Premenstrual Syndrome (PMS) and PMDD: Diagnosis and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Le SPM est un ensemble de sympt\u00f4mes physiques et psychologiques survenant en phase lut\u00e9ale. TDPM, ISRS, contraceptifs, calcium et prise en charge des formes s\u00e9v\u00e8res au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"syndrome pr\u00e9menstruel, SPM, TDPM trouble dysphorique pr\u00e9menstruel, SPM traitement, ISRS SPM, SPM sympt\u00f4mes, dysm\u00e9norrh\u00e9e SPM, SPM calcium, SPM contraceptifs, SPM Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Gyn\u00e9cologie & Psychiatrie & M\u00e9decine de famille<\/span>\n <h1>Syndrome pr\u00e9menstruel (SPM) et trouble dysphorique pr\u00e9menstruel (TDPM)<\/h1>\n<style>.oc-fiche-cta{margin:8px 0 34px;padding:22px 24px;border:1.5px solid rgba(50,60,82,.15);border-left:4px solid #FF611C;border-radius:12px;background:#F4F6F8;font-family:Poppins,sans-serif}.oc-fiche-cta-t{font-size:18px;font-weight:600;color:#323C52;margin:0 0 4px;line-height:1.35}.oc-fiche-cta-x{font-size:15px;color:#4D6577;margin:0 0 14px;line-height:1.55}.oc-fiche-cta-b{display:flex;flex-wrap:wrap;gap:10px}.oc-fiche-cta-b a{display:inline-flex;align-items:center;justify-content:center;min-height:44px;padding:10px 18px;border-radius:8px;font-size:14px;font-weight:600;text-decoration:none;box-sizing:border-box}.oc-fiche-cta-b .oc-p{background:#FF611C;color:#fff}.oc-fiche-cta-b .oc-p:hover{background:#E04E0C}.oc-fiche-cta-b .oc-s{background:#fff;color:#323C52;border:1.5px solid rgba(50,60,82,.25)}@media (max-width:600px){.co-wrap h1{font-size:24px;line-height:1.25;text-transform:none}.oc-fiche-cta{padding:18px 16px}.oc-fiche-cta-b a{flex:1 1 100%}body .co-wrap > .co-table,body .co-wrap > .co-table tbody,body .co-wrap > .co-table tr,body .co-wrap > .co-table td{display:block;width:100%;box-sizing:border-box}body .co-wrap > .co-table{min-width:0;table-layout:auto}body .co-wrap > .co-table thead{display:none}body .co-wrap > .co-table tr{margin:0 0 10px;border:1px solid rgba(77,101,119,.18);border-radius:8px;overflow:hidden}body .co-wrap > .co-table td{padding:9px 12px;border:0}body .co-wrap > .co-table td:first-child{font-weight:600;color:#323C52;background:rgba(77,101,119,.07)}#ocw{transform:scale(.8);transform-origin:bottom right}}<\/style><div class=\"oc-fiche-cta\" data-oc-cta=\"fiche-haut-consult\"><p class=\"oc-fiche-cta-t\">Obtenir un avis adapt\u00e9 \u00e0 votre situation<\/p><p class=\"oc-fiche-cta-x\">Consultation en clinique ou en t\u00e9l\u00e9consultation, partout au Qu\u00e9bec.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/consultation-en-ligne\/\">Consult online<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n Le syndrome pr\u00e9menstruel (SPM) d\u00e9signe un ensemble de sympt\u00f4mes physiques, comportementaux et psychologiques r\u00e9currents survenant de fa\u00e7on cyclique pendant la phase lut\u00e9ale du cycle menstruel (7 \u00e0 14 jours avant les r\u00e8gles) et disparaissant dans les premiers jours des menstruations, suffisamment s\u00e9v\u00e8res pour interf\u00e9rer avec les activit\u00e9s quotidiennes et les relations interpersonnelles, sans cause psychiatrique ou somatique sous-jacente pouvant les expliquer enti\u00e8rement. Avec une pr\u00e9valence de 30 \u00e0 40 % des femmes en \u00e2ge de procr\u00e9er pour les formes l\u00e9g\u00e8res \u00e0 mod\u00e9r\u00e9es, et de 3 \u00e0 8 % pour les formes s\u00e9v\u00e8res (trouble dysphorique pr\u00e9menstruel \u2014 TDPM), le SPM est l'une des plaintes gyn\u00e9cologiques les plus fr\u00e9quentes en m\u00e9decine de premi\u00e8re ligne. Sa physiopathologie est multifactorielle et encore incompl\u00e8tement \u00e9lucid\u00e9e : la fluctuation des taux d'\u0153strog\u00e8ne et de progest\u00e9rone pendant le cycle menstruel \u2014 normale chez toutes les femmes \u2014 interagit avec des syst\u00e8mes neuromodulateurs centraux (principalement le syst\u00e8me s\u00e9rotoninergique + le syst\u00e8me GABAergique via les neurost\u00e9ro\u00efdes m\u00e9tabolites de la progest\u00e9rone \u2014 allopr\u00e9gnanolone) et p\u00e9riph\u00e9riques d'une fa\u00e7on anormalement amplifi\u00e9e chez les femmes pr\u00e9dispos\u00e9es, entra\u00eenant des modifications de l'humeur + de la sensibilit\u00e9 aux douleurs + de la r\u00e9gulation neurov\u00e9g\u00e9tative. La s\u00e9v\u00e9rit\u00e9 des sympt\u00f4mes est ind\u00e9pendante des taux hormonaux mesur\u00e9s (les taux d'hormones sont normaux dans le SPM \u2014 c'est la sensibilit\u00e9 c\u00e9r\u00e9brale \u00e0 ces fluctuations normales qui est alt\u00e9r\u00e9e). Le trouble dysphorique pr\u00e9menstruel (TDPM) \u2014 reconnu comme entit\u00e9 diagnostique distincte dans le DSM-5 depuis 2013 \u2014 repr\u00e9sente la forme la plus s\u00e9v\u00e8re du spectre SPM et se caract\u00e9rise par une dysphorie pr\u00e9dominante (d\u00e9pression intense + anxi\u00e9t\u00e9 + labilit\u00e9 \u00e9motionnelle + irritabilit\u00e9 s\u00e9v\u00e8re) compromettant significativement le fonctionnement social et professionnel, n\u00e9cessitant une prise en charge m\u00e9dicale active.\n <\/div>\n\n <h2>Sympt\u00f4mes cliniques<\/h2>\n <ul class=\"co-list\">\n <li><strong>Sympt\u00f4mes psychologiques et comportementaux :<\/strong> Irritability + anger + emotional lability (crying + mood swings) + anxiety + inner tension + feeling overwhelmed + difficulty concentrating + depression + guilt + loss of interest in usual activities + hypersomnia or insomnia + changes in appetite (cravings + desire for sweets + salt)<\/li>\n <li><strong>Physical symptoms :<\/strong> Breast pain and tenderness (cyclical mastalgia) + abdominal bloating + water retention + lower limb edema + pelvic pain + headaches + migraines (catamenial migraines) + joint and muscle pain + acne + fatigue + bowel transit issues<\/li>\n <li><strong>Temporalit\u00e9 caract\u00e9ristique :<\/strong> Spotting during the luteal phase (7\u201314 days before menstruation) + progressive worsening until menstruation + rapid improvement within 2\u20134 days after the onset of menstruation + absence of symptoms during the follicular phase (symptom-free period post-menstrually)<\/li>\n <\/ul>\n\n <h2>Crit\u00e8res diagnostiques du TDPM (DSM-5)<\/h2>\n <ul class=\"co-list\">\n <li><strong>Crit\u00e8re A \u2014 Temporalit\u00e9 :<\/strong> In the majority of menstrual cycles, at least 5 symptoms must be present during the last week before menstruation, disappear within the first few days of menstruation, and be absent during the week after menstruation.