Premenstrual dysphoric disorder is a cyclical disorder presenting with distressing mood and behavioral symptoms that occur during the late luteal phase of the ovulatory cycle; it is a severe form of premenstrual syndrome.
It results in considerable impairment of the patient's personal functioning that occurs in approximately 5% of women of reproductive age.

Patient Education

  • Emphasize the need to seek help due to the following reasons:
    • Premenstrual dysphoric disorder (PMDD) tends to recur each cycle and may become severe over time
    • This dysfunction can be readily diagnosed and effectively treated
  • Educate both the patient and the family/spouse as this disorder impacts on the entire family context

Lifestyle Modification

Diet Modification

  • Dietary changes can have a noticeable impact on premenstrual syndrome (PMS) severity
    • Reduction of caffeine intake may diminish anxiety and irritability
    • Decreasing Na intake can lessen bloating and edema
    • Patients should also be encouraged to reduce intake of refined sugar and eat small balanced meals rich in complex carbohydrates

Increase in Physical Exercise

  • Has been shown to significantly improve mood and decrease lethargy
  • Evidence of effect is largely anecdotal but can be advised as part of healthy lifestyle
  • Aerobic exercise for 20-30 min, 3-4x/week has been recommended
  • Reduction of body weight to within 20% of ideal is an appropriate goal
Editor's Recommendations
Most Read Articles
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
10 Nov 2017
Inhibition of hippocampal retrieval processes through gamma-aminobutyric acid (GABA) enables the suppression of intrusive thoughts, a recent study shows.
Dr Joslyn Ngu, 30 Nov 2017

According to a review, using a patient-centred approach to provide early and optimal pharmacotherapy in major depressive disorder is more likely to result in full functional recovery. [Int J Neuropsychopharmacol 2017; Doi:10.1093/ijnp/pyx081. Epub ahead of print]

Jairia Dela Cruz, 14 Oct 2017
Naturalistic use of psychedelic drugs among marginalized women who are street-involved is independently related to reduced suicidality, whereas crystal methamphetamine use and childhood trauma signal a high risk of attempting suicide in this population, according to a study from Canada.