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Premenstrual dysphoric disorder (PMDD) is a common mood disorder associated with the menstrual cycle. A new study published in Nature Communications shows that PMDD does not follow any universal pattern and that there are three subtypes with different patterns of symptoms. The hope is that this discovery will lead to more individualized treatment.

Premenstrual dysphoric disorder is a more severe form of premenstrual syndrome (PMS) that affects women in their childbearing years. What distinguishes PMDD from other mood disorders is its link to the menstrual cycle, where symptoms can start shortly after ovulation and continue until the onset of menstruation.

The study involved 90 women with PMDD and 40 healthy controls. They kept a diary for two months and reported what symptoms they felt and their severity. The women were asked to rate their levels of anxiety, depression, irritability and mood swings.

Using advanced statistical methods, the researchers were then able to study when different symptoms emerged and when they subsided in the menstrual cycle, and also to see how changes in one symptom affected other symptoms. Based on the women's responses, the researchers were able to identify three different subtypes of PMDD.

"Our results show that PMDD does not look the same for everyone. Even if two people have the same diagnosis, their symptoms can start at different points in the menstrual cycle and differ in how severe they become and in their offset," says Erika Comasco, who led the study and is a professor of molecular psychiatry at Uppsala University.

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