A guide to treating premenstrual dysphoric disorder

Roughly 5% of people who menstruate are affected by premenstrual dysphoric disorder, a cyclical, hormone-trigged mood disorder that can cause symptoms like irritability, anxiety and depression. And about a quarter of those with the disorder do not respond to standard treatments.

Yet, an effective treatment for treatment-resistant premenstrual dysphoric disorder is often not offered to patients because providers do not have all the information they need, according to a new paper from UIC researchers. The researchers, therefore, wrote a primer for practitioners on treatment-resistant PMDD with a guide to the treatment, called gonadotropin-releasing hormone analogs with stable hormone addback. The paper is published in The Journal of Clinical Psychiatry.

It is critical that practitioners, including psychiatrists, be familiar with the disorder and how to treat it because, the authors write, those with premenstrual dysphoric disorder are at increased risk for suicide. The article walks through how to diagnose PMDD, the first line of treatment, and then how to assess the use of gonadotropin-releasing hormone analogs with stable hormone addback if the standard treatments are not effective.

“Despite the fact that PMDD represents a psychiatric condition characterized by a neurobiological sensitivity to hormone changes, most psychiatrists — even reproductive psychiatrists — do not currently offer [this] treatment for severe, treatment-resistant PMDD,” the authors write.

The research was conducted by the College of Medicine’s Dr. Melissa Wagner-Schuman, Jordan Barone, Jaclyn Ross, Dr. Ashley Mulvihill and Tory Eisenlohr-Moul, along with Alyssa Kania, a graduate of the College of Medicine.