<\/li>\n <li><strong>Crit\u00e8re B \u2014 Au moins 1 sympt\u00f4me affectif pr\u00e9dominant :<\/strong> Marked emotional lability (tears + sensitivity to rejection) + irritability + marked anger + depressed mood + feeling of hopelessness + anxiety + tension + feeling at the end of one's rope + at least 1 of these 4 symptoms must be present<\/li>\n <li><strong>Crit\u00e8re C \u2014 Sympt\u00f4mes additionnels :<\/strong> At least 5 symptoms in total, including the following: decreased interest in usual activities + difficulty concentrating + fatigue + change in appetite + hypersomnia or insomnia + feeling overwhelmed + physical symptoms (breast tenderness + bloating + headaches + joint pain)<\/li>\n <li><strong>Crit\u00e8re D \u2014 Retentissement :<\/strong> symptoms associated with clinically significant distress or impairment in social, occupational, or school functioning<\/li>\n <li><strong>Crit\u00e8re E \u2014 Confirmation prospective :<\/strong> Symptoms must be prospectively documented over at least 2 symptomatic cycles (daily symptom diary) to confirm cyclicity + DRSP (Daily Record of Severity of Problems) or PMTS questionnaires are validated tools<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Le journal quotidien des sympt\u00f4mes sur 2 cycles menstruels cons\u00e9cutifs est l'outil diagnostic indispensable pour confirmer le SPM\/TDPM. Il permet d'\u00e9tablir la cyclicit\u00e9 lut\u00e9ale des sympt\u00f4mes (augmentation progressive en pr\u00e9-menstruel + fen\u00eatre libre en post-menstruel) et d'\u00e9liminer un trouble d\u00e9pressif chronique ou anxieux qui s'aggraverait en p\u00e9riode pr\u00e9menstruelle plut\u00f4t qu'un vrai SPM. Une d\u00e9pression chronique sous-jacente aggrav\u00e9e en phase lut\u00e9ale ne constitue pas un TDPM \u2014 le traitement sera diff\u00e9rent.<\/span>\n <\/div>\n\n <h2>Treatment \u2014 stepped approach<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Bearing<\/th>\n <th>Treatment<\/th>\n <th>Efficiency and comments<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>1re ligne \u2014 Mesures hygi\u00e9no-di\u00e9t\u00e9tiques<\/td>\n <td>Exercice physique r\u00e9gulier (150 min\/semaine) + r\u00e9duction caf\u00e9ine + alcool + sel + sucre raffin\u00e9 + alimentation riche en glucides complexes + technique de relaxation + gestion du stress + sommeil r\u00e9gulier + psycho\u00e9ducation<\/td>\n <td>Am\u00e9lioration mod\u00e9r\u00e9e + qualit\u00e9 des preuves limit\u00e9e mais sans effets ind\u00e9sirables + \u00e0 maintenir en combinaison avec tout traitement pharmacologique + l'exercice a\u00e9robique est le mieux document\u00e9 (r\u00e9duction de 20\u201330 % des sympt\u00f4mes)<\/td>\n <\/tr>\n <tr>\n <td>1re ligne \u2014 Suppl\u00e9ments (formes l\u00e9g\u00e8res)<\/td>\n <td>Calcium carbonate 1 000\u20131 200 mg\/jour (meilleure \u00e9vidence) + vitamine D 1 000 UI\/jour + magn\u00e9sium 200\u2013400 mg\/jour (phase lut\u00e9ale) + vitamine B6 50\u2013100 mg\/jour<\/td>\n <td>Calcium : r\u00e9duction de 48 % des sympt\u00f4mes (\u00e9tude Thys-Jacobs) + surtout tension mammaire + d\u00e9pression + ballonnements + magn\u00e9sium : r\u00e9duit la r\u00e9tention hydrique + les c\u00e9phal\u00e9es + vitamine B6 : am\u00e9lioration mod\u00e9r\u00e9e des sympt\u00f4mes affectifs (m\u00e9ta-analyse Cochrane) + s\u00e9curitaires \u00e0 ces doses<\/td>\n <\/tr>\n <tr>\n <td>2e ligne \u2014 ISRS (formes mod\u00e9r\u00e9es \u00e0 s\u00e9v\u00e8res \u2014 SPM + TDPM)<\/td>\n <td>Sertraline 50\u2013150 mg\/jour + ou fluox\u00e9tine 10\u201320 mg\/jour (Sarafem\u00ae \u2014 approuv\u00e9e FDA pour le TDPM) + ou escitalopram 10\u201320 mg\/jour + ou parox\u00e9tine CR 12,5\u201325 mg\/jour en continu ou en dosage intermittent (phase lut\u00e9ale seulement \u2014 J14 aux r\u00e8gles)<\/td>\n <td>Traitement le plus efficace du TDPM + r\u00e9duction de 60\u201370 % des sympt\u00f4mes affectifs + r\u00e9ponse souvent d\u00e8s le 1er cycle (plus rapide que pour la d\u00e9pression \u2014 m\u00e9canisme diff\u00e9rent) + dosage intermittent (phase lut\u00e9ale) aussi efficace que le continu pour certains ISRS (sertraline + fluox\u00e9tine) + moins d'effets ind\u00e9sirables avec la prise intermittente + effets ind\u00e9sirables : naus\u00e9es + troubles sexuels + insomnie<\/td>\n <\/tr>\n <tr>\n <td>2e ligne \u2014 Contraceptifs oraux<\/td>\n <td>Drospir\u00e9none + \u00e9thinylestradiol 20 \u00b5g (Yaz\u00ae + Yazmin\u00ae \u2014 formule 24\/4 \u2014 24 jours actifs + 4 jours placebo) \u2192 drospir\u00e9none a des propri\u00e9t\u00e9s antimin\u00e9ralocortico\u00efdes (r\u00e9duit la r\u00e9tention hydrique) et antiandrog\u00e9niques + approuv\u00e9e FDA pour le TDPM<\/td>\n <td>Efficacit\u00e9 d\u00e9montr\u00e9e sur les sympt\u00f4mes physiques (ballonnements + tension mammaire) + sympt\u00f4mes affectifs mod\u00e9r\u00e9ment am\u00e9lior\u00e9s + option si contraception souhait\u00e9e simultan\u00e9ment + les contraceptifs oraux classiques peuvent aggraver ou am\u00e9liorer le SPM selon les individus \u2192 essai de 3 cycles<\/td>\n <\/tr>\n <tr>\n <td>3e ligne \u2014 Agonistes GnRH (formes tr\u00e8s s\u00e9v\u00e8res r\u00e9fractaires)<\/td>\n <td>Leupror\u00e9line (Lupron\u00ae) + ou nafar\u00e9line + ou gos\u00e9r\u00e9line \u2192 suppression ovarienne \u2192 am\u00e9norrh\u00e9e m\u00e9dicale \u2192 disparition des sympt\u00f4mes du SPM + add-back hormonal (\u0153strog\u00e8ne + progest\u00e9rone) recommand\u00e9 apr\u00e8s 6 mois pour pr\u00e9venir la perte osseuse<\/td>\n <td>Tr\u00e8s efficaces (quasi-100 %) + mais effets ind\u00e9sirables de la m\u00e9nopause artificielle (bouff\u00e9es de chaleur + s\u00e9cheresse vaginale + perte osseuse) + co\u00fbt \u00e9lev\u00e9 + usage limit\u00e9 \u00e0 6 mois + option ponctuelle pour confirmer le diagnostic ou en pr\u00e9paration \u00e0 une ovariectomie chirurgicale<\/td>\n <\/tr>\n <tr>\n <td>Other options<\/td>\n <td>Spironolactone 25\u2013100 mg\/jour en phase lut\u00e9ale (r\u00e9tention hydrique + ballonnements) + alprazolam 0,25 mg en PRN phase lut\u00e9ale (anxi\u00e9t\u00e9 s\u00e9v\u00e8re \u2014 risque de d\u00e9pendance + usage prudent) + buspirone 10\u201330 mg\/jour (anxi\u00e9t\u00e9 sans