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What Causes PMDD?


Updated September 01, 2011

Question: What Causes PMDD?

The causes of premenstrual dysphoric disorder (PMDD) are not well understood, but it is thought to be a hereditary condition in which a woman's monthly hormonal fluctuations cause changes in the neurotransmitters related to mood regulation, especially serotonin.

While there is not an overwhelming amount of evidence supporting this theory, selective serotonin reuptake inhibitors (SSRIs) and other drugs that affect the serotonin pump mechanism, have proven to be successful in treating PMDD in clinical trials.

It has been known for awhile now that ovulation -- and the progesterone production which follows -- are involved in this condition, but it is not clear what role progesterone plays. Prescribing drugs that block ovulation and surgical removal of the ovaries are both highly effective treatments, however.

Dietary and vitamin deficiencies have also been proposed as possible causes of PMDD, but the theories have been difficult to prove. Nutritional deficiencies do not appear to be a major cause of PMDD.

Some researchers have looked at prolactin excess as a potential cause because many women complain of breast tenderness, but no link has been proven.

Finally, because some symptoms of PMDD appear to be related to prostaglandin activity and are relieved by treatment with NSAIDS, prostaglandins have been studies as a potential cause. No causal relationship has been established, however.


Katz, Vern L. et. al. Comprehensive Gynecology. 5th ed. Philadelphia: Mosby Elsevier, 2007.


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