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aapko educational topic number 49
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premenstrual syndrome and premenstrual
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dysphoric disorder
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you may remember our friend Aunt Flo are
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popular euphemism for menstruation in
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this video we will discuss your daughter
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premenstrual pre comes to visit during
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the luteal phase before on Flo and she
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can cause significant disruption the
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objectives of this video are to identify
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the criteria for making the diagnosis of
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PMS and PMDD and to describe treatment
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options for PMS and PMDD premenstrual
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comes to visit many women before Aunt
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Flo premenstrual symptoms occur in
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approximately 75 to 85% of women it
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causes significant disruption in
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approximately five to ten percent of
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women will start with premenstrual
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syndrome or PMS PMS is a group of
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physical mood related and behavioral
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changes that occur in a regular cyclic
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relationship to the luteal phase of the
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menstrual cycle and that interfere with
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some aspect of the patient’s life
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PMS can be diagnosed if a patient
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reports at least one of the following
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symptoms during the five days before
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menses of three menstrual cycles
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depression angry outbursts irritability
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anxiety confusion social withdrawal
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breast tenderness abdominal bloating
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headache or swelling of extremities the
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diagnostic criteria for premenstrual
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dysphoric disorder or PMDD is outlined
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in the Diagnostic and Statistical Manual
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of Mental Disorders fourth edition this
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DSM 4 states that PMDD can be diagnosed
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if there are a specific set of at least
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five of eleven possible symptoms with at
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least one course symptom of depressed
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mood anxiety or tension irritability or
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decreased interest in activities or
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anhedonia other possible symptoms
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include a subjective sense of having
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difficulty concentrating lethargy
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fatigue or a marked lack of energy a
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marked change in appetite and cravings
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for certain foods hypersomnia or
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insomnia feeling overwhelmed or out of
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control or somatic symptoms such as
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abdominal bloating fatigue and breast
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tenderness these disturbances markedly
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interfere with work school or with usual
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social activities and relationships with
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others moving now to diagnosis the
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majority of patients who present for
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treatment of PMS do not
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actually demonstrate symptoms related to
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the luteal phase the differential
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diagnosis should include medical
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problems and psychiatric disorders a
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menstrual diary involves a patient
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monitoring her symptoms for two or more
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consecutive menstrual cycles for the
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diagnosis of PMS she only needs one
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symptom and a symptom free interval
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after her menses for the diagnosis of
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PMDD she needs five of the listed eleven
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symptoms with one core symptom and she
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must have a symptom free follicular
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phase let’s conclude by discussing
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treatment non pharmacological treatments
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include aerobic exercise calcium and
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magnesium supplementation and eating
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fresh rather than processed foods
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pharmacological treatment involves
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non-steroidal anti-inflammatory drugs
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ovulation suppression with oral
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contraception and serotonin selective
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reuptake inhibitors this concludes the
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OP Cove ideo on PMS and PMDD we’ve
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identified the criteria for making the
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diagnosis of these two conditions and
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describe treatment options as well
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you