
Contents
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Introduction Introduction
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Definitions, Symptoms, and Subtypes Definitions, Symptoms, and Subtypes
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Epidemiology Epidemiology
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Prevalence Prevalence
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Morbidity Morbidity
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Risk Factors Risk Factors
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Etiology Etiology
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Serotonin Serotonin
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Gonadal Steroids Gonadal Steroids
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Progesterone Progesterone
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Diagnosis Diagnosis
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ACOG Diagnosis of PMS (ACOG Practice Bulletin 15, 2000) ACOG Diagnosis of PMS (ACOG Practice Bulletin 15, 2000)
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ISPOG Diagnosis of PMS () ISPOG Diagnosis of PMS ()
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PMDD Diagnosis () PMDD Diagnosis ()
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Daily Symptom Reports Daily Symptom Reports
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Diagnostic Procedures Diagnostic Procedures
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Treatments Treatments
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Serotonergic Antidepressants Serotonergic Antidepressants
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Insufficient Response to an SSRI Insufficient Response to an SSRI
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Other Antidepressants Other Antidepressants
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Hormones Hormones
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Oral Contraceptives Oral Contraceptives
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Estrogen and Progesterone Estrogen and Progesterone
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Gonadotropin-Releasing Hormone Agonists Gonadotropin-Releasing Hormone Agonists
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Anxiolytics Anxiolytics
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Nonpharmacological Therapies Nonpharmacological Therapies
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Vitex Agnus Castus Vitex Agnus Castus
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Calcium Calcium
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Vitamin B6 Vitamin B6
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Behavioral Therapies Behavioral Therapies
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Exercise Exercise
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Clinical Management Clinical Management
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Duration of Treatment Duration of Treatment
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Placebo Response Placebo Response
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Summary Summary
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Future Directions Future Directions
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References References
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21 Premenstrual Dysphoric Disorder
Get accessPerelman School of Medicine, University of Pennsylvania
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Published:05 October 2015
Cite
Abstract
This chapter examines premenstrual dysphoric disorder (PMDD) and the less restricted condition of clinically significant premenstrual syndrome (PMS). PMDD is distinguished from a clinical diagnosis of PMS by the number of specific symptoms required for a PMDD diagnosis. Both are characterized by changes in mood as well as behavioral and physical symptoms that occur in relation to regular menstrual cycles and impair functioning. Circulating levels of the reproductive hormones are in the normal range, but some women may be vulnerable to the normal fluctuations of one or more of these hormones. The chapter presents the epidemiology, diagnosis, and treatments of PMDD/PMS based on evidence in randomized clinical trials. There is no one treatment that entirely fits this complex disorder, but the weight of current evidence supports treatments aimed at modifying serotonin transmission or suppressing ovulation. The chapter concludes with suggestions for further research to increase our knowledge of the causes and treatments of menstrually related disorders.
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