risque de d\u00e9pendance)<\/td>\n <td>Spironolactone : efficace sur les sympt\u00f4mes physiques + peu d'impact sur les sympt\u00f4mes affectifs + alprazolam : r\u00e9serv\u00e9 aux formes avec anxi\u00e9t\u00e9 s\u00e9v\u00e8re + usage intermittent strict + risque de d\u00e9pendance si usage quotidien<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Differential diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>D\u00e9pression majeure avec aggravation pr\u00e9menstruelle :<\/strong> Depression present throughout the cycle + worsened in the luteal phase -> NO free window in post-menstrual -> continuous antidepressant treatment<\/li>\n <li><strong>Trouble anxieux g\u00e9n\u00e9ralis\u00e9 :<\/strong> Chronic non-cyclic anxiety: Symptom diary shows absence of characteristic cyclicity<\/li>\n <li><strong>Endom\u00e9triose :<\/strong> Pelvic pain + dyspareunia + severe dysmenorrhea \u2192 can overlap with PMS \u2192 gynecological examination + ultrasound + laparoscopy if suspected<\/li>\n <li><strong>Dysm\u00e9norrh\u00e9e primaire :<\/strong> Menstrual pain starting with menstruation (not before) \u2192 NSAIDs + contraceptives + not to be confused with PMS pelvic pain starting in the luteal phase<\/li>\n <li><strong>Pathologies thyro\u00efdiennes :<\/strong> Hypothyroidism + hyperthyroidism \u2192 can mimic or worsen PMS symptoms \u2192 systematic TSH in the workup<\/li>\n <\/ul>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si les sympt\u00f4mes pr\u00e9menstruels interf\u00e8rent significativement avec le travail + les relations interpersonnelles + les activit\u00e9s quotidiennes + ou si des pens\u00e9es de se faire du mal apparaissent en phase pr\u00e9menstruelle \u2014 le TDPM est associ\u00e9 \u00e0 un risque accru de comportements auto-destructeurs pendant la phase lut\u00e9ale et n\u00e9cessite une prise en charge m\u00e9dicale active incluant les ISRS. Pour le diagnostic du SPM\/TDPM + la prescription du journal des sympt\u00f4mes + l'initiation du traitement adapt\u00e9 (calcium + ISRS + contraceptifs), Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron diagnostiquent le SPM et le TDPM par l'anamn\u00e8se d\u00e9taill\u00e9e et le journal prospectif des sympt\u00f4mes sur 2 cycles, distinguent le TDPM d'une d\u00e9pression chronique sous-jacente, initient les mesures hygi\u00e9no-di\u00e9t\u00e9tiques et les suppl\u00e9ments (calcium + magn\u00e9sium + B6) pour les formes l\u00e9g\u00e8res, prescrivent les ISRS pour les formes mod\u00e9r\u00e9es \u00e0 s\u00e9v\u00e8res (TDPM), proposent les contraceptifs oraux (drospir\u00e9none) si contraception souhait\u00e9e, et orientent vers la gyn\u00e9cologie ou la psychiatrie pour les formes r\u00e9fractaires ou avec comorbidit\u00e9s psychiatriques significatives. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un gyn\u00e9cologue. Le diagnostic de SPM\/TDPM repose sur la documentation prospective des sympt\u00f4mes sur au moins 2 cycles \u2014 un diagnostic bas\u00e9 uniquement sur le souvenir r\u00e9trospectif des sympt\u00f4mes est insuffisant. Si des pens\u00e9es de se faire du mal apparaissent en p\u00e9riode pr\u00e9menstruelle, consulter un m\u00e9decin sans d\u00e9lai.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron Gyn\u00e9cologie & Psychiatrie & M\u00e9decine de famille Syndrome pr\u00e9menstruel (SPM) et trouble dysphorique pr\u00e9menstruel (TDPM) Le syndrome pr\u00e9menstruel (SPM) d\u00e9signe un ensemble de sympt\u00f4mes physiques, comportementaux et psychologiques r\u00e9currents survenant de fa\u00e7on cyclique pendant la phase lut\u00e9ale du cycle menstruel (7 \u00e0 14… <a href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Premenstrual Syndrome (PMS) and PMDD: Diagnosis and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Syndrome pr\u00e9menstruel (SPM) | Brossard | Clinique Omicron","_metasync_otto_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_otto_twitter_title":"Syndrome Premenstruel | Clinique Omicron","_metasync_otto_twitter_description":"","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","_aioseo_description":"Le SPM regroupe sympt\u00f4mes physiques et psychologiques en phase lut\u00e9ale. TDPM DSM-5 journal 2 cycles, calcium 1200mg magn\u00e9sium B6, ISRS sertraline fluox\u00e9tine intermittent, drospir\u00e9none Yaz agonistes GnRH au Qu\u00e9bec.","_metasync_seo_title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","_metasync_seo_desc":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_imported_seo_title":"","_metasync_imported_seo_desc":"","_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-09-13T17:01:24+00:00\"}","_metasync_robots_advanced":"","_metasync_og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","_metasync_og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_twitter_title":"Syndrome Premenstruel | Clinique Omicron","_metasync_twitter_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","footnotes":""},"class_list":["post-24987","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.\" \/>\n\t<meta name=\"robots\" content=\"max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n\t<meta name=\"google-site-verification\" content=\"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM\" \/>\n\t<meta name=\"msvalidate.01\" content=\"3225E6935FC4F40C7DDCE56C37141BA8\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO Pro (AIOSEO) 5.0.1.1\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Clinique Omicron - Clinique M\u00e9dicale\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec\" \/>\n\t\t<meta property=\"og:description\" content=\"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" \/>\n\t\t<meta property=\"og:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"og:image:secure_url\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2026-03-01T02:54:45+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2026-09-14T23:52:11+00:00\" \/>\n\t\t<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/cliniqueomicron\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:site\" content=\"@CliniqueOmicron\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec\" \/>\n\t\t<meta name=\"twitter:description\" content=\"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...