Dr. Dresner explains Premenstrual Syndrome (PMS) And Premenstrual Dysphoric Disorder (PMDD).
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PMS and PMDD in Women Over the years, there has been a host of descriptions of what women experience emotionally and physically before menses. What happens over the course of the menstrual cycle is that hormone levels rise in the early half of the cycle, other hormones, other hormone levels shift at the time of ovulation and after ovulation, levels of estrogen and progesterone drop until uterine lining is shed, and a woman experiences her period, menstrual period. In that period of decline, women in the last half of themenstrual cycle, what we call the luteal phase of the menstrual cycle, women tend to experience physical and emotional symptoms: breast tenderness, bloating, irritability, even lethargy, low mood, and as a woman approaches her period, those symptoms may become more severe. Most women, up to 85 percent of women, report some emotional or physical symptoms before their period. A very small number of women, about three percent, meet criteria for a disorder called the Premenstrual Dysphoric Disorder, PMDD, which has been called a whole other, bunch of other things in the last 30 years but is described as really a dysphoric disorder, depressive disorder. It’s not that irritability, it’s not that impatience, it’s really a depressive syndrome that occurs premenstrually, that meets criteria really for a depressive disorder, except not for the duration. So, that’s not two weeks long and might just be three or four days long. It’s relieved with menses. It goes away with menses, and as hormone levels begin to rise again in the next cycle, and it’s very, very well treated with selective serotonin reuptake inhibitors. So there’s a lot of good research in literature to show that those symptoms, premenstrual dysphoric disorder, responds to anti-depressant medications.