Unusual manifestations of premenstrual syndrome

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The authors have identified six unusual manifestations of premenstrual syndrome: (i) typical premenstrual dysphoric disorder symptoms during ovulation; (ii) upper airway infection in the premenstrual phase that remits after onset of menstruation; (iii) recurrent perimenstrual erythematous and edematous skin plaques; (iv) hypomanic or manic state 2–3 days before onset of menstruation; (v) auditory hallucinations and delusion of reference, present only premenstrually; and (vi) remitted bipolar disorder presenting with premenstrual psychotic features. Psychiatrists should be aware of menstrual cycle-related changes in mental illness, physical illness, or both in women of reproductive age, if cyclic trends are suspected.

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