#223 Premenstrual Dysphoric Disorder (PMDD) with Professor Jayashri Kulkarni

Professor Jayashri Kulkarni is one of Australia's leading psychiatrists and researchers specialising in women's mental health. She is the Director of the HER Centre Australia (Health, Education and Research for Women's Mental Health) and Professor of Psychiatry at Monash University. Professor Kulkarni's work focuses on mood disorders across the female lifespan, with particular attention to the neurochemical effects of reproductive hormones on brain function, including perimenopausal depression and premenstrual dysphoric disorder. She is the developer of the Meno-D rating scale and has been a leading voice for over four decades in the recognition and treatment of hormone-related mental illness in women. This is a supplementary episode to the GP Show's earlier conversation with Professor Kulkarni on perimenopausal mental health, recorded in the same sitting. In it, Dr. Ashlea Broomfield and Professor Kulkarni discuss what distinguishes PMDD from common premenstrual symptoms; the emerging evidence on trauma and gene expression as a mechanism for PMDD onset; why current guidelines default to SSRIs rather than hormonal treatment and the limitations of that approach; practical hormonal treatment options for women with and without contraceptive needs; and the role of trauma therapy alongside hormonal management. Professor Kulkarni argues that PMDD is a brain condition, not an end-organ condition, and that treatment should reflect that. RESOURCES "How to Treat PMDD" — Professor Jayashri Kulkarni, Australian Doctor. Read here UK Guidelines: The Green-top Guideline 48 — Management of Premenstrual Syndrome Green LJ, O'Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians andGynaecologists. Management of premenstrual syndrome. BJOG 2017 ; 124:e73–e105 HER Centre Australia — monash.edu/medicine/her-centre Perimenopausal Mental Health episode — The GP S