Premenstrual Syndrome and Premenstrual Dysphoric Disorder in Adolescence

Faith Claman, MSN, CPNP, WHNP; Terri Miller, MSN, WHNP


J Pediatr Health Care. 2006;20(5):329-333. 

In This Article


Premenstrual syndrome (PMS), a common cyclic disorder occurring in up to 40% of reproductive-aged women, is characterized by emotional and physical symptoms consistently occurring during the menstrual cycle's luteal phase (the phase that begins with ovulation and ends with the onset of menses). Studies indicate that 14% to 88% of adolescent girls have moderate-to-severe symptoms of PMS (Cleckner-Smith et al 1998, Derman et al 2004, Raja et al 1992), the range of reported symptoms being particularly wide likely because of the self-reported nature of the data. About 3% to 5% of reproductive women meet the criteria for a more severe affective disorder called premenstrual dysphoric disorder (PMDD). The prevalence of PMDD in adolescence is considered to be low, but little research has been done to confirm this presumption; providers of adolescent health care must have the diagnostic skills to discern the symptoms of both PMDD and PMS.

The most common affective symptoms of PMS include irritability, tension, and dysphoria. Somatic symptoms also include breast tenderness, abdominal bloating, headache, and extremity swelling. The etiology is unknown, but data suggest that ovulation triggers changes in neurotransmitters and neurohormonal systems, including a luteal phase reduction in serotonin (Johnson, 2004). Symptoms of PMS may be precipitated by an underlying genetic predisposition of increased sensitivity to changes in gonadal hormones that interact with certain neurotransmittors and neurohormones (Mishell, 2005).


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