Mood flare-ups are common in the one to two weeks preceding menstruation. Many teens and women have premenstrual symdrome (PMS), where the symptoms are transient - emerging and disappearing on a fairly predictable basis. Others experience a more severe type of mood disturbance known as premenstrual dysphoric disorder (PMDD). For others, underlying conditions such as depression or anxiety disorders may worsen during those weeks and thus appear to be triggered by the hormonal changes that take place during the monthly cycle.

• Premenstrual syndrome (PMS) is a general pattern of physical, emotional, and behavioral symptoms occurring for one or two weeks before the monthly menstrual flow begins. PMS is common, affecting from 30-80 percent of women and teens of reproductive age. The most common behavioral symptoms of PMS are fatigue, forgetfulness, poor concentration, and mild mood changes, including irritability, anxiety and depressed mood. Women and teens with PMS are also more sensitive to rejection, more easily overwhelmed, more easily angered, and more likely to withdraw socially. These symptoms fade when the menstrual period begins.
  
  
• Premenstrual dysphoric disorder (PMDD) is a more severe form of premenstrual syndrome, affecting 3-8 percent of women and teenage girls. The most common symptom is irritability, but many individuals also report depressed mood, anxiety, or mood swings. As with PMS, these symptoms emerge one to two weeks preceding menstruation and resolve completely when the menstrual period begins. PMDD causes noticeable impairment, particularly in social and work relationships.

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Treatments for Premenstrual Conditions

Treatment recommendations commonly include simple lifestyle changes in diet, exercise, and stress management. For women and teens with mild physical and emotional symptoms of PMS, doctors may also recommend a trial of nutritional supplements, including calcium, magnesium, and vitamin B6.

Selective serotonin reuptake inhibitors (SSRI) antidepressant medications may be prescribed to reduce severe symptoms of PMS or PMDD. Doctors may sometimes prescribe oral contraceptives to reduce PMS or PMDD mood symptoms, although the evidence for this practice is limited. Helpful information about specific medications can be found at www.medlineplus.gov (click on "Drugs and Supplements").

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