Most women experience some degree of emotional or physical discomfort a few days before and just after their menstrual period begins each month. About 5% of women of childbearing age, however, experience premenstrual symptoms that are so severe they cause significant mental distress and interfere with work, school, or relationships - thereby meeting the criteria for premenstrual dysphoric disorder, or PMDD, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; see below). Another 18% to 35% of women suffer from less severe, but nevertheless bothersome, premenstrual symptoms.

Although sometimes dismissed as trivial, PMDD can disrupt a woman's life and relationships so completely, she may despair that life itself is not worth living. About 15% of women with PMDD attempt suicide. Fortunately, treatment options exist for PMDD - but the most effective are not always prescribed.

Key points
Antidepressants that slow the reuptake of serotonin provide effective treatment for premenstrual dysphoric disorder (PMDD).

These drugs alleviate PMDD more quickly than depression, which means that women don't necessarily have to take the drugs every day.

Hormone therapies provide additional options, but are generally considered second-line treatments.

Some dietary and lifestyle changes may also help relieve symptoms.