Premenstrual Dysphoric Disorder Workup

  • Author: Thwe T Htay, MD; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych (UK)   more...
 
Updated: May 14, 2012
 

Laboratory Studies

The initial steps in evaluating a patient for premenstrual dysphoric disorder (PMDD) are aimed at excluding organic syndromes with manifestations similar to those of PMDD, such as thyroid disorders, anemia, perimenopause, and menopause. The role of laboratory studies is limited to screening for medical conditions considered in the differential diagnosis. Although some tests may be needed to reassure the patient, excessive testing can be counterproductive by making the patient more anxious.

Laboratory studies should include the following:

  • Thyroid function tests
  • Complete blood count (CBC)
  • Follicle-stimulating hormone (FSH) level
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Thwe T Htay, MD  Assistant Professor, Department of Medicine, University of Texas Health Science Center at San Antonio

Thwe T Htay, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

KoKo Aung, MD, MPH, FACP  Associate Professor, Department of Medicine, University of Texas Health Science Center at San Antonio; Adjunct Associate Professor of Public Health, University of Texas School of Public Health

KoKo Aung, MD, MPH, FACP is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych (UK)  Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of Health Sciences: Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych (UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, American Psychiatric Association, American Society of Clinical Psychopharmacology, and Royal College of Psychiatrists

Disclosure: Nothing to disclose.

Additional Contributors

Ronald C Albucher, MD Chief Medical Officer, Westside Community Services; Consulting Staff, California Pacific Medical Center

Ronald C Albucher, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

John Carrick, MD Consulting Staff, Department of Psychiatry, Flagstaff Medical Center

John Carrick, MD is a member of the following medical societies: American Association for Geriatric Psychiatry

Disclosure: Nothing to disclose.

Romeo Papica II MD Staff Physician, Premier Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

  1. Endicott J. History, evolution, and diagnosis of premenstrual dysphoric disorder. J Clin Psychiatry. 2000;61 Suppl 12:5-8. [Medline].

  2. Frank RT. The hormonal causes of premenstrual tension. Arch Neurol Psych. 1931;26:1053-57.

  3. Dell DL. Premenstrual Syndrome, Premenstrual Dysphoric Disorder, and Premenstrual Exacerbation of Another Disorder. Clin Obstet Gynecol. Sep 2004;47(3):568-575. [Medline].

  4. Klock SC. Premenstrual dysphoric disorder. In: Ryan KJ, ed. Kistner's Gynecology and Women's Health. 7th ed. 520-4.

  5. Steiner M, Pearlstein T. Premenstrual dysphoria and the serotonin system: pathophysiology and treatment. J Clin Psychiatry. 2000;61 Suppl 12:17-21. [Medline].

  6. Mueller EA, Murphy DL, Sunderland T. Neuroendocrine effects of M-chlorophenylpiperazine, a serotonin agonist, in humans. J Clin Endocrinol Metab. Dec 1985;61(6):1179-84. [Medline].

  7. Ling FW. Recognizing and treating premenstrual dysphoric disorder in the obstetric, gynecologic, and primary care practices. J Clin Psychiatry. 2000;61 Suppl 12:9-16. [Medline].

  8. Boyle CA, Berkowitz GS, Kelsey JL. Epidemiology of premenstrual symptoms. Am J Public Health. Mar 1987;77(3):349-50. [Medline].

  9. Grady-Weliky TA. Clinical practice. Premenstrual dysphoric disorder. N Engl J Med. Jan 30 2003;348(5):433-8. [Medline].

  10. Banerjee N, Roy KK, Takkar D. Premenstrual dysphoric disorder--a study from India. Int J Fertil Womens Med. Sep-Oct 2000;45(5):342-4. [Medline].

  11. Tschudin S, Bertea PC, Zemp E. Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample. Arch Womens Ment Health. Dec 2010;13(6):485-94. [Medline].

  12. Issa BA, Yussuf AD, Olatinwo AW, Ighodalo M. Premenstrual dysphoric disorder among medical students of a Nigerian university. Ann Afr Med. Jul-Sep 2010;9(3):118-22. [Medline].

  13. Stout AL, Grady TA, Steege JF, et al. Premenstrual symptoms in black and white community samples. Am J Psychiatry. Nov 1986;143(11):1436-9. [Medline].

