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American Family Physician Aug 2016Premenstrual disorders affect up to 12% of women. The subspecialties of psychiatry and gynecology have developed overlapping but distinct diagnoses that qualify as a... (Review)
Review
Premenstrual disorders affect up to 12% of women. The subspecialties of psychiatry and gynecology have developed overlapping but distinct diagnoses that qualify as a premenstrual disorder; these include premenstrual syndrome and premenstrual dysphoric disorder. These conditions encompass psychological and physical symptoms that cause significant impairment during the luteal phase of the menstrual cycle, but resolve shortly after menstruation. Patientdirected prospective recording of symptoms is helpful to establish the cyclical nature of symptoms that differentiate premenstrual syndrome and premenstrual dysphoric disorder from other psychiatric and physical disorders. Physicians should tailor therapy to achieve the greatest functional improvement possible for their patients. Select serotonergic antidepressants are first-line treatments. They can be used continuously or only during the luteal phase. Oral contraceptives and calcium supplements may also be used. There is insufficient evidence to recommend treatment with vitamin D, herbal remedies, or acupuncture, but there are data to suggest benefit from cognitive behavior therapy.
Topics: Calcium; Cognitive Behavioral Therapy; Contraceptives, Oral, Hormonal; Dietary Supplements; Female; Humans; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Selective Serotonin Reuptake Inhibitors
PubMed: 27479626
DOI: No ID Found -
Magnesium Research Feb 2017A growing amount of evidence suggests that magnesium deficiency may play an important role in several clinical conditions concerning women health such as premenstrual... (Review)
Review
A growing amount of evidence suggests that magnesium deficiency may play an important role in several clinical conditions concerning women health such as premenstrual syndrome, dysmenorrhea, and postmenopausal symptoms. A number of studies highlighted a positive correlation between magnesium administration and relief or prevention of these symptoms, thus suggesting that magnesium supplementation may represent a viable treatment for these conditions. Despite this amount of evidence describing the efficacy of magnesium, few and un-systematize data are available about the pharmacological mechanism of this ion for these conditions. Herein, we review and systematize the available evidence about the use of oral magnesium supplementation in several gynecological conditions and discuss the pharmacological mechanisms that characterize these interventions. The picture that emerges indicates that magnesium supplementation is effective in the prevention of dysmenorrhea, premenstrual syndrome, and menstrual migraine and in the prevention of climacteric symptoms.
Topics: Dietary Supplements; Dysmenorrhea; Female; Humans; Magnesium; Osteoporosis, Postmenopausal; Postmenopause; Premenstrual Syndrome
PubMed: 28392498
DOI: 10.1684/mrh.2017.0419 -
The Journal of Obstetrics and... Feb 2023Recently, the term premenstrual disorders (PMDs), which includes premenstrual syndrome and premenstrual dysphoric disorder as a continuum, has been proposed. Although... (Review)
Review
Recently, the term premenstrual disorders (PMDs), which includes premenstrual syndrome and premenstrual dysphoric disorder as a continuum, has been proposed. Although the precise etiology of PMDs remains unknown, the involvement of hormonal fluctuations is clear. The brain transmitters, serotonin and γ-amino butyric acid, also seem to be involved. Serotonin reuptake inhibitors and oral contraceptives are the current mainstay of treatment, but these are insufficient. Even the currently used prospective two-period symptom diary is not widely used in actual clinical practice, creating a major problem of discrepancy between research and clinical practice. In this review, I would like to outline the latest information and problems in the etiology, diagnosis, and treatment of PMDs, with an emphasis on promising new therapies.
