Eli Lilly, the pharmaceutical company that introduced Prozac, was moving towards the end of its patent. This means other companies would be able to create generic versions of Prozac and Eli Lilly would lose money. In order to renew the patent, the company would need to prove that it could treat another disorder. Prozac was then rebranded as Sarafem (the drug was exactly the same) and was reported to treat PMDD, legitimizing the disorder. 

Sarafem and Prozac in Relation to PMDD

PMS came with tremendous negative connotations and was used as a weapon of sorts to push women down. After it was added to the DSM 3 millions of women wrote in with complaints and it was eventually taken down with the introduction of the DSM 3-R. 

PMS controversy as an addition to the DSM

In the 1950s doctors started noticing that women would complain with a number of symptoms prior to menses. These symptoms eventually were added to the DSM 3 as premenstrual syndrome or PMS. This addition was met with many controversies and finally removed with the DSM 3-R. This phenomenon or symptoms before menses hadn't left the medical community and PMS was eventually rebranded as PMDD. However, it was only accepted as a legitimate disorder once Prozac or Sarafem was approved by the FDA to treat it.

New York University

Premenstrual Dysphoric Disorder or PMDD is categorized as a mood disorder. It is marked by a slew of symptoms that occur the week prior to the start of menses. Its existence as a disorder and its inclusion in the DSM is highly controversial. 

Premenstrual Dysphoric Disorder

Chrisler, J. C., & Gorman, J. A. (2015). The medicalization of women’s moods: Premenstrual syndrome of premenstrual dysphoric disorder. In The Wrong Prescription for Women. M. McHugh and J. Chrisler, Eds. New York: Praeger

The medicalization of women’s moods: Premenstrual syndrome of premenstrual dysphoric disorder

Symptoms of PMDD must be present the week prior the the onset of menses, start to dissipate two to three days into menses, and resolve in the week post menses. These symptoms include:
- Marked affective lability (ex: mood swings, feeling suddenly sad or tearful, or increased sensitivity )
- Marked irritability or anger or increased interpersonal conflicts
- Depressed mood, feelings of hopelessness, or self-deprecating thoughts
- Anxiety, tension, and/or feelings of being on edge
- Decreased interest in usual activities
- Difficulty in concentration
- Lethargy, easy fatigability, or lack of energy
- Change in appetite; overeating or specific food cravings
- Hypersomnia or insomnia
- A sense of being overwhelmed or out of control
- Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain
Note: At least five of these symptoms must be present

PMDD Symptoms

References for PMDD Topics

PMDD History

When PMDD was added to the DSM it was met with a lot of controversies. This included the pathologizing and medicalization of women's moods and criticisms of the mental health system as a whole.

PMDD Controversy 

There is no one treatment for PMDD for all women that experience it. This is due to the wide range of things that may cause it. 

Treating PMDD and PMS

In order to get formally diagnosed with PMDD, a psychiatrist or obstetrician-gynecologist will ask the patient to track and rate their symptoms everyday for two to three months. 

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