  14. Woods NF, Most A, Dery GK. Prevalene of perimenstrual symptoms. Am J Public Health. Nov 1982;72(11):1257-64. [Medline].

  15. Chang AM, Holroyd E, Chau JP. Premenstrual syndrome in employed Chinese women in Hong Kong. Health Care Women Int. Nov-Dec 1995;16(6):551-61. [Medline].

  16. The American Psychiatric Association. Diagnostic and statistical manual of mental disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000:717-8.

  17. Bhatia SC, Bhatia SK. Depression in women: diagnostic and treatment considerations. Am Fam Physician. Jul 1999;60(1):225-34, 239-40. [Medline].

  18. Baca-Garcia E, Diaz-Sastre C, Ceverino A, García Resa E, Oquendo MA, Saiz-Ruiz J, et al. Premenstrual symptoms and luteal suicide attempts. Eur Arch Psychiatry Clin Neurosci. Oct 2004;254(5):326-9. [Medline].

  19. Kim SY, Park HJ, Lee H, Lee H. Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJOG. Jul 2011;118(8):899-915. [Medline].

  20. Goodale IL, Domar AD, Benson H. Alleviation of premenstrual syndrome symptoms with the relaxation response. Obstet Gynecol. Apr 1990;75(4):649-55. [Medline].

  21. Lam RW, Carter D, Misri S, et al. A controlled study of light therapy in women with late luteal phase dysphoric disorder. Psychiatry Res. Jun 30 1999;86(3):185-92. [Medline].

  22. Krasnik C, Montori VM, Guyatt GH, Heels-Ansdell D, Busse JW. The effect of bright light therapy on depression associated with premenstrual dysphoric disorder. Am J Obstet Gynecol. Sep 2005;193(3 Pt 1):658-61. [Medline].

  23. Parry BL, Cover H, Mostofi N, et al. Early versus late partial sleep deprivation in patients with premenstrual dysphoric disorder and normal comparison subjects. Am J Psychiatry. Mar 1995;152(3):404-12. [Medline].

  24. Blake F, Salkovskis P, Gath D, et al. Cognitive therapy for premenstrual syndrome: a controlled trial. J Psychosom Res. Oct 1998;45(4):307-18. [Medline].

  25. Busse JW, Montori VM, Krasnik C, Patelis-Siotis I, Guyatt GH. Psychological intervention for premenstrual syndrome: a meta-analysis of randomized controlled trials. Psychother Psychosom. 2009;78(1):6-15. [Medline].

  26. Lustyk MK, Gerrish WG, Shaver S, Keys SL. Cognitive-behavioral therapy for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Womens Ment Health. Apr 2009;12(2):85-96. [Medline].

  27. drospirenone and ethinyl estradiol (YAZ®) [package insert]. Wayne, NJ: Bayer Health Care Phamaceuticals; 2007. [Full Text].

  28. Wyatt K, Dimmock P, O'Brien PMS. Premenstrual syndrome. Clin Evid. 2000;4:1121-33.

  29. Pearlstein T, Steiner M. Non-antidepressant treatment of premenstrual syndrome. J Clin Psychiatry. 2000;61 Suppl 12:22-7. [Medline].

  30. Andersen AN, Larsen JF, Steenstrup OR, Svendstrup B, Nielsen J. Effect of bromocriptine on the premenstrual syndrome. A double-blind clinical trial. Br J Obstet Gynaecol. May 1977;84(5):370-4. [Medline].

  31. Kullander S, Svanberg L. Bromocriptine treatment of the premenstrual syndrome. Acta Obstet Gynecol Scand. 1979;58(4):375-8. [Medline].

  32. Graham JJ, Harding PE, Wise PH, Berriman H. Prolactin suppression in the treatment of premenstrual syndrome. Med J Aust. Nov 4 1978;2(3 Suppl):18-20. [Medline].

  33. Werch A, Kane RE. Treatment of premenstrual tension with metolazone: a double-blind evaluation of a new diuretic. Curr Ther Res Clin Exp. Jun 1976;19(6):565-72. [Medline].

  34. Rickels K, Freeman E, Sondheimer S. Buspirone in treatment of premenstrual syndrome. Lancet. Apr 8 1989;1(8641):777. [Medline].

