Premenstrual dysphoric disorder

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Depression and the menstrual cycle

PMDD

Women with PMDD may be helped by the following:

• Regular exercise 3-5 times per week
• Adequate rest
• A balanced diet (with increased whole grains, vegetables, fruit, and decreased or no salt, sugar, alcohol, and caffeine)

In addition, it is important to keep a diary or calendar to record the type, severity, and duration of symptoms.

Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa).

Nutritional supplements -- such as vitamin B6, calcium, and magnesium -- may be recommended. Pain relievers such as aspirin or ibuprofen may be prescribed for headache, backache, menstrual cramping and breast tenderness. Diuretics may be useful for women who have significant weight gain due to fluid retention.

After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels.

PMDD symptoms may become severe enough that they interfere with a woman's daily life. Women with depression may have worse symptoms during the second half of their cycle and may require medication adjustments.

As many as 10% of women who report PMS symptoms, particularly those with PMDD, have had suicidal thoughts. The incidence of suicide in women with depression is significantly higher during the latter half of the menstrual cycle.

PMDD may be associated with eating disorders and smoking.

Call 911 immediately if you are having suicidal thoughts.

Call for an appointment with your health care provider if:

• PMS symptoms do not improve with self-treatment
• PMS symptoms are interfering with your daily life

Review Date: 11/08/2006
Reviewed By: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.