PMDD is premenstrual syndrome (PMS) that is so severe it can be debilitating due to either physical, mental or emotional symptoms. Treatment is recommended because PMDD interferes with the sufferer's ability to function in her social or occupational life. The cardinal symptom--surfacing between ovulation and menstruation, and disappearing within a few days after the onset of the bleeding--is irritability. Anxiety, anger, and depression may also occur. The main symptoms, which can be disabling, included.

• feelings of deep sadness or despair, possible suicide ideation
• feelings of tension or anxiety
• panic attacks
• diarrhea
• mood swings, crying
• lasting irritability or anger, increased interpersonal conflicts
• apathy or disinterest in daily activities and relationships
• difficulty concentrating
• fatigue
• food cravings or binge eating
• insomnia or hypersomnia
• feeling "out of control"
• increase or decrease in sex drive
• increased need for emotional closeness
• physical symptoms: bloating, heart palpitations, breast tenderness, headaches, joint or muscle pain

Five or more of these symptoms may indicate PMDD. Symptoms occur during the week before the menstrual cycle and disappear within a few days after the onset of the bleeding.

Genetic Link

In 2007, the first significant genetic finding in premenstrual dysphoric disorder was reported, which represents an important advance in understanding PMDD.

Previously, researchers have shown that women with PMDD have an abnormal response to normal hormone levels, and, thus, are differentially sensitive to their own hormone changes.

In a study by Dr. Liang Huo and colleagues it was found variants in the estrogen receptor alpha gene that are associated with PMDD. Women with these genetic variants were more likely to suffer from PMDD. They also discovered that this association is seen only in women with a variant form of another gene, catechol -- o -- methyltransferase (COMT), which is involved in regulating the function of the prefrontal cortex, a critical regulator of mood.

These findings were published in an "Risk for Premenstrual Dysphoric Disorder Is Associated with Genetic Variation in ESR1, the Estrogen Receptor Alpha Gene" by Liang Huo, Richard E. Straub, Peter J. Schmidt, Kai Shi, Radhakrishna Vakkalanka, Daniel R. Weinberger and David R. Rubinow, in Biological Psychiatry, Volume 62, Issue 8 (October 15, 2007), published by Elsevier.