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How are PMDD and PMS diagnosed and treated?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

Recently, I have been experiencing a range of distressing symptoms that seem to worsen in the days leading up to my menstrual period. These include intense stress, anxiety, frequent crying spells, soreness in my breasts, persistent headaches, acne breakouts, and significant bloating. After researching my symptoms, I came across premenstrual dysphoric disorder (PMDD), and premenstrual syndrome (PMS) as possible explanations. I am particularly concerned about PMDD because of its severe impact on mood and daily functioning. Can you please provide more information about the differences between PMDD and PMS, and how they are diagnosed and treated?

Thank you.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

PMDD is characterized by depressed or labile mood, anxiety, irritability, anger, and other symptoms occurring exclusively during the two weeks preceding menses.

Decreased interest in usual activities (work, school, friends, and hobbies).

Subjective sense of difficulty in concentrating.

Lethargy, easy fatigability, or marked lack of energy.

Marked change in appetite, overeating, or specific food cravings.

Hypersomnia(excessive sleep) or insomnia(poor sleep).

A subjective sense of being overwhelmed or out of control.

Other physical symptoms include breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain.

Diagnosis:

Thyroid function tests.

Complete blood count (CBC).

Follicle-stimulating hormone (FSH) level.

Treatment is by hormones:

Diuretics.

Nonsteroidal anti-inflammatory drugs (NSAIDs).

Anxiolytics, antidepressants, and mood stabilizers.

Premenstrual syndrome (PMS) is a recurrent luteal-phase condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in the deterioration of interpersonal relationships and normal activity. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS.

Symptoms may be divided into five basic categories—anxiety, craving, depression, hydration, and others.

Medical care for PMS is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. Selective serotonin reuptake inhibitors (SSRIs) are commonly considered suitable first-line therapy for premenstrual disorders.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.

Medically reviewed byiCliniq medical review team

Published At July 18, 2024
Reviewed AtJuly 18, 2024

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