Episode 181

Understanding PMS and PMDD: Managing Premenstrual Disorders with Professor Jayashri Kulkarni

In this episode of The Good GP, Karin Sekhon speaks with Professor Jayashri Kulkarni, a renowned psychiatrist, about premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Professor Kulkarni explains the distinctions between PMS and PMDD, emphasising that PMS is more prevalent and generally involves physical symptoms like bloating and headaches, while PMDD affects a smaller percentage of women and includes severe psychological symptoms such as major depression, anxiety, and brain fog. She talks about the genetic and environmental factors contributing to PMDD, highlighting a specific gene complex that may be activated by trauma.


Discussing the primary pharmacological treatments for PMDD, Professor Kulkarni advises starting with hormonal treatments like the combined oral contraceptive pill; she recommends the pill "Zoely" for its balanced hormone levels. She also elaborates on the use of SSRIs like sertraline for additional support and gives a stepped approach to treatment, including the possible need for hormone replacement therapy (HRT) or menstrual suppression in complex cases.


They also touched on the potential role of complementary therapies and the importance of holistic care, involving psychological support and lifestyle modifications. Professor Kulkarni provides guidance on when GPs should consider referring patients to specialists and emphasises the collaborative role of GPs in managing PMDD effectively.


If you want to learn more about this topic, consider the HER Centre Australia's online short course on Women's Mental Health: https://www.monash.edu/medicine/translational/psychiatry/short-courses/womens-mental-health


The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network


If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com

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About the Podcast

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The Good GP
The Good GP, the education podcast for busy GPs

About your hosts

Profile picture for Tim Koh

Tim Koh

Dr Tim Koh is a Perth-based GP with over 20 years of experience and a strong focus on GP education and evidence-based practice. He provides practical insights and advice on key topics in primary care.
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Krystyna de Lange

Dr Krystyna de Lange is a GP with nine years of experience, specialising in Aboriginal and Torres Strait Islander health, women’s health, and chronic disease management. She delivers practical insights and fosters engaging discussions on essential health topics.
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Sean Stevens

Dr Sean Stevens is a GP with 27 years of experience, recognised for his expertise in medical education and innovation. He has contributed to over 60 episodes, sharing valuable insights to promote quality care in general practice.