Depressive Disorders | Premenstrual Dysphoric Disorder

March 6, 2025

• A severe form of premenstrual syndrome marked by significant mood disturbances and physical symptoms.

  
  

• Symptoms occur during the luteal phase (typically the week before menstruation) and remit shortly after menstruation begins.

  
  

• Must be documented for at least two consecutive menstrual cycles.

  
  

• PREVALENCE:

  • Affects approximately 3-8% of women of reproductive age.

Differential Diagnosis

Premenstrual Syndrome (PMS):

• Does not require a minimum of five symptoms.

• Symptoms are generally less severe than PMDD.

• May include somatic or behavioral symptoms without mood-related symptoms.

• More common than PMDD, with an estimated prevalence of ~20%.

  
  

Dysmenorrhea:

• Characterized by painful menstruation, not affective changes.

• Symptoms begin with the onset of menses, whereas PMDD symptoms start before menses and may linger into early menstruation.

Use of Hormonal Treatments:

• Hormonal contraceptives or other hormone-based treatments may induce mood symptoms similar to PMDD.

• If symptoms begin after starting hormonal therapy and disappear upon stopping, they may be due to substance/medication-induced depressive disorder rather than PMDD.