The premenstrual syndromes PMD and PMDD: Premenstrual dysphoric disorder—myth or disorder in need of treatment?

Background: Approximately 70–90% of women of reproductive age have some physical and mental discomfort or dysphoria in the second half of the menstrual cycle, especially in the week before menstruation. Symptoms are often mild, but can be severe enough to substantially affect daily activities. Premenstrual dysphoric disorder (PMDD) affects 3–8% of premenopausal women. Objective: Premenstrual psychiatric syndromes were not defined by specific criteria until DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edn) in 2013 and will shortly be followed by ICD-11 (International Classification of Diseases, 11th edn). Thus clinical diagnosis was difficult. Material and methods: Diagnostic criteria of PMDD according to DSM-5, etiology and treatment options are reported. Results: According to the DSM-5 criteria PMDD is defined as the occurrence of at least five symptoms in most menstrual cycles during the past year, such as affective lability, irritability, depressed mood, anxiety, loss of interest, lethargy, changes in appetite or sleep, loss of control or bloating. These symptoms need to begin the week before and improve a few days after the onset of menstruation (on-off phenomenon). Therapy options include serotonin reuptake inhibitors in continuous and also intermittent intake in the luteal phase as well as oral contraceptives. Conclusion: The diagnostic criteria facilitate the diagnosis, e.g., based on a cycle diary and improvement in the treatment of women suffering from PMDD. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.