Topics: Female; Humans; Premenstrual Dysphoric Disorder; Prospective Studies; Premenstrual Syndrome; Contraceptives, Oral; Selective Serotonin Reuptake Inhibitors
PubMed: 36317488
DOI: 10.1111/jog.15484 -
American Journal of Obstetrics and... Jan 2018Premenstrual disorders include premenstrual syndrome, premenstrual dysphoric disorder, and premenstrual worsening of another medical condition. While the underlying... (Review)
Review
Premenstrual disorders include premenstrual syndrome, premenstrual dysphoric disorder, and premenstrual worsening of another medical condition. While the underlying causes of these conditions continue to be explored, an aberrant response to hormonal fluctuations that occurs with the natural menstrual cycle and serotonin deficits have both been implicated. A careful medical history and daily symptom monitoring across 2 menstrual cycles is important in establishing a diagnosis. Many treatments have been evaluated for the management of premenstrual disorders. The most efficacious treatments for premenstrual syndrome and premenstrual dysphoric disorder include serotonin reuptake inhibitors and contraceptives with shortened to no hormone-free interval. Women who do not respond to these and other interventions may benefit from gonadotropin-releasing hormone agonist treatment.
Topics: Androstenes; Cognitive Behavioral Therapy; Complementary Therapies; Diagnostic and Statistical Manual of Mental Disorders; Ethinyl Estradiol; Exercise; Female; Gonadotropin-Releasing Hormone; Humans; Hysterectomy; Ovariectomy; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Risk Factors; Salpingectomy; Selective Serotonin Reuptake Inhibitors
PubMed: 28571724
DOI: 10.1016/j.ajog.2017.05.045 -
Molecules (Basel, Switzerland) Dec 2021Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms and gynecological disorders (such as premenstrual syndrome and... (Review)
Review
Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms and gynecological disorders (such as premenstrual syndrome and dysmenorrhea) are the indications where pharmacological therapy may have serious adverse events, hence many women prefer to use herbal products to help with these symptoms. Here, we reviewed plants and derived products, which are commonly used for the abovementioned indications, focusing on clinical data, safely profile and whether or not their use is justified. We noted that limited data are available on the use of some plants for alleviating the symptoms of menopause and gynecological disorders. While black cohosh () and red clover () were consistently shown to help reduce menopausal symptoms in clinical studies, currently available data do not fully support the use of fenugreek (), hops (), valerian (), and soybean ( and ) for this indication. For premenstrual syndrome and premenstrual dysphoric disorder, chaste tree () shows effectiveness, but more clinical studies are needed to confirm such effect upon the use of evening primrose ().
Topics: Dysmenorrhea; Female; Humans; Menopause; Phytotherapy; Plants, Medicinal; Premenstrual Syndrome
PubMed: 34946512
DOI: 10.3390/molecules26247421 -
Clinical Obstetrics and Gynecology Mar 2018Premenstrual dysphoric disorder (PMDD) is defined by both physical and psychiatric symptoms that impact a woman significantly during the luteal phase of her menstrual... (Review)
Review
Premenstrual dysphoric disorder (PMDD) is defined by both physical and psychiatric symptoms that impact a woman significantly during the luteal phase of her menstrual cycle. Diagnostic criteria for PMDD were firmly established in the Diagnostic and Statistical Manual of Mental Disorders V in 2013, but many patients fall short of the diagnosis while still appreciably affected by severe premenstrual symptoms. More recent and robust investigations have evaluated the efficacy of treatment ranging from serotonergic therapy to hormonal treatment as well as lifestyle and herbal remedies. This article reviews the evidence for diagnosis and treatment of PMDD.
Topics: Cognitive Behavioral Therapy; Contraceptives, Oral, Hormonal; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Life Style; Phytotherapy; Premenstrual Syndrome; Prevalence; Salpingo-oophorectomy; Selective Serotonin Reuptake Inhibitors; Surveys and Questionnaires; Vitamins
PubMed: 29298169
DOI: 10.1097/GRF.0000000000000339 -
The Medical Clinics of North America Jul 2019Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual... (Review)
Review
Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.