  35. Harrison WM, Endicott J, Nee J. Treatment of premenstrual dysphoria with alprazolam. A controlled study. Arch Gen Psychiatry. Mar 1990;47(3):270-5. [Medline].

  36. Schmidt PJ, Grover GN, Rubinow DR. Alprazolam in the treatment of premenstrual syndrome. A double-blind, placebo-controlled trial. Arch Gen Psychiatry. Jun 1993;50(6):467-73. [Medline].

  37. Eriksson E. Serotonin reuptake inhibitors for the treatment of premenstrual dysphoria. Int Clin Psychopharmacol. May 1999;14 Suppl 2:S27-33. [Medline].

  38. The Medical Letter. Which SSRI?. Med Lett Drugs Ther. Nov 24 2003;45(1170):93-5. [Medline].

  39. Steiner M. Recognition of premenstrual dysphoric disorder and its treatment. Lancet. Sep 30 2000;356(9236):1126-7. [Medline].

  40. Brown J, O' Brien PM, Marjoribanks J, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. Apr 15 2009;CD001396. [Medline].

  41. Steiner M, Steinberg S, Stewart D, et al. Fluoxetine in the treatment of premenstrual dysphoria. Canadian Fluoxetine/Premenstrual Dysphoria Collaborative Study Group. N Engl J Med. Jun 8 1995;332(23):1529-34. [Medline].

  42. The Medical Letter. Fluoxetine (Sarafem) for premenstrual dysphoric disorder. Med Lett Drugs Ther. Jan 22 2001;43(1096):5-6. [Medline].

  43. Yonkers KA, Halbreich U, Freeman E, et al. Symptomatic improvement of premenstrual dysphoric disorder with sertraline treatment. A randomized controlled trial. Sertraline Premenstrual Dysphoric Collaborative Study Group. JAMA. Sep 24 1997;278(12):983-8. [Medline].

  44. Young SA, Hurt PH, Benedek DM, Howard RS. Treatment of premenstrual dysphoric disorder with sertraline during the luteal phase: a randomized, double-blind, placebo-controlled crossover trial. J Clin Psychiatry. Feb 1998;59(2):76-80. [Medline].

  45. Steiner M, Hirschberg AL, Bergeron R, et al. Luteal phase dosing with paroxetine controlled release (CR) in the treatment of premenstrual dysphoric disorder. Am J Obstet Gynecol. 2005;193:352-60. [Medline].

  46. Steiner M, Ravindran AV, LeMelledo JM, Carter D, Huang JO, Anonychuk AM, et al. Luteal phase administration of paroxetine for the treatment of premenstrual dysphoric disorder: a randomized, double-blind, placebo-controlled trial in Canadian women. J Clin Psychiatry. Jun 2008;69(6):991-8. [Medline].

  47. Freeman EW, Rickels K, Sondheimer SJ, et al. Nefazodone in the treatment of premenstrual syndrome: a preliminary study. J Clin Psychopharmacol. Jun 1994;14(3):180-6. [Medline].

  48. Freeman EW, Rickels K, Yonkers KA, et al. Venlafaxine in the treatment of premenstrual dysphoric disorder. Obstet Gynecol. Nov 2001;98(5 Pt 1):737-44. [Medline].

  49. Freeman EW, Sondheimer SJ, Sammel MD, et al. A preliminary study of luteal phase versus symptom-onset dosing with escitalopram for premenstrual dysphoric disorder. J Clin Psychiatry. 2005;66:769-73. [Medline].

  50. Shah NR, Jones JB, Aperi J, Shemtov R, Karne A, Borenstein J. Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder: a meta-analysis. Obstet Gynecol. May 2008;111(5):1175-82. [Medline].

  51. Kayatekin ZE, Sabo AN, Halbreich U. Levetiracetam for treatment of premenstrual dysphoric disorder: a pilot, open-label study. Arch Womens Ment Health. Jul 2008;11(3):207-11. [Medline].

  52. Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ. May 22 1999;318(7195):1375-81. [Medline].

  53. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. Am J Obstet Gynecol. Aug 1998;179(2):444-52. [Medline].

  54. Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. Aug 1991;78(2):177-81. [Medline].

  55. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Womens Health. Nov 1998;7(9):1157-65. [Medline].

  56. Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of value in the treatment of premenstrual syndrome?. Control Clin Trials. Feb 1996;17(1):60-8. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.