Menstruation and premenstrual dysphoric disorder: Its impact on mood

In the premenstruum, women may experience physical or affective symptoms such as fatigue, irritability, or bloating. Such symptoms occur on a continuum, with approximately 3-8 % of women experiencing symptoms severe enough to impact function in daily activities. This severe cluster of symptoms is classified as Premenstrual Dysphoric Disorder (PMDD). Researchers continue to unravel the biopsychosocial contributors to premenstrual symptoms, including stress and hormonal changes. Women with premenstrual symptoms likely have altered central nervous system sensitivity to normal hormonal fluctuations. In particular, altered GABAergic response to neurosteroid metabolites may be key in the etiology of PMDD. This chapter includes a brief overview of the menstrual cycle, PMDD diagnosis and pathophysiology, and treatment approaches.