\" \/>\n\t\t<meta name=\"twitter:creator\" content=\"@CliniqueOmicron\" \/>\n\t\t<meta name=\"twitter:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#breadcrumblist\",\"itemListElement\":[{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\",\"nextItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#listItem\",\"name\":\"Syndrome pr\\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\"}},{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#listItem\",\"position\":2,\"name\":\"Syndrome pr\\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\",\"previousItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"name\":\"Accueil\"}}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#webpage\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/\",\"name\":\"Syndrome pr\\u00e9menstruel (SPM) | Clinique Omicron\",\"description\":\"Le syndrome pr\\u00e9menstruel regroupe sympt\\u00f4mes physiques et \\u00e9motionnels avant les r\\u00e8gles. Causes, forme s\\u00e9v\\u00e8re, habitudes de vie et traitements possibles.\",\"inLanguage\":\"en-CA\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#breadcrumblist\"},\"datePublished\":\"2026-02-28T22:54:45-04:00\",\"dateModified\":\"2026-09-14T19:52:11-04:00\"},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/\",\"name\":\"Clinique Omicron\",\"description\":\"Clinique M\\u00e9dicale\",\"inLanguage\":\"en-CA\",\"publisher\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#organization\"}}]}\n\t\t<\/script>\n\t\t\r\n\t\t<title>Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron<\/title>\n\n","aioseo_head_json":{"title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","canonical_url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","robots":"max-snippet:-1, max-image-preview:large, max-video-preview:-1","keywords":"","webmasterTools":{"google-site-verification":"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM","msvalidate.01":"3225E6935FC4F40C7DDCE56C37141BA8","miscellaneous":""},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"BreadcrumbList","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#breadcrumblist","itemListElement":[{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","position":1,"name":"Accueil","item":"https:\/\/cliniqueomicron.ca\/en","nextItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#listItem","name":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron"}},{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#listItem","position":2,"name":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","previousItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","name":"Accueil"}}]},{"@type":"WebPage","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#webpage","url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","name":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","inLanguage":"en-CA","isPartOf":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#website"},"breadcrumb":{"@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#breadcrumblist"},"datePublished":"2026-02-28T22:54:45-04:00","dateModified":"2026-09-14T19:52:11-04:00"},{"@type":"WebSite","@id":"https:\/\/cliniqueomicron.ca\/en\/#website","url":"https:\/\/cliniqueomicron.ca\/en\/","name":"Clinique Omicron","description":"Clinique M\u00e9dicale","inLanguage":"en-CA","publisher":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#organization"}}]},"og:locale":"en_US","og:site_name":"Clinique Omicron - Clinique M\u00e9dicale","og:type":"article","og:title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","og:description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","og:url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","og:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","og:image:secure_url":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","article:published_time":"2026-03-01T02:54:45+00:00","article:modified_time":"2026-09-14T23:52:11+00:00","article:publisher":"https:\/\/www.facebook.com\/cliniqueomicron","twitter:card":"summary_large_image","twitter:site":"@CliniqueOmicron","twitter:title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","twitter:description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","twitter:creator":"@CliniqueOmicron","twitter:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg"},"aioseo_meta_data":{"post_id":"24987","title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","keywords":null,"keyphrases":{"focus":{"keyphrase":"SPM","score":68,"analysis":{"keyphraseInTitle":{"score":9,"maxScore":9,"error":0},"keyphraseInDescription":{"score":9,"maxScore":9,"error":0},"keyphraseLength":{"score":9,"maxScore":9,"error":0,"length":1},"keyphraseInURL":{"score":1,"maxScore":5,"error":1},"keyphraseInIntroduction":{"score":9,"maxScore":9,"error":0},"keyphraseInSubHeadings":{"score":3,"maxScore":9,"error":1},"keyphraseInImageAlt":[],"keywordDensity":{"type":"high","score":0,"maxScore":9,"error":1}}},"additional":[]},"primary_term":null,"canonical_url":null,"og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":"","og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":true,"twitter_card":"summary_large_image","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":"Syndrome Premenstruel | Clinique Omicron","twitter_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"WebPage","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":false,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":"-1","robots_max_videopreview":"-1","robots_max_imagepreview":"large","priority":null,"frequency":"default","local_seo":null,"seo_analyzer_scan_date":"2026-09-15 00:17:37","breadcrumb_settings":null,"limit_modified_date":false,"reviewed_by":null,"open_ai":null,"ai":{"faqs":[],"keyPoints":[],"titles":[],"descriptions":[],"socialPosts":{"email":[],"linkedin":[],"twitter":[],"facebook":[],"instagram":[]}},"created":"2026-03-01 04:11:08","updated":"2026-09-15 00:22:17","focus_keyword":"SPM","additional_keywords":null,"truseo_locale":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t<a href=\"https:\/\/cliniqueomicron.ca\/en\" title=\"Accueil\">Accueil<\/a>\n<\/span><span class=\"aioseo-breadcrumb-separator\">\u203a<\/span><span class=\"aioseo-breadcrumb\">\n\tSyndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\n<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Accueil","link":"https:\/\/cliniqueomicron.ca\/en"},{"label":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","link":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/"}],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24987"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987\/revisions"}],"predecessor-version":[{"id":31601,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987\/revisions\/31601"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

