Premenstrual Mood Disorders
While over 50% of menstruating women report mild irritability or depression prior to their periods, between 5% and 8 % suffer from the more serious mood changes of Premenstrual Dysphoric Disorder (PMDD). These women are usually seen by their Ob/Gyn first. PMDD is a risk factor for both perinatal depression and perimenopausal depression. PMDD can have a significant impact on social and occupational functioning. Lifestyle modification and cognitive-behavioral therapy are helpful in reducing some of the symptoms, but there is now a large body of evidence also supporting the use of serotonergic antidepressants for the treatment of PMDD. It is important to keep in mind that premenstrual mood changes may not be PMS or PMDD, but may represent cyclical worsening of an underlying mood disorder. The symptoms must be evaluated prospectively in order to make the proper diagnosis and insure proper treatment.