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Clinical Feature: Premenstrual Dysphoric Disorder

Published:September 02, 2022DOI:


      • Etiological theories of premenstrual dysphoric disorder (PMDD) suggest a sensitivity to hormonal and serotonergic changes during the luteal phase of menstrual cycle.
      • PMDD may be managed by nurse practitioners within primary care and gynecology settings, along with support from psychiatric mental health nurse practitioners.
      • Prospective rating scales are recommended to confirm PMDD diagnosis.
      • Pharmacologic treatment options include antidepressants and combined oral contraceptives. Nonpharmacologic interventions for symptom management, such as psychotherapy, dietary changes, and physical activity are also reviewed.


      Premenstrual dysphoric disorder is a depressive disorder associated with the luteal phase of the menstrual cycle. It affects 1.5%–5.8% of individuals who menstruate and is characterized by the presence of emotional, cognitive, behavioral, and somatic symptoms. Symptoms should be assessed over 2 menstrual cycles with the use of prospective rating scales for adequate diagnosing. Treatment includes pharmacologic approaches, such as antidepressants or hormone therapy, as well as nonpharmacologic lifestyle modifications and psychotherapy. This clinical feature is intended to inform nursing practice and present future considerations for a wide array of patient populations who experience this condition.


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      Amy P. Biondo, MSN, PMHNP-BC, LMHC, is a licensed mental health counselor, New York, NY, and can be contacted at [email protected]


      Margaret J. Brown, DNP, PMHNP-BC, is an assistant professor, MGH Institute of Health Professions, Boston, MA.