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So, Just How Common Is the Severe Form of PMS?

WebMD Health News

May 9, 2001 (New Orleans) -- It's been a matter of hot debate: Is the very severe type of PMS called premenstrual dysphoric disorder, or PMDD, a real disease or is it just a label some doctors use when talking about normal things that some women might experience? Two new studies using strict criteria to determine the prevalence of PMDD suggest two answers: It is real, and it is significantly disruptive in some women's lives.

The studies were presented here at the annual meeting of the American Psychiatric Association. They looked at both women of child-bearing age and women nearing menopause and suggest that the estimates of the yearly occurrence of PMDD of 3%-5% are roughly correct.

These studies also show that PMDD is very distinct from what is commonly called PMS, which has a yearly occurrence in women of 15%-16%, according to one researcher, Claudio Soares, MD, PhD, of the department of psychiatry at Massachusetts General Hospital, Boston. The two conditions run along a continuum, with PMDD at the much-more-severe end of the spectrum, he says.

He adds that a hallmark distinguishing PMDD from PMS is functional and social impairment. "Some of these women quit their jobs because of their disorder," he tells WebMD.

One study of 513 women age 36 to 44, showed that 6.4% met clinical criteria for PMDD. The survey was part of a study of a larger group of women looking at demographic and lifestyle characteristics associated with the disorder, according to Lee Cohen, MD, and Soares.

PMDD was associated with lower education, a history of major depression, current cigarette smoking, and working outside the home.

Because the study looked only at older premenstrual women, the yearly occurrence may have been found to be higher than what exists in reality. In addition, subjects in the study were followed for only a month; if they were followed for a longer period, the occurrence of PMDD might have been slightly smaller, Soares says.

Preliminary findings from another study of PMDD among females age 13 to 55 found a lower occurrence of the disorder. Of 430 subjects surveyed, less than 2% met criteria for a diagnosis of PMDD, according to the survey sponsored by the National Institute of Mental Health.

But Shirley Ann Hartlage, PhD, says the 430 subjects represent only a small portion of the 2,600 surveyed. As analysis of the total survey sample continues, the true picture of the how many women have PMDD may become clearer and may go up, Hartlage says.

In addition, the preliminary data reveal that some women who do not meet criteria for the disorder still report problems with mood, she says.

Of the 423 women in the sample who did not meet criteria for a diagnosis, 73% said they were less productive and efficient at home, 68% said their symptoms interfered with ability to get things done at home, and 64% said their symptoms interfered with relationships at home.

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