\n\t\t\t\t

\n\t\t\t\t\t

\n\t\t\t\t

\n\t\t\t\t\t\n\n\n\n\nPremenstrual Syndrome (PMS) and PMDD: Diagnosis and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Le SPM est un ensemble de sympt\u00f4mes physiques et psychologiques survenant en phase lut\u00e9ale. TDPM, ISRS, contraceptifs, calcium et prise en charge des formes s\u00e9v\u00e8res au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"syndrome pr\u00e9menstruel, SPM, TDPM trouble dysphorique pr\u00e9menstruel, SPM traitement, ISRS SPM, SPM sympt\u00f4mes, dysm\u00e9norrh\u00e9e SPM, SPM calcium, SPM contraceptifs, SPM Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Gyn\u00e9cologie & Psychiatrie & M\u00e9decine de famille<\/span>\n <h1>Syndrome pr\u00e9menstruel (SPM) et trouble dysphorique pr\u00e9menstruel (TDPM)<\/h1>\n<style>.oc-fiche-cta{margin:8px 0 34px;padding:22px 24px;border:1.5px solid rgba(50,60,82,.15);border-left:4px solid #FF611C;border-radius:12px;background:#F4F6F8;font-family:Poppins,sans-serif}.oc-fiche-cta-t{font-size:18px;font-weight:600;color:#323C52;margin:0 0 4px;line-height:1.35}.oc-fiche-cta-x{font-size:15px;color:#4D6577;margin:0 0 14px;line-height:1.55}.oc-fiche-cta-b{display:flex;flex-wrap:wrap;gap:10px}.oc-fiche-cta-b a{display:inline-flex;align-items:center;justify-content:center;min-height:44px;padding:10px 18px;border-radius:8px;font-size:14px;font-weight:600;text-decoration:none;box-sizing:border-box}.oc-fiche-cta-b .oc-p{background:#FF611C;color:#fff}.oc-fiche-cta-b .oc-p:hover{background:#E04E0C}.oc-fiche-cta-b .oc-s{background:#fff;color:#323C52;border:1.5px solid rgba(50,60,82,.25)}@media (max-width:600px){.co-wrap h1{font-size:24px;line-height:1.25;text-transform:none}.oc-fiche-cta{padding:18px 16px}.oc-fiche-cta-b a{flex:1 1 100%}body .co-wrap > .co-table,body .co-wrap > .co-table tbody,body .co-wrap > .co-table tr,body .co-wrap > .co-table td{display:block;width:100%;box-sizing:border-box}body .co-wrap > .co-table{min-width:0;table-layout:auto}body .co-wrap > .co-table thead{display:none}body .co-wrap > .co-table tr{margin:0 0 10px;border:1px solid rgba(77,101,119,.18);border-radius:8px;overflow:hidden}body .co-wrap > .co-table td{padding:9px 12px;border:0}body .co-wrap > .co-table td:first-child{font-weight:600;color:#323C52;background:rgba(77,101,119,.07)}#ocw{transform:scale(.8);transform-origin:bottom right}}<\/style><div class=\"oc-fiche-cta\" data-oc-cta=\"fiche-haut-consult\"><p class=\"oc-fiche-cta-t\">Obtenir un avis adapt\u00e9 \u00e0 votre situation<\/p><p class=\"oc-fiche-cta-x\">Consultation en clinique ou en t\u00e9l\u00e9consultation, partout au Qu\u00e9bec.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/consultation-en-ligne\/\">Consult online<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n Le syndrome pr\u00e9menstruel (SPM) d\u00e9signe un ensemble de sympt\u00f4mes physiques, comportementaux et psychologiques r\u00e9currents survenant de fa\u00e7on cyclique pendant la phase lut\u00e9ale du cycle menstruel (7 \u00e0 14 jours avant les r\u00e8gles) et disparaissant dans les premiers jours des menstruations, suffisamment s\u00e9v\u00e8res pour interf\u00e9rer avec les activit\u00e9s quotidiennes et les relations interpersonnelles, sans cause psychiatrique ou somatique sous-jacente pouvant les expliquer enti\u00e8rement. Avec une pr\u00e9valence de 30 \u00e0 40 % des femmes en \u00e2ge de procr\u00e9er pour les formes l\u00e9g\u00e8res \u00e0 mod\u00e9r\u00e9es, et de 3 \u00e0 8 % pour les formes s\u00e9v\u00e8res (trouble dysphorique pr\u00e9menstruel \u2014 TDPM), le SPM est l'une des plaintes gyn\u00e9cologiques les plus fr\u00e9quentes en m\u00e9decine de premi\u00e8re ligne. Sa physiopathologie est multifactorielle et encore incompl\u00e8tement \u00e9lucid\u00e9e : la fluctuation des taux d'\u0153strog\u00e8ne et de progest\u00e9rone pendant le cycle menstruel \u2014 normale chez toutes les femmes \u2014 interagit avec des syst\u00e8mes neuromodulateurs centraux (principalement le syst\u00e8me s\u00e9rotoninergique + le syst\u00e8me GABAergique via les neurost\u00e9ro\u00efdes m\u00e9tabolites de la progest\u00e9rone \u2014 allopr\u00e9gnanolone) et p\u00e9riph\u00e9riques d'une fa\u00e7on anormalement amplifi\u00e9e chez les femmes pr\u00e9dispos\u00e9es, entra\u00eenant des modifications de l'humeur + de la sensibilit\u00e9 aux douleurs + de la r\u00e9gulation neurov\u00e9g\u00e9tative. La s\u00e9v\u00e9rit\u00e9 des sympt\u00f4mes est ind\u00e9pendante des taux hormonaux mesur\u00e9s (les taux d'hormones sont normaux dans le SPM \u2014 c'est la sensibilit\u00e9 c\u00e9r\u00e9brale \u00e0 ces fluctuations normales qui est alt\u00e9r\u00e9e). Le trouble dysphorique pr\u00e9menstruel (TDPM) \u2014 reconnu comme entit\u00e9 diagnostique distincte dans le DSM-5 depuis 2013 \u2014 repr\u00e9sente la forme la plus s\u00e9v\u00e8re du spectre SPM et se caract\u00e9rise par une dysphorie pr\u00e9dominante (d\u00e9pression intense + anxi\u00e9t\u00e9 + labilit\u00e9 \u00e9motionnelle + irritabilit\u00e9 s\u00e9v\u00e8re) compromettant significativement le fonctionnement social et professionnel, n\u00e9cessitant une prise en charge m\u00e9dicale active.\n <\/div>\n\n <h2>Sympt\u00f4mes cliniques<\/h2>\n <ul class=\"co-list\">\n <li><strong>Sympt\u00f4mes psychologiques et comportementaux :<\/strong> Irritability + anger + emotional lability (crying + mood swings) + anxiety + inner tension + feeling overwhelmed + difficulty concentrating + depression + guilt + loss of interest in usual activities + hypersomnia or insomnia + changes in appetite (cravings + desire for sweets + salt)<\/li>\n <li><strong>Physical symptoms :<\/strong> Breast pain and tenderness (cyclical mastalgia) + abdominal bloating + water retention + lower limb edema + pelvic pain + headaches + migraines (catamenial migraines) + joint and muscle pain + acne + fatigue + bowel transit issues<\/li>\n <li><strong>Temporalit\u00e9 caract\u00e9ristique :<\/strong> Spotting during the luteal phase (7\u201314 days before menstruation) + progressive worsening until menstruation + rapid improvement within 2\u20134 days after the onset of menstruation + absence of symptoms during the follicular phase (symptom-free period post-menstrually)<\/li>\n <\/ul>\n\n <h2>Crit\u00e8res diagnostiques du TDPM (DSM-5)<\/h2>\n <ul class=\"co-list\">\n <li><strong>Crit\u00e8re A \u2014 Temporalit\u00e9 :<\/strong> In the majority of menstrual cycles, at least 5 symptoms must be present during the last week before menstruation, disappear within the first few days of menstruation, and be absent during the week after menstruation.