Answer 5

1) Provide support for both the emotional and physical distress
2) Advice the patient to keep a daily diary of all symptoms for 2-3 months
- —(a) Daily record of severity of problems
- ——-1) Evaluate the timing and characteristics of her symptoms
(4) If symptoms occur throughout the month rather in the two weeks before menses, she may have depression or other mental health problems in addition to PMS/PMDD.

Question 6

If symptoms occur throughout the month rather in the two weeks before menses, she may have _____ in addition to PMS/PMDD

Answer 6

depression or other mental health problems

Question 7

Treatment PMDD/PMS

Mild to moderate symptoms

Answer 7

Lifestyle changes

(a) Aerobic exercise
(b) Reduction of caffeine, salt and alcohol
(c) Increase in dietary calcium (1200mg/day)
(d) Vitamin D or magnesium
(e) Increase complex carbohydrates
(f) Alternative therapies (acupuncture or herbal treatments)

Question 8

Treatment PMS/PMDD

Medications that prevent ovulation such as _______ may lessen symptoms.

Answer 8

hormonal contraceptives

Question 9

When mood symptoms predominate what medications have been shown to be effective in relieving tension, irritability, and dysphoria?

Answer 9

SSRIs

-Given either daily or on symptom days