Premenstrual Syndrome and Premenstrual Dysphoric Disorder
Premenstrual syndrome (PMS) is a group of physi-P cal, mood-related, and behavioral changes that occurin a regular, cyclic relationship to the luteal phase of the menstrual cycle and that interfere with some aspect of the patient’s life. These symptoms occur in most cycles, resolv-ing usually with onset of menses, but certainly by cessa-tion of menses. This cyclic symptom complex varies both in severity and in the degree of disruption of the patient’s work, home, or leisure life. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), liststhe diagnostic criteria for premenstrual dysphoric disorder(PMDD) as a specific set of at least 5 of 11 possible symptoms,with at least 1 core symptom—specifically depressed mood, anxiety or tension, irritability, or decreased interest in activities (anhe-donia). These symptoms occur regularly during the lutealphase of the menstrual cycle.
PMDD identifies women with PMS who have more severe emotional symptoms that may require more intensive therapy.
The pathophysiology of both entities is not well-elucidated. Neither condition should be confused with normal cyclic symptoms associated with ovulation.