UNC Obstetrics and Gynecology Clerkship

Case Based Seminar Series

Topic / PMS/PMDD/Dysmenorrhea
APGO Objectives / 46, 49
Beckman & Ling, 6th ed. / 39, 30(277-9)
Hacker & Moore, 4th ed / 21(256-9), 36(386-8)

·  Differentiate the criteria for the diagnosis of PMS, PMDD and major depressive disorder

·  Detail possible treatment options

·  Define primary and secondary dysmenorrhea

·  List the etiologies of dysmenorrhea

·  Understand the evaluation and management of dysmenorrhea

Case Vignette:

A 28 yo G0 finds herself getting increasingly irritable leading up to her menses. She also complains of bloating and breast tenderness. Please discuss diagnosis, methods of documenting symptoms, and management strategies.

Questions:

1.  What is the difference between PMS and PMDD?

2.  What are the diagnostic criteria for PMS?

3.  Where do you find the diagnostic criteria for PMDD? What are they?

4.  What tool do you use to diagnose PMDD?

5.  Why is a prospective diagnosis important?

6.  What is the gold standard of treatment for PMDD? Is this based on good data?

7.  What alternative therapies have been examined?

8.  What is the definition of dysmenorrhea? What is the differential diagnosis when a patient presents with this?

9.  What tests should be ordered to confirm the diagnosis?

10.  What are the treatment options?

UNC Obstetrics and Gynecology Clerkship

Case Based Seminar Series