In order to establish the timeline of symptoms required for a diagnosis of PMDD symptoms need to be tracked using scales like the Calendar of Premenstrual Experiences or the Daily Record of Severity of Problems.Menopausal transition – affective symptoms associated with the menopausal transition most commonly start when menstrual cycle starts to become irregular or anovulatory whereas PMDD symptoms occur during the luteal phase of ovulatory cycles. Thyroid disorders—patients with both hyperthyroidism and hypothyroidism may present with affective symptoms. The patients history is very important to determine whether the provider should suspect thyroid disorders. Patients should also have thyroid hormone levels checked to ensure no underlying thyroid disorder is present. Treatment
Medication
Several medications have been shown to effectively reduce the physical and emotional symptoms of PMDD. Antidepressant Treatment
Selective serotonin reuptake inhibitors (SSRIs) are the first-line medication. Women taking SSRIs to ease PMDD generally report >50% alleviation in symptoms, which was significant improvement compared to placebo. Two approaches to dosing have been studied: continuous dosing (daily) and luteal dosing (14 days before menstruation and discontinuing at the onset of menses). Both dosing schedules have similar effectiveness with some recent studies demonstrating greater symptom control with continuous dosing. This gives patients control of how they want to dose their medication in alliance with their mental health provider. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) have also been studied in the treatment of PMDD and shown efficacy in reducing symptoms. These are an alternative for patients who do not respond to SSRIs.
Also, it may be associated with hyponatremia (hypervolemic hyponatremia). Causes
Excessive sodium and/or fluid intake:

IV therapy containing sodium
As a transfusion reaction to a rapid blood transfusion. High intake of sodiumSodium and water retention:

Heart failure
Liver cirrhosis
Nephrotic syndrome
Corticosteroid therapy
Hyperaldosteronism
Low protein intakeFluid shift into the intravascular space:

Fluid remobilization after burn treatment
Administration of hypertonic fluids, e.g. mannitol or hypertonic saline solution
Administration of plasma proteins, such as albumin

Treatment
Treatment includes diuretics, particularly loop diuretics. See also
Volume status
Volume overload
Fluid balance
Edema
Anasarca (swelling of skin)
Pleural effusion (excess fluid in the pleural cavity)
Diuretics
Aquapheresis
Low pressure receptor zones
Apsia

References


== External links ==