Topics: Contraceptives, Oral; Contraceptives, Oral, Hormonal; Female; Humans; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Selective Serotonin Reuptake Inhibitors; Women's Health
PubMed: 31078196
DOI: 10.1016/j.mcna.2019.02.007 -
Current Psychiatry Reports Nov 2015Recently designated as a disorder in the DSM-5, premenstrual dysphoric disorder (PMDD) presents an array of avenues for further research. PMDD's profile, characterized... (Review)
Review
Recently designated as a disorder in the DSM-5, premenstrual dysphoric disorder (PMDD) presents an array of avenues for further research. PMDD's profile, characterized by cognitive-affective symptoms during the premenstruum, is unique from that of other affective disorders in its symptoms and cyclicity. Neurosteroids may be a key contributor to PMDD's clinical presentation and etiology, and represent a potential avenue for drug development. This review will present recent literature on potential contributors to PMDD's pathophysiology, including neurosteroids and stress, and explore potential treatment targets.
Topics: Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Disease Management; Female; Humans; Mood Disorders; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; gamma-Aminobutyric Acid
PubMed: 26377947
DOI: 10.1007/s11920-015-0628-3 -
Maturitas Dec 2015Premenstrual syndrome (PMS) is characterized by recurrent, moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal menstrual cycle... (Review)
Review
Premenstrual syndrome (PMS) is characterized by recurrent, moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal menstrual cycle and disappear within a few days of menstruation. Premenstrual dysphoric disorder (PMDD) is a severe and disabling condition that can affect personal relationships and occupational activities. PMS occurs in 30-40% of reproductive-age females; PMDD affects 3-8% of this population. Although the etiology of PMS is unclear, several theories suggest increased sensitivity to normal hormonal changes and neurotransmitter abnormalities. The diagnostic method of PMS is the Daily Record of Severity of Problems, which women with PMS can use to self-report several symptoms and their severity. Although combined oral contraceptives and serotonergic antidepressants are effective drugs, each is a different option for treating PMS/PMDD. Serotonergic antidepressants are the drugs of choice for improving both physical and mood symptoms. Combined oral contraceptives appear to primarily improve physical symptoms. Clinicians should consider each patient's situation individually. Other treatment options include lifestyle modification, cognitive behavioral therapy, and herbal medicine (e.g., chasteberry).
Topics: Cognitive Behavioral Therapy; Contraceptives, Oral, Combined; Dietary Supplements; Female; Gonadotropin-Releasing Hormone; Humans; Life Style; Luteal Phase; Plant Preparations; Premenstrual Syndrome; Selective Serotonin Reuptake Inhibitors; Vitex
PubMed: 26351143
DOI: 10.1016/j.maturitas.2015.08.010 -
Current Problems in Pediatric and... May 2022Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent two premenstrual disorders characterized by physical and psychological symptoms that...
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent two premenstrual disorders characterized by physical and psychological symptoms that occur in the luteal phase of the menstrual cycle, prior to the onset of menses, and have a negative impact on the psychosocial functioning of affected individuals. PMS, more common than PMDD, affects 20-40% of menstruating women, with common symptoms including fatigue, irritability, mood swings, depression, abdominal bloating, breast tenderness, acne, changes in appetite and food cravings. PMDD, affecting a smaller percentage of women, is characterized by more severe symptoms and is listed as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While the pathophysiology of these premenstrual disorders remains unclear, it has been hypothesized that sensitivity to hormonal fluctuations during the luteal phase of the menstrual cycle, abnormal serotonergic activity, and aberrations in progesterone and the neurotransmitter gamma aminobutyric acid (GABA) may all play a role in these disorders. Treatment of PMS and PMDD is focused on alleviation of symptoms and improvement of functioning and quality of life for affected individuals. The treatment of severe PMS and PMDD typically requires pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs), oral contraceptive pills (OCPs), gonadotropin-releasing hormone (GnRH) agonists, and non-contraceptive estrogen formulations. Non-pharmacologic treatment with diet, exercise, cognitive behavioral therapy (CBT), certain vitamin and herbal supplements, and acupuncture may additionally be effective for some individuals.
Topics: Adolescent; Female; Humans; Mood Disorders; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Quality of Life; Selective Serotonin Reuptake Inhibitors
PubMed: 35534402
DOI: 10.1016/j.cppeds.2022.101187