Premenstrual dysphoric disorder (PMDD) is the most severe form of premenstrual syndrome (PMS). It is characterized by physical and behavioral symptoms that occur repeatedly in the late luteal phase of the menstrual cycle, usually beginning the week before menstruation and resolving a few days after menstruation. These symptoms cause significant distress or interference with daily activities and are not caused by an underlying psychiatric condition.[1] Anger, irritability, depression, and internal tension are especially prominent symptoms. PMDD is a chronic condition, typically beginning in the adolescent years and continuing until the menopause transition, and requires an individualized approach to treatment.[2]