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Premenstrual Dysphoric Disorder

Rashmi Nemade, Ph.D., edited by Kathryn Patricelli, MA

Symptoms of this condition can include:

  • feeling depressed or having mood swings
  • feeling anxious
  • being easily tired or not having interest in normal activities
  • being irritable
  • having changes in eating or sleeping habits irritability
  • feeling overwhelmed and out of control

sad womanSymptoms occur repeatedly during the premenstrual phase of the woman's cycle and decrease or disappear around the onset of her period or shortly after. Symptoms must occur in most of the menstrual cycles during the past year. They also must make it difficult to work or interact with other people. Women who have major depressive disorder tend to experience this condition as well.

How this disorder is displayed can be closely related to social and cultural background characteristics. These can include family perspectives, religious beliefs, social tolerance, and female gender role issues. For example, in some families or cultures, women can express sadness or irritability with ease. In other families or cultures, women are expected to be silent followers of male leaders and not express their feelings or thoughts. While in other religions and cultures, the menstrual cycle is a time of rest and respect for women, and women are excused from daily tasks in order to deal with their biology. In this situation, women may feel more free to display any emotional or depressive symptoms they are experiencing. Thus, this particular condition is tied closely to cultural, social, and religious perspectives of women and women's issues in general.

Approximately 1.8% to 5.8% of menstruating women suffer from this condition. It can happen at any time after a woman's first period. Many women report symptoms get worse as they approach menopause. However, after menopause symptoms stop. If hormone replacement treatment is used, then symptoms can happen again. It is not currently known whether this condition has genetic risk factors or runs in families. Because of the social, cultural, and religious perceptions of women, the range for estimating if this disorder is inherited is between 30% to 80%.

Additional environmental risk factors include stress, history of trauma, and seasonal changes. Women who use oral contraceptives ("the pill") may have fewer symptoms than women who do not use them.

While this condition is displayed and accepted in a variety of different ways in various societies, it is not a bound to any one culture, religion, society, ethnicity, or country. It is found all over the world. However, how often it happens, how intense it is, how it is displayed, and if women/families seek help are strongly influenced by where the woman lives. For example, if a woman lives in a culture that ignores this condition and brushes it off as a women's problem that does not require medical attention, she will likely not seek help. But if that same woman moves to a more accepting culture or marries into a more accepting family, she may go on to receive medical attention. Symptoms can affect marriages, relationships with children or other family members, and can cause problems at work.

There are a number of medical and mental health conditions that may make this condition worse. These include asthma, allergies, seizure disorders, depressive and bipolar disorders, anxiety disorders, bulimia nervosa, and substance use disorders.