PME, or premenstrual exacerbation of an underlying disorder, occurs when an woman/AFAB has a chronic diagnosis (e.g., depression, anxiety, arthritis) that is made worse prior to and potentially during their period. The symptoms follow a similar trajectory to PMDD, but they never resolve completely.
At IAPMD, we focus on the premenstrual exacerbation of psychiatric disorders, including (but not limited to):
Major Depressive Disorder/Persistent Depressive Disorder
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder
Substance Use Disorder
Attention Deficit/Hyperactivity Disorder
Social Anxiety Disorder
Psychosis and Schizophrenia
Personality Disorders (e.g., Borderline Personality Disorder)
When it comes to treatment, we know that symptoms showing a PME pattern tend not to respond as consistently to PMDD treatments (although of course each person is unique). Some evidence suggests that PME of depression does not improve with medical menopause using GnRH agonists, with drospirenone-containing oral contraceptives, or with in-development GABA-focused treatments like isoallopregnanolone). This suggest that PME, especially of depressive symptoms, may have a different mechanism that requires a different treatment approach.
My laboratory has conducted experiments showing that hormone changes do trigger PME of depression, but possibly in a different way than in PMDD. We hope that our work will eventually clarify the unique mechanisms of PME and help to develop more effective, targeted treatments for PME.
Updated 16 November, 2019 by Tory Eisenlohr-Moul, PhD