Premenstrual syndrome / dysphoric disorder - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Premenstrual syndrome (PMS) is characterized by repetitive, cyclical, physical, and behavioral symptoms occurring in the luteal phase of the normal menstrual cycle. Symptoms may extend into the first few days of menses. The symptoms cannot be an exacerbation of another disorder, and they must interfere with some aspects of the woman's life.
Premenstrual dysphoric disorder (PMDD) is a more severe variant of PMS. In addition to physical symptoms, at least one affective symptom such as anger, irritability, and/or internal tension occurs during the second half of the menstrual cycle, and sometimes in the first few days of menses. Symptoms must remit post-menses, and not represent an exacerbation of another psychiatric disorder.
PMS and PMDD are diagnoses of exclusion, confirmed by a prospective symptom diary that verifies their repetitive, cyclical nature. Physical exam and limited laboratory testing are typically normal.
Treatment options include lifestyle modification, behavioral therapy, pharmacologic interventions, and, in severe refractory cases, surgical removal of the ovaries.

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Citations

Key Articles

American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 7: management of premenstrual disorders. Dec 2023 [internet publication].[Full Text]
Ismaili E, Walsh S, O'Brien PMS, et al; Consensus Group of the International Society for Premenstrual Disorders. Fourth consensus of the International Society for Premenstrual Disorders (ISPMD): auditable standards for diagnosis and management of premenstrual disorder. Arch Womens Ment Health. 2016 Dec;19(6):953-8.[Abstract]
Green LJ, O'Brien PMS, Panay N, et al; Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome: green-top guideline no. 48. BJOG. 2017 Feb;124(3):e73-105.[Abstract][Full Text]
World Health Organization. International classification of diseases 11th revision. Jan 2022 [internet publication].[Full Text]

Referenced Articles

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