Premenstrual syndrome

Abstract

The premenstrual disorders, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are psychoneuroendocrine disorders characterized by a constellation of affective, somatic, and behavioural symptoms that occur monthly, during the luteal phase of the menstrual cycle with relief soon after the onset of menses. PMS affects approximately 15–40% of reproductive aged women depending on criteria for diagnosis. PMDD is a severe form of PMS, with an emphasis on the affective symptoms. It has been estimated that only 5–8% of women meet the strict criteria for PMDD, but up to 20% may be one symptom short of meeting the criteria (1). The premenstrual syndromes adversely impact relationships, activities of daily living, and workplace productivity. The research and treatment of the premenstrual disorders have been hampered by lack of consensus regarding the specific diagnostic criteria, methods of assessment of symptoms and impairment, and absence of animal models or biological markers for the disorders. However, elucidation of various aspects of the pathophysiology, well designed multicentre treatment trials, and patient and clinician education have successfully improved diagnosis and management This chapter will review symptoms, definitions, diagnostic criteria, aetiology, evaluation, and nonpharmacological and pharmacological management of PMS and PMDD.