PREMENSTRUAL DYSPHORIC DISORDER Flashcards
General considerations of Premenstrual Dysphoric Disorder
(1) Premenstrual syndrome (PMS)
(a) 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
(2) Premenstrual dysphoric disorder (PMDD)
(a) When emotional or mood symptoms predominate along with the physical symptoms and there is a clear functional impairment with work or personal relationships
(3) Intermittently affects about 40% of premenopausal women
(a) Primarily 25-40 years of age
(4) About 5-8% the symptoms are severe
(5) Pathogenesis is uncertain
Signs and symptoms of Premenstrual Dysphoric Disorder
(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
Work up of Premenstrual Dysphoric Disorder
(1) Provide support for both the emotional and physical distress
(2) Careful evaluation of the patient with understanding explanation and reassurance
(3) 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
Treatment of Premenstrual Dysphoric Disorder
(1) Mild to moderate symptoms
(a) Aerobic exercise
(b) Reduction of caffeine, salt and alcohol
(c) Increase Ca, Vit. D or magnesium, &complex carbs
(d) Alternative therapies
(2) Medications that prevent ovulation such as hormonal contraceptives may
lessen symptoms
(a) Combined oral contraceptives
(3) When mood disorders predominate SSRIs have been shown to be effective in relieving tension, irritability, and dysphoria
(a) Given either daily or on symptom days
(b) SSRI
