Premenstrual Dysphoric Disorder

Premenstrual Dysphoric Disorder

Life Sciences

Amina Mohamed

2024

Olanrewaju Sorinola

Premenstrual Dysphoric Disorder is characterised by the cyclical nature of psychological and somatic symptoms occurring in the luteal phase of the menstrual cycle that significantly affect the functioning of various aspects of daily life. Controversy, paucity of knowledge and awareness surrounds the research on Premenstrual dysphoric Disorder. It is an under-researched disorder riddled with methodological limitations, lack of diversity in cohort studies, small samples and a lack of systemic reviews, meta-analysis and randomised control trials. No universal diagnostic and screening standardised method is used worldwide, nor is there a different nomenclature used to describe the disorder. First-line treatment of the disease differs among professional healthcare bodies. The foundations of Premenstrual dysphoric disorder were always controversial, as seen with its inclusion in the American Psychiatric DSM-5 and the World Health Organisation’s ICD11 caused controversy where psychologists and feminist thinkers alike argued that this is a way of pathologising a natural process, adding to the stigma around women’s emotions being tied to their hormones. The pathophysiology of the disease is still relatively unknown. However, a widely accepted cause is the interaction of reproductive steroids like oestrogen, progesterone and allopregnanolone on central neurotransmitters like serotonin and GABAa receptors and the Hypothalamic-pituitary-ovarian axis. Other possible causes, associations, and co-morbidities are discussed. There needs to be more precise definitions around premenstrual dysphoric disorder separated from premenstrual syndrome and more education within healthcare systems about the disorder in order to improve patient-provider communication for better experiences and a more accurate clinical picture of the disorder. As well as more personalised care for women with PMDD and approaching research of the pathophysiology from a psychosomatic perspective.