A 28-year-old woman with PMDD reports severe mood swings and irritability before her period. These symptoms resolve once her period begins. Which of the following best describes the phase of the menstrual cycle in which PMDD symptoms are most prominent?
Group of answer choices
- Menstrual phase
- Luteal phase
- Ovulatory phase
- Follicular phase
The correct answer is: Luteal phase
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Explanation:
Premenstrual dysphoric disorder (PMDD) is characterized by severe emotional and physical symptoms that:
- Occur during the luteal phase (the 1–2 weeks before menstruation).
- Resolve shortly after menstruation begins (menstrual phase).
Key Features of the Luteal Phase:
- Follows ovulation (ovulatory phase).
- Dominated by progesterone (and some estrogen) secretion from the corpus luteum.
- In PMDD, sensitivity to hormonal fluctuations (especially progesterone metabolites) triggers:
- Mood swings, irritability, depression, anxiety.
- Physical symptoms (bloating, fatigue).
Why Not the Other Phases?
- Follicular phase (post-menstruation to ovulation): Generally asymptomatic in PMDD.
- Ovulatory phase (~day 14): Brief estrogen surge; not typically linked to PMDD symptoms.
- Menstrual phase (bleeding): Symptoms improve during/after menses.
Thus, PMDD symptoms peak in the luteal phase due to hormonal changes.
