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Premenstrual dysphoric disorder (PMDD) is a severe form of Premenstrual syndrome[1], afflicting 3% to 8% of women.[2] It is a mood disorder associated with the luteal phase of the menstrual cycle.
PMDD is premenstrual syndrome (PMS) that is so severe it can be debilitating due to either physical, mental or emotional symptoms. Treatment is recommended because PMDD interferes with the sufferer’s ability to function in her social or occupational life. The cardinal symptom–surfacing between ovulation and menstruation, and disappearing within a few days after the onset of the bleeding–is irritability (PMID 11571794). Anxiety, anger, and depression may also occur. The main symptoms, which can be disabling, include[3]
Five or more of these symptoms may indicate PMDD. Symptoms occur during the week before the menstrual cycle and disappear within a few days after the onset of the bleeding.
In 2007, the first significant genetic finding in premenstrual dysphoric disorder was reported, which represents an importance advance in understanding PMDD.
Previously, researchers have shown that women with PMDD have an abnormal response to normal hormone levels, and, thus, are differentially sensitive to their own hormone changes. In a study, Dr. Liang Huo and colleagues, found variants in the estrogen receptor alpha gene that are associated with PMDD. Women with these genetic variants were more likely to suffer from PMDD. They also discovered that this association is seen only in women with a variant form of another gene, catechol — o — methyltransferase (COMT), which is involved in regulating the function of the prefrontal cortex, a critical regulator of mood.
These findings were published in an “Risk for Premenstrual Dysphoric Disorder Is Associated with Genetic Variation in ESR1, the Estrogen Receptor Alpha Gene” by Liang Huo, Richard E. Straub, Peter J. Schmidt, Kai Shi, Radhakrishna Vakkalanka, Daniel R. Weinberger and David R. Rubinow, in Biological Psychiatry, Volume 62, Issue 8 (October 15, 2007), published by Elsevier.
Originally called late luteal phase dysphoric disorder (LLPDD), the disorder was renamed PMDD by the American Psychiatric Association in its May 1993 revision of the DSM-IV. PMDD was moved from a position in the appendix of the manual to a “disorder requiring further study.”[4][5] While no one denies the reality of the suffering caused by PMDD, or advocates withholding treatment if a woman desires it, some psychiatrists and women’s groups object to the labeling of a severe form of PMS as a psychiatric disorder.
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