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Premenstrual syndrome and PMDD

Syndroma praemenstruale / dysphoria praemenstrualis · Premenstruační syndrom a PMDD

female only

What it is

Mood, body and energy symptoms in the week or two before a period; in premenstrual dysphoric disorder the mood crash is severe enough to disable.

Symptoms & signs

  • Irritability, anger or low mood
  • anxiety and tearfulness
  • bloating and breast tenderness
  • food cravings
  • tiredness and poor sleep
  • relief within days of the period starting

🚩 Get help if…

  • call 112 / 911 now Thoughts of suicide or self-harm
  • see a doctor soon Low mood that lasts after the period ends
  • see a doctor soon Unable to work or care for yourself each month
  • see a doctor soon Bleeding between periods or after sex

Where it strikes

Medical treatment

  • Symptom diary over two cycles
  • SSRIs (daily or in the second half of the cycle)
  • the combined pill (drospirenone)
  • cognitive behavioural therapy
  • GnRH analogues with add-back for severe PMDD

Natural & lifestyle

  • Exercise
  • less caffeine, salt and alcohol before periods
  • regular sleep

Emerging & experimental

  • Ulipristal acetate
  • sepranolone (allopregnanolone blocker)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Calcium (1200 mg a day) — trials reduce symptoms trials support
  • Chasteberry (Vitex agnus-castus) — several trials help; quality varies mixed evidence
  • Vitamin B6 — trials disagree mixed evidence
  • Magnesium — small trials ease bloating and mood early / small studies

ICD codes