<\/li>\n <li><strong>Crit\u00e8re B \u2014 Au moins 1 sympt\u00f4me affectif pr\u00e9dominant :<\/strong> Marked emotional lability (tears + sensitivity to rejection) + irritability + marked anger + depressed mood + feeling of hopelessness + anxiety + tension + feeling at the end of one's rope + at least 1 of these 4 symptoms must be present<\/li>\n <li><strong>Crit\u00e8re C \u2014 Sympt\u00f4mes additionnels :<\/strong> At least 5 symptoms in total, including the following: decreased interest in usual activities + difficulty concentrating + fatigue + change in appetite + hypersomnia or insomnia + feeling overwhelmed + physical symptoms (breast tenderness + bloating + headaches + joint pain)<\/li>\n <li><strong>Crit\u00e8re D \u2014 Retentissement :<\/strong> symptoms associated with clinically significant distress or impairment in social, occupational, or school functioning<\/li>\n <li><strong>Crit\u00e8re E \u2014 Confirmation prospective :<\/strong> Symptoms must be prospectively documented over at least 2 symptomatic cycles (daily symptom diary) to confirm cyclicity + DRSP (Daily Record of Severity of Problems) or PMTS questionnaires are validated tools<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Le journal quotidien des sympt\u00f4mes sur 2 cycles menstruels cons\u00e9cutifs est l'outil diagnostic indispensable pour confirmer le SPM\/TDPM. Il permet d'\u00e9tablir la cyclicit\u00e9 lut\u00e9ale des sympt\u00f4mes (augmentation progressive en pr\u00e9-menstruel + fen\u00eatre libre en post-menstruel) et d'\u00e9liminer un trouble d\u00e9pressif chronique ou anxieux qui s'aggraverait en p\u00e9riode pr\u00e9menstruelle plut\u00f4t qu'un vrai SPM. Une d\u00e9pression chronique sous-jacente aggrav\u00e9e en phase lut\u00e9ale ne constitue pas un TDPM \u2014 le traitement sera diff\u00e9rent.<\/span>\n <\/div>\n\n <h2>Treatment \u2014 stepped approach<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Bearing<\/th>\n <th>Treatment<\/th>\n <th>Efficiency and comments<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>1re ligne \u2014 Mesures hygi\u00e9no-di\u00e9t\u00e9tiques<\/td>\n <td>Exercice physique r\u00e9gulier (150 min\/semaine) + r\u00e9duction caf\u00e9ine + alcool + sel + sucre raffin\u00e9 + alimentation riche en glucides complexes + technique de relaxation + gestion du stress + sommeil r\u00e9gulier + psycho\u00e9ducation<\/td>\n <td>Am\u00e9lioration mod\u00e9r\u00e9e + qualit\u00e9 des preuves limit\u00e9e mais sans effets ind\u00e9sirables + \u00e0 maintenir en combinaison avec tout traitement pharmacologique + l'exercice a\u00e9robique est le mieux document\u00e9 (r\u00e9duction de 20\u201330 % des sympt\u00f4mes)<\/td>\n <\/tr>\n <tr>\n <td>1re ligne \u2014 Suppl\u00e9ments (formes l\u00e9g\u00e8res)<\/td>\n <td>Calcium carbonate 1 000\u20131 200 mg\/jour (meilleure \u00e9vidence) + vitamine D 1 000 UI\/jour + magn\u00e9sium 200\u2013400 mg\/jour (phase lut\u00e9ale) + vitamine B6 50\u2013100 mg\/jour<\/td>\n <td>Calcium : r\u00e9duction de 48 % des sympt\u00f4mes (\u00e9tude Thys-Jacobs) + surtout tension mammaire + d\u00e9pression + ballonnements + magn\u00e9sium : r\u00e9duit la r\u00e9tention hydrique + les c\u00e9phal\u00e9es + vitamine B6 : am\u00e9lioration mod\u00e9r\u00e9e des sympt\u00f4mes affectifs (m\u00e9ta-analyse Cochrane) + s\u00e9curitaires \u00e0 ces doses<\/td>\n <\/tr>\n <tr>\n <td>2e ligne \u2014 ISRS (formes mod\u00e9r\u00e9es \u00e0 s\u00e9v\u00e8res \u2014 SPM + TDPM)<\/td>\n <td>Sertraline 50\u2013150 mg\/jour + ou fluox\u00e9tine 10\u201320 mg\/jour (Sarafem\u00ae \u2014 approuv\u00e9e FDA pour le TDPM) + ou escitalopram 10\u201320 mg\/jour + ou parox\u00e9tine CR 12,5\u201325 mg\/jour en continu ou en dosage intermittent (phase lut\u00e9ale seulement \u2014 J14 aux r\u00e8gles)<\/td>\n <td>Traitement le plus efficace du TDPM + r\u00e9duction de 60\u201370 % des sympt\u00f4mes affectifs + r\u00e9ponse souvent d\u00e8s le 1er cycle (plus rapide que pour la d\u00e9pression \u2014 m\u00e9canisme diff\u00e9rent) + dosage intermittent (phase lut\u00e9ale) aussi efficace que le continu pour certains ISRS (sertraline + fluox\u00e9tine) + moins d'effets ind\u00e9sirables avec la prise intermittente + effets ind\u00e9sirables : naus\u00e9es + troubles sexuels + insomnie<\/td>\n <\/tr>\n <tr>\n <td>2e ligne \u2014 Contraceptifs oraux<\/td>\n <td>Drospir\u00e9none + \u00e9thinylestradiol 20 \u00b5g (Yaz\u00ae + Yazmin\u00ae \u2014 formule 24\/4 \u2014 24 jours actifs + 4 jours placebo) \u2192 drospir\u00e9none a des propri\u00e9t\u00e9s antimin\u00e9ralocortico\u00efdes (r\u00e9duit la r\u00e9tention hydrique) et antiandrog\u00e9niques + approuv\u00e9e FDA pour le TDPM<\/td>\n <td>Efficacit\u00e9 d\u00e9montr\u00e9e sur les sympt\u00f4mes physiques (ballonnements + tension mammaire) + sympt\u00f4mes affectifs mod\u00e9r\u00e9ment am\u00e9lior\u00e9s + option si contraception souhait\u00e9e simultan\u00e9ment + les contraceptifs oraux classiques peuvent aggraver ou am\u00e9liorer le SPM selon les individus \u2192 essai de 3 cycles<\/td>\n <\/tr>\n <tr>\n <td>3e ligne \u2014 Agonistes GnRH (formes tr\u00e8s s\u00e9v\u00e8res r\u00e9fractaires)<\/td>\n <td>Leupror\u00e9line (Lupron\u00ae) + ou nafar\u00e9line + ou gos\u00e9r\u00e9line \u2192 suppression ovarienne \u2192 am\u00e9norrh\u00e9e m\u00e9dicale \u2192 disparition des sympt\u00f4mes du SPM + add-back hormonal (\u0153strog\u00e8ne + progest\u00e9rone) recommand\u00e9 apr\u00e8s 6 mois pour pr\u00e9venir la perte osseuse<\/td>\n <td>Tr\u00e8s efficaces (quasi-100 %) + mais effets ind\u00e9sirables de la m\u00e9nopause artificielle (bouff\u00e9es de chaleur + s\u00e9cheresse vaginale + perte osseuse) + co\u00fbt \u00e9lev\u00e9 + usage limit\u00e9 \u00e0 6 mois + option ponctuelle pour confirmer le diagnostic ou en pr\u00e9paration \u00e0 une ovariectomie chirurgicale<\/td>\n <\/tr>\n <tr>\n <td>Other options<\/td>\n <td>Spironolactone 25\u2013100 mg\/jour en phase lut\u00e9ale (r\u00e9tention hydrique + ballonnements) + alprazolam 0,25 mg en PRN phase lut\u00e9ale (anxi\u00e9t\u00e9 s\u00e9v\u00e8re \u2014 risque de d\u00e9pendance + usage prudent) + buspirone 10\u201330 mg\/jour (anxi\u00e9t\u00e9 sans risque de d\u00e9pendance)<\/td>\n <td>Spironolactone : efficace sur les sympt\u00f4mes physiques + peu d'impact sur les sympt\u00f4mes affectifs + alprazolam : r\u00e9serv\u00e9 aux formes avec anxi\u00e9t\u00e9 s\u00e9v\u00e8re + usage intermittent strict + risque de d\u00e9pendance si usage quotidien<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Differential diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>D\u00e9pression majeure avec aggravation pr\u00e9menstruelle :<\/strong> Depression present throughout the cycle + worsened in the luteal phase -> NO free window in post-menstrual -> continuous antidepressant treatment<\/li>\n <li><strong>Trouble anxieux g\u00e9n\u00e9ralis\u00e9 :<\/strong> Chronic non-cyclic anxiety: Symptom diary shows absence of characteristic cyclicity<\/li>\n <li><strong>Endom\u00e9triose :<\/strong> Pelvic pain + dyspareunia + severe dysmenorrhea \u2192 can overlap with PMS \u2192 gynecological examination + ultrasound + laparoscopy if suspected<\/li>\n <li><strong>Dysm\u00e9norrh\u00e9e primaire :<\/strong> Menstrual pain starting with menstruation (not before) \u2192 NSAIDs + contraceptives + not to be confused with PMS pelvic pain starting in the luteal phase<\/li>\n <li><strong>Pathologies thyro\u00efdiennes :<\/strong> Hypothyroidism + hyperthyroidism \u2192 can mimic or worsen PMS symptoms \u2192 systematic TSH in the workup<\/li>\n <\/ul>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si les sympt\u00f4mes pr\u00e9menstruels interf\u00e8rent significativement avec le travail + les relations interpersonnelles + les activit\u00e9s quotidiennes + ou si des pens\u00e9es de se faire du mal apparaissent en phase pr\u00e9menstruelle \u2014 le TDPM est associ\u00e9 \u00e0 un risque accru de comportements auto-destructeurs pendant la phase lut\u00e9ale et n\u00e9cessite une prise en charge m\u00e9dicale active incluant les ISRS. Pour le diagnostic du SPM\/TDPM + la prescription du journal des sympt\u00f4mes + l'initiation du traitement adapt\u00e9 (calcium + ISRS + contraceptifs), Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron diagnostiquent le SPM et le TDPM par l'anamn\u00e8se d\u00e9taill\u00e9e et le journal prospectif des sympt\u00f4mes sur 2 cycles, distinguent le TDPM d'une d\u00e9pression chronique sous-jacente, initient les mesures hygi\u00e9no-di\u00e9t\u00e9tiques et les suppl\u00e9ments (calcium + magn\u00e9sium + B6) pour les formes l\u00e9g\u00e8res, prescrivent les ISRS pour les formes mod\u00e9r\u00e9es \u00e0 s\u00e9v\u00e8res (TDPM), proposent les contraceptifs oraux (drospir\u00e9none) si contraception souhait\u00e9e, et orientent vers la gyn\u00e9cologie ou la psychiatrie pour les formes r\u00e9fractaires ou avec comorbidit\u00e9s psychiatriques significatives. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un gyn\u00e9cologue. Le diagnostic de SPM\/TDPM repose sur la documentation prospective des sympt\u00f4mes sur au moins 2 cycles \u2014 un diagnostic bas\u00e9 uniquement sur le souvenir r\u00e9trospectif des sympt\u00f4mes est insuffisant. Si des pens\u00e9es de se faire du mal apparaissent en p\u00e9riode pr\u00e9menstruelle, consulter un m\u00e9decin sans d\u00e9lai.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron Gyn\u00e9cologie & Psychiatrie & M\u00e9decine de famille Syndrome pr\u00e9menstruel (SPM) et trouble dysphorique pr\u00e9menstruel (TDPM) Le syndrome pr\u00e9menstruel (SPM) d\u00e9signe un ensemble de sympt\u00f4mes physiques, comportementaux et psychologiques r\u00e9currents survenant de fa\u00e7on cyclique pendant la phase lut\u00e9ale du cycle menstruel (7 \u00e0 14… <a href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Premenstrual Syndrome (PMS) and PMDD: Diagnosis and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Syndrome pr\u00e9menstruel (SPM) | Brossard | Clinique Omicron","_metasync_otto_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_otto_twitter_title":"Syndrome Premenstruel | Clinique Omicron","_metasync_otto_twitter_description":"","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","_aioseo_description":"Le SPM regroupe sympt\u00f4mes physiques et psychologiques en phase lut\u00e9ale. TDPM DSM-5 journal 2 cycles, calcium 1200mg magn\u00e9sium B6, ISRS sertraline fluox\u00e9tine intermittent, drospir\u00e9none Yaz agonistes GnRH au Qu\u00e9bec.","_metasync_seo_title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","_metasync_seo_desc":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_imported_seo_title":"","_metasync_imported_seo_desc":"","_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-09-13T17:01:24+00:00\"}","_metasync_robots_advanced":"","_metasync_og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","_metasync_og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","_metasync_twitter_title":"Syndrome Premenstruel | Clinique Omicron","_metasync_twitter_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","footnotes":""},"class_list":["post-24987","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.\" \/>\n\t<meta name=\"robots\" content=\"max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n\t<meta name=\"google-site-verification\" content=\"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM\" \/>\n\t<meta name=\"msvalidate.01\" content=\"3225E6935FC4F40C7DDCE56C37141BA8\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO Pro (AIOSEO) 5.0.1.1\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Clinique Omicron - Clinique M\u00e9dicale\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec\" \/>\n\t\t<meta property=\"og:description\" content=\"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/\" \/>\n\t\t<meta property=\"og:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"og:image:secure_url\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2026-03-01T02:54:45+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2026-09-14T23:52:11+00:00\" \/>\n\t\t<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/cliniqueomicron\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:site\" content=\"@CliniqueOmicron\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec\" \/>\n\t\t<meta name=\"twitter:description\" content=\"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...