Loading…
Loading…
From premenstrual dysphoric disorder to perinatal depression — gender-informed psychiatric care
Women experience depression and anxiety at twice the rate of men, with onset often linked to hormonal transitions: premenstrual, perinatal, and perimenopausal periods. Perinatal mental health disorders affect 10–20% of mothers and have profound effects on infant bonding, development, and family functioning. Dr. Ruja's clinic provides gender-informed psychiatric care: screening for PMDD, perinatal depression and anxiety (Edinburgh Postnatal Depression Scale), postpartum psychosis risk assessment, and hormone-related mood disorders with integrated treatment plans.
Kathmandu Neurology Clinic & Cognitive Center
Authored and reviewed by Dr. Ruja Shrestha (MBBS, MD (Psychiatry), NMC 19766). Evidence-based, no fabricated outcomes.
Women experience depression and anxiety at twice the rate of men, with onset often linked to hormonal transitions: premenstrual, perinatal, and perimenopausal periods. Perinatal mental health disorders affect 10–20% of mothers and have profound effects on infant bonding, development, and family functioning. Dr. Ruja's clinic provides gender-informed psychiatric care: screening for PMDD, perinatal depression and anxiety (Edinburgh Postnatal Depression Scale), postpartum psychosis risk assessment, and hormone-related mood disorders with integrated treatment plans.
Reviewed by Dr. Ruja Shrestha, MBBS, MD — Consultant Psychiatrist & CBT Therapist (NMC 19766), Kathmandu Neurology Clinic. For evaluation, book an appointment.
Premenstrual dysphoric disorder (PMDD) affects 3–8% of menstruating women, with severe mood lability, irritability, and functional impairment in the luteal phase. Perinatal depression and anxiety affect 10–20% of mothers, ranging from adjustment difficulties to severe postpartum depression and psychosis. Perimenopause brings increased depression risk, sleep disruption, and cognitive complaints. The clinic uses symptom tracking (daily ratings for PMDD, EPDS for perinatal) and considers hormonal interventions where appropriate.
Perinatal depression: psychotherapy (CBT, IPT) first-line for mild–moderate; SSRIs (sertraline, escitalopram) considered for moderate–severe or treatment-resistant, with breastfeeding safety counseling. PMDD: SSRIs (luteal-phase dosing or continuous), combined oral contraceptives (drospirenone-containing), or GnRH agonists for severe cases. Perimenopausal depression: HRT may help mood and vasomotor symptoms; SSRIs/SNRIs for concurrent depression. Postpartum psychosis requires psychiatric hospitalization and urgent treatment.
Guidelines referenced:
NICE CG192 — Antenatal and postnatal mental health: clinical management and service guidanceACOG Committee Opinion No. 757: Screening for Perinatal DepressionYonkers KA et al. The management of depression during pregnancy: a report from the APA and ACOG. Gen Hosp PsychiatryContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.