Premenstrual Dysphoric Disorder in Adults


ICD-10 code: F32.81

Premenstrual dysphoric disorder (PMDD) is part of a cluster of diagnoses called the depressive disorders.  Depressive disorders are a group of psychiatric conditions that include:

  • Major depressive disorder
  • Persistent depressive disorder (dysthymia)
  • Premenstrual dysphoric disorder
  • Disruptive mood dysregulation disorder (children only)

The depressive disorders are characterized primarily by mood disturbance (sad, empty, or irritable mood).  Individuals with depressive disorders often experience significant somatic changes, such as disruptions in sleep (insomnia or hypersomnia), eating (overeating or loss of appetite), or energy level.  Changes in cognition, such as difficulty concentrating, indecisiveness, and morbid ideation (such as thoughts of death) are also common.  

Individuals with major depressive disorder experience pervasive sadness or anhedonia (loss of interest) along with significant changes in somatic and/or cognitive functioning.  To be diagnosed, these problems must be present nearly every day for at least two weeks.  Individuals with persistent depressive disorder (dysthymia) experience similar symptoms, including sad mood and problems with somatic and/or cognitive functioning that occur most days for at least two years. Individuals with premenstrual dysphoric disorder experience marked changes in mood and interpersonal functioning that begin sometime following ovulation and remit within a few days of the onset of menses. Disruptive mood dysregulation disorder is diagnosed in children under 12 years old who experience persistent irritability and extreme behavioral dyscontrol.

What is premenstrual dysphoric disorder?

PMDD is a psychiatric disorder that will affect approximately 1-8% of menstruating women at some point in their lives.  An individual with PMDD experiencesa variety of mood-related symptoms that emerge in the final week before the onset of menses, improve within a few days after the onset of menses, and become minimal or absent in the week post-menses.  

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Understanding Premenstrual Dysphoric Disorder

PMDD severity can range from mild to severe.  In severe cases, PMDD may lead to impaired ability to fulfill responsibilities at work, school, or home while symptoms are present.  PMDD may also cause problems in interpersonal relationships, for example if irritability and rejection sensitivity are pronounced.  Many people with PMDD also have other psychiatric conditions, most commonly a history of a major depressive episode.

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How is premenstrual dysphoric disorder treated?

PMDD is treatable.  Published treatment guidelines for PMDD include those from theAssociation of Reproductive Health Professionals, the Journal of Women's Health, and the American Academy of Family Physicians.

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