Premenstrual disorders

Am J Obstet Gynecol. 2018 Jan;218(1):68-74. doi: 10.1016/j.ajog.2017.05.045. Epub 2017 May 29.


Premenstrual disorders include premenstrual syndrome, premenstrual dysphoric disorder, and premenstrual worsening of another medical condition. While the underlying causes of these conditions continue to be explored, an aberrant response to hormonal fluctuations that occurs with the natural menstrual cycle and serotonin deficits have both been implicated. A careful medical history and daily symptom monitoring across 2 menstrual cycles is important in establishing a diagnosis. Many treatments have been evaluated for the management of premenstrual disorders. The most efficacious treatments for premenstrual syndrome and premenstrual dysphoric disorder include serotonin reuptake inhibitors and contraceptives with shortened to no hormone-free interval. Women who do not respond to these and other interventions may benefit from gonadotropin-releasing hormone agonist treatment.

Keywords: menstrual cycle; premenstrual disorder; premenstrual dysphoric disorder; premenstrual symptoms; premenstrual syndrome; premenstrual tension.

Publication types

  • Review

MeSH terms

  • Androstenes / therapeutic use
  • Cognitive Behavioral Therapy
  • Complementary Therapies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Ethinyl Estradiol / therapeutic use
  • Exercise
  • Female
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Hysterectomy
  • Ovariectomy
  • Premenstrual Dysphoric Disorder / diagnosis*
  • Premenstrual Dysphoric Disorder / psychology
  • Premenstrual Dysphoric Disorder / therapy*
  • Premenstrual Syndrome / diagnosis*
  • Premenstrual Syndrome / therapy*
  • Risk Factors
  • Salpingectomy
  • Selective Serotonin Reuptake Inhibitors / therapeutic use


  • Androstenes
  • Serotonin Uptake Inhibitors
  • drospirenone and ethinyl estradiol combination
  • Gonadotropin-Releasing Hormone
  • Ethinyl Estradiol