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Prämenstruelle dysphorische Störung

Premenstrual dysphoric disorder

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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Viele Frauen fühlen sich in den Tagen vor der Regelblutung unwohl. Im Vordergrund stehen psychische Symptome wie Depressivität oder Ängstlichkeit, aber auch körperliche Symptome wie Brustspannen. Von einer prämenstruellen dysphorischen Störung [„premenstrual dysphoric disorder“ (PMDD)], der schwersten Form des prämenstruellen Syndroms, sind dagegen nur wenige Frauen betroffen. Eine PMDD kann die Frauen sehr belasten und ihre Lebensqualität stark einschränken. Die komplexe Pathophysiologie der Erkrankung ist nicht vollständig verstanden. Als Basis der Diagnose empfiehlt sich eine prospektive Dokumentation der Beschwerden über 2 Monate. Andere mögliche Diagnosen müssen sicher ausgeschlossen werden. Die Therapie erfolgt symptomorientiert. Primäre Therapiestrategien sind heute die Gabe von selektiven Serotoninwiederaufnahmehemmern, entweder kontinuierlich oder nur in der Lutealphase, sowie der Einsatz hormoneller Kontrazeptiva mit verkürztem hormonfreiem Intervall oder kontinuierlich.

Abstract

Many women of reproductive age complain about some premenstrual discomfort. Mood and behavioral symptoms, such as depression or anxiety, and somatic symptoms, such as breast tenderness, may be present. However, only a minority of women meet the criteria for PMDD (premenstrual dysphoric disorder), the most severe form of premenstrual syndrome (PMS), causing substantial distress or functional impairment. The complex pathophysiology of PMDD is not completely understood. As a basis for diagnosis, symptoms should be recorded using prospective daily charting for 2 months. It is mandatory to eliminate other possible diagnoses. Treatment should be tailored according to symptomatology. First-line therapies include serotonin reuptake inhibitors, taken either throughout the whole cycle or during the luteal phase only, and combined hormonal contraceptives with shortened hormone-free intervals or continuously.

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Authors and Affiliations

  1. Praxis für gynäkologische Endokrinologie, HORMONE HAMBURG, Gynaekologicum Hamburg, Altonaerstr. 59, 20357, Hamburg, Deutschland

    Anneliese Schwenkhagen &  Katrin Schaudig

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  1. Anneliese Schwenkhagen
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  2. Katrin Schaudig
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Correspondence to Anneliese Schwenkhagen.

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A. Schwenkhagen und K. Schaudig geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Schwenkhagen, A., Schaudig, K. Prämenstruelle dysphorische Störung. Gynäkologische Endokrinologie 13, 245–256 (2015). https://doi.org/10.1007/s10304-015-0035-1

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