<unk>  <unk>  is a mood disorder characterized by emotional, cognitive, and physical symptoms that cause significant distress or impairment in menstruating women during the luteal phase of the menstrual cycle. The symptoms occur in the luteal phase, (between ovulation and menses), improve within a few days after the onset of menses, and are minimal or absent in the week after menses.<unk>  has a profound impact on a person's quality of life and dramatically increases the risk of suicidal ideation and even suicide attempts. Many females of reproductive age experience discomfort or mild mood changes prior to menstruation. However, 5-8% experience severe premenstrual syndrome causing significant distress or functional impairment. Within this population of reproductive age, some women will meet the criteria for<unk> .<unk>  is most common from age 25-35, but can occur anytime during a woman's reproductive years. The exact cause of<unk>  is currently unknown. However, because the symptoms are only present during ovulatory cycles and resolve after menses, it is believed to be caused by fluctuations in gonadal sex hormones or variations in sensitivity to sex hormones. In 2017, researchers at the National Institutes of Health discovered that women with<unk>  have genetic changes that make their emotional regulatory pathways more sensitive to estrogen and progesterone, as well as their chemical derivatives. The researchers believe that this increased sensitivity may be responsible for<unk>  symptoms. Some studies have suggested that those with<unk>  are more at risk of developing postpartum depression after pregnancy, but other evidence has been found to suggest against that notion.<unk>  was added to the list of depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders in 2013. It has 11 main symptoms, and a woman has to exhibit at least five to be diagnosed with<unk> . Roughly 20% of women have some symptoms of<unk> , but either have less than five or do not have functional impairment. First line treatment for<unk>  is with selective serotonin reuptake inhibitors (SSRIs). Hormonal therapy with oral contraceptives that contain drospirenone have demonstrated efficiency in reducing<unk>  symptoms as well. Cognitive behavioral therapy, whether in combination with SSRIs or alone, has shown to be effective in reducing impairment. Dietary modifications and exercise may also be helpful, but studies investigating these treatments have not demonstrated efficacy in reducing<unk>  symptoms.
Premenstrual dysphoric disorder
Major depressive disorder
Premenstrual syndrome
Anxiety disorder
Menstrual disorder
Postpartum depression
Postpartum psychosis
Minor depressive disorder