premenstrual%20dysphoric%20disorder
PREMENSTRUAL DYSPHORIC DISORDER
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:
    • PMDD tends to recur each cycle and may become severe over time
    • This dysfunction can be readily diagnosed and effectively treated
  • Advise regarding the benefits and risks of each therapeutic agent and how to safely stop drug intake 
  • Inform the patient regarding the mixed results of studies on complementary medicines 
  • 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 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
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