Review, 2018

How should doctors diagnose and treat PMDD?

This review explains that PMDD needs to be carefully told apart from other mental health conditions, and that antidepressants (SSRIs and SNRIs) are the recommended first treatment, with other options available if those don't work.

Early or limited evidence No new patients were studied; this review focuses on women experiencing premenstrual symptoms, PMS, and PMDD in general.

What they did

This is a review article, not a new study. It summarises current medical understanding of how PMDD is diagnosed and how it is best treated.

What they found

Most ovulating women have some premenstrual symptoms, but these are usually mild and do not affect quality of life. A smaller group has PMS or PMDD severe enough that, left untreated, it damages their functioning and relationships. The review states that SSRIs and SNRIs are the first-line drug treatment. Continuous combined oral contraceptives have limited evidence of helping with PMDD. Medical ovarian suppression is often recommended when first-line treatments fail or cannot be tolerated. Cognitive behavioural therapy looks promising but is limited by sparse research data and limited access to trained therapists.

What it means for you

Getting an accurate diagnosis, especially distinguishing PMDD from other psychiatric conditions, is described as essential to choosing an effective treatment. The main limit is that this is a summary review, not a clinical trial, so it does not provide new evidence on how well treatments actually work, just a description of current recommendations.

About the study

Original title: Premenstrual Dysphoric Disorder: Contemporary Diagnosis and Management
Authors: Reid RL, Soares CN
Journal: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
Year: 2018
Study design: Review
What was tested: Reviews existing options: SSRIs/SNRIs, combined oral contraceptives, ovarian suppression, and cognitive behavioural therapy.
Read the paper: doi.org/10.1016/j.jogc.2017.05.018

Topics

Premenstrual syndrome (PMS)Premenstrual dysphoric disorder (PMDD)Menstrual cycle and mood Low mood and depression SSRIs and antidepressants Oral contraceptives and drospirenone GnRH agonists and ovarian suppression Cognitive behavioral therapy Surgical menopause

Review, 2018

What are the most effective treatments for premenstrual syndrome and PMDD?

Review, 2015

What do we know about PMS and PMDD and how are they treated?

Case report, 2023

Can stopping ovulation help severe PMDD when other treatments do not work?

Study, 2022

What are the symptoms, causes, and treatments of PMS and PMDD?

Systematic review, 2024

What are the best treatments for PMDD and PMS?

Systematic review, 2022