Underlying anxiety, depressive disorders, or perimenopause should be considered in PMDD patients, especially if symptoms appear later in life.

“PMDDD patients, you do want to make sure they don't have a chronic underlying anxiety depressive disorder. So, I always refer them to uh a psychiatrist, but you can absolutely treat it. For pmenopausal women, you can also treat them with hormone replacement. So, someone in her 40s, I want to make sure if she didn't have it and suddenly she has, it's not like she hasn't had PMDDD and suddenly she has PMDDD, it's probably it could be pmenopause. So, you don't want to miss that.”