For a woman exhibiting symptoms consistent with premenstrual dysphoric disorder, what is the most appropriate management step?

For a woman exhibiting symptoms consistent with premenstrual dysphoric disorder (PMDD), the most appropriate management step is fluoxetine.

Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), has been shown to be effective in alleviating the psychological and physical symptoms associated with PMDD. The disorder is characterized by severe emotional and physical symptoms that occur in the luteal phase of the menstrual cycle, and SSRIs help by stabilizing mood and reducing irritability, anxiety, and depression that often accompany PMDD. Clinicians typically prescribe fluoxetine for its efficacy in treating the mood-related symptoms of PMDD, and it may be taken continuously or just during the luteal phase depending on the severity and individual symptoms.

While other management options exist, they may not address the core symptoms as effectively. Combined oral contraceptives can help regulate menstrual cycles and may reduce some symptoms, but they are not the first-line treatment for PMDD as the primary concern is mood stabilization. Ibuprofen can alleviate physical symptoms such as pain and discomfort but does not address the emotional and psychological aspects of PMDD. Lifestyle modifications can be beneficial, including diet changes, exercise, or stress management techniques, but these approaches are often most effective when combined with pharmac