User:Mr. Ibrahem/Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that interferes with functioning. Symptom may include sadness, irritability, trouble focusing, low energy, abdominal cramps, and breast tenderness. Onset is a week or two before the start of the period, with symptoms improving within a day of two after the period begins. Complications may include suicide.

The cause is unknown. Risk factors include past trauma, anxiety disorders, smoking, obesity, and family history. The underlying mechanism may involve hormonal changes or the brain chemical serotonin. PMDD was first listed as a depressive disorder in the DSM-5 in 2013. Diagnosis is based on the presence at least 5 out of the 11 main symptoms, with at least one of the symptoms involving mood changes.

Treatment may involve lifestyle changes such as exercise, dietary changes, and stress management or medication. Medications may include selective serotonin reuptake inhibitors (SSRIs) or ovulation suppression using birth control pills or GnRH analogues. SSRIs are the most common treatment, as they work well with a few side effects. NSAIDs may be used for physical symptoms. If other measures are not effective surgical removal of the ovaries may be carried out.

PMDD affects about 2–6% of menstruating women in a given year. It can occur in anyone who is menstruating. Up to 90% of menstruating women have some symptoms, but either have less than the number required for diagnosis or do not have functional impairment. Descriptions of premenstrual symptoms date from at least 400 BC in the writings of Hippocrates.