Premenstrual dysphoric disorder is a severe form of premenstrual syndrome that causes significant emotional and physical symptoms during the luteal phase of the menstrual cycle. PMDD symptoms may include depressed mood, anxiety and depression, mood symptoms, irritability, low energy, food cravings, breast tenderness, breast pain, muscle pain, fluid retention, and functional impairment that disrupts usual activities. Symptoms typically improve after the period starts or at the onset of menses.
PMDD is classified as a psychiatric disorder in the Statistical Manual of Mental Disorders by the American Psychiatric Association and is considered part of a broader group of Premenstrual Disorders. Risk factors may include family history, sensitivity to hormonal changes, and underlying mood disorders such as major depression, major depressive disorder, or postpartum depression.
PMDD treatment options focus on evidence-based and individualized care. Treatment of PMDD may include Selective serotonin reuptake inhibitors used continuously or with intermittent dosing, oral contraceptives containing ethinyl estradiol, or hormonal strategies aimed at ovarian suppression such as GnRH agonists when severe PMS or severe symptoms persist. Coordination with an OB/GYN or Women’s Health provider is often essential for comprehensive care.
Michael Feldman, PA-C, brings extensive experience to Psychiatric Mental Health treatment through a rare combination of scientific research and clinical practice. With an academic foundation in molecular and cellular biology, he understands how biological processes influence mental health conditions and psychiatric responses.
After earning his M.Sc. from The Hebrew University of Jerusalem, PA Feldman participated in advanced research at institutions including the Weizmann Institute of Science and Mount Sinai Hospital in New York. He later completed the Physician Assistant program at PACE University – Lenox Hill Hospital in 2017.
Since then, he has worked in both inpatient and outpatient psychiatric practice settings, treating complex psychiatric conditions such as anxiety disorders, psychotic disorders, postpartum depression, autism spectrum disorder, ADHD, and resistant depression. His clinical experience allows him to stay informed about advancements in psychiatric medications, Transcranial Magnetic Stimulation, nasal spray treatments, and psychiatric medication management, ensuring patients receive evidence-based treatment options.
Fluent in English, Russian, and Hebrew, PA Feldman provides compassionate care grounded in cultural sensitivity and personalized mental healthcare.
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A Psychiatrist evaluates and treats a wide range of mental health conditions using medical, diagnostic, and evidence-based approaches. This can include psychiatric evaluations, psychiatric medication management, and ongoing monitoring for conditions such as mood disorders, anxiety disorders, panic disorder, obsessive-compulsive disorder, personality disorders, eating disorders, psychotic disorders, Attention Deficit Hyperactivity Disorder, treatment-resistant depression, postpartum depression, and substance abuse. The goal is improved stability, functioning, and overall quality of life.
PMDD is a severe form of premenstrual syndrome that causes intense emotional and physical symptoms leading to functional impairment. Unlike PMS symptoms, PMDD symptoms significantly disrupt daily activities, relationships, and mental health. Diagnosis of PMDD is based on symptom timing, severity, and impact across multiple menstrual cycles.
The exact cause of PMDD is not fully understood. Research suggests it is linked to abnormal sensitivity to hormonal changes rather than hormone levels alone. Fluctuations in estrogen and progesterone may affect serotonin levels, contributing to mood symptoms. Risk factors include family history, mood disorders, and prior depressive conditions.
Effective PMDD treatment may include Selective serotonin reuptake inhibitors, oral contraceptives, or hormonal treatments such as GnRH agonists in severe cases. Treatment of PMDD often combines medication with lifestyle changes, cognitive behavioral therapy, and coordination with a healthcare provider for individualized care.
Professional care should be considered when PMDD symptoms interfere with work, relationships, or quality of life. If emotional symptoms, depressive symptoms, or severe PMS persist despite self-care, a healthcare professional can help guide diagnosis and treatment of premenstrual dysphoric disorder.
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