Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). About 75% of women of childbearing age suffer from PMS. Approximately 2 - 10% of them suffer from the PMDD.

The symptoms of PMDD develop in the second half of each menstrual cycle, after ovulation, and appear during the first few days of each menstrual period.

The main symptoms of PMDD are:

• well-marked low mood, feeling of hopelessness or self-deprecating thoughts
• well-marked anxiety, tension, feeling of overexcitement
• distinct affective lability (eg, quickly advancing sadness or tearfulness)
• persistent and distinct irritability, increased frequency of interpersonal conflicts
• reduced interest in daily activities (eg, work, school, friends, hobbies)
• subjective difficulty concentrating
• apathy, fatigue, lack of energy
• distinct change in appetite, overeating or specific taste preferences
• drowsiness or insomnia
• subjective feeling of depression or uncontrollability
• other physical symptoms such as increased sensitivity or enlargement of breast, headache, joint or muscle pain, swelling, body weight gain

These symptoms hinder professional activities, studies, and disturb interpersonal relationships. If these symptoms occur 10 - 14 days before the expected menstruation and disappear without your intervention when the bleeding starts, it is possible that you suffer from the PMDD.

The treatment of PMDD depends on the severity of the sundrome. If symptoms are mild and do not cause serious inconvenience, the doctor will recommend some changes in diet or lifestyle. In severe cases, drug therapy is recommended.

The drugs used in PMDD treatment include:

• non-hormonal agents like magnesium, vitamins, minerals
• diuretics for PMDD accompanied by swellings
• selective serotonin reuptake inhibitors (SSRIs) may be assigned to the patient with the prevalence of psychic symptoms. Most often are used fluoxetin (Prozac), sertraline (Zoloft), citalopram (Celexa, Cipramil)
• inhibitors of prostaglandins (NSAIDs)
• different hormonal drugs, including oral birth control