\" \/>\n\t\t<meta name=\"twitter:creator\" content=\"@CliniqueOmicron\" \/>\n\t\t<meta name=\"twitter:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#breadcrumblist\",\"itemListElement\":[{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\",\"nextItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#listItem\",\"name\":\"Syndrome pr\\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\"}},{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#listItem\",\"position\":2,\"name\":\"Syndrome pr\\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\",\"previousItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"name\":\"Accueil\"}}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#webpage\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/\",\"name\":\"Syndrome pr\\u00e9menstruel (SPM) | Clinique Omicron\",\"description\":\"Le syndrome pr\\u00e9menstruel regroupe sympt\\u00f4mes physiques et \\u00e9motionnels avant les r\\u00e8gles. Causes, forme s\\u00e9v\\u00e8re, habitudes de vie et traitements possibles.\",\"inLanguage\":\"en-CA\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/syndrome-premenstruel\\\/#breadcrumblist\"},\"datePublished\":\"2026-02-28T22:54:45-04:00\",\"dateModified\":\"2026-09-14T19:52:11-04:00\"},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/\",\"name\":\"Clinique Omicron\",\"description\":\"Clinique M\\u00e9dicale\",\"inLanguage\":\"en-CA\",\"publisher\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#organization\"}}]}\n\t\t<\/script>\n\t\t\r\n\t\t<title>Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron<\/title>\n\n","aioseo_head_json":{"title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","canonical_url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","robots":"max-snippet:-1, max-image-preview:large, max-video-preview:-1","keywords":"","webmasterTools":{"google-site-verification":"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM","msvalidate.01":"3225E6935FC4F40C7DDCE56C37141BA8","miscellaneous":""},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"BreadcrumbList","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#breadcrumblist","itemListElement":[{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","position":1,"name":"Accueil","item":"https:\/\/cliniqueomicron.ca\/en","nextItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#listItem","name":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron"}},{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#listItem","position":2,"name":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","previousItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","name":"Accueil"}}]},{"@type":"WebPage","@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#webpage","url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","name":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","inLanguage":"en-CA","isPartOf":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#website"},"breadcrumb":{"@id":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/#breadcrumblist"},"datePublished":"2026-02-28T22:54:45-04:00","dateModified":"2026-09-14T19:52:11-04:00"},{"@type":"WebSite","@id":"https:\/\/cliniqueomicron.ca\/en\/#website","url":"https:\/\/cliniqueomicron.ca\/en\/","name":"Clinique Omicron","description":"Clinique M\u00e9dicale","inLanguage":"en-CA","publisher":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#organization"}}]},"og:locale":"en_US","og:site_name":"Clinique Omicron - Clinique M\u00e9dicale","og:type":"article","og:title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","og:description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","og:url":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/","og:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","og:image:secure_url":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","article:published_time":"2026-03-01T02:54:45+00:00","article:modified_time":"2026-09-14T23:52:11+00:00","article:publisher":"https:\/\/www.facebook.com\/cliniqueomicron","twitter:card":"summary_large_image","twitter:site":"@CliniqueOmicron","twitter:title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","twitter:description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","twitter:creator":"@CliniqueOmicron","twitter:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg"},"aioseo_meta_data":{"post_id":"24987","title":"Syndrome pr\u00e9menstruel (SPM) | Clinique Omicron","description":"Le syndrome pr\u00e9menstruel regroupe sympt\u00f4mes physiques et \u00e9motionnels avant les r\u00e8gles. Causes, forme s\u00e9v\u00e8re, habitudes de vie et traitements possibles.","keywords":null,"keyphrases":{"focus":{"keyphrase":"SPM","score":68,"analysis":{"keyphraseInTitle":{"score":9,"maxScore":9,"error":0},"keyphraseInDescription":{"score":9,"maxScore":9,"error":0},"keyphraseLength":{"score":9,"maxScore":9,"error":0,"length":1},"keyphraseInURL":{"score":1,"maxScore":5,"error":1},"keyphraseInIntroduction":{"score":9,"maxScore":9,"error":0},"keyphraseInSubHeadings":{"score":3,"maxScore":9,"error":1},"keyphraseInImageAlt":[],"keywordDensity":{"type":"high","score":0,"maxScore":9,"error":1}}},"additional":[]},"primary_term":null,"canonical_url":null,"og_title":"Syndrome Premenstruel | Clinique Omicron Qu\u00e9bec","og_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":"","og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":true,"twitter_card":"summary_large_image","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":"Syndrome Premenstruel | Clinique Omicron","twitter_description":"Syndrome pr\u00e9menstruel (SPM) Syndrome pr\u00e9menstruel (SPM) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos pro...","schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"WebPage","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":false,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":"-1","robots_max_videopreview":"-1","robots_max_imagepreview":"large","priority":null,"frequency":"default","local_seo":null,"seo_analyzer_scan_date":"2026-09-15 00:17:37","breadcrumb_settings":null,"limit_modified_date":false,"reviewed_by":null,"open_ai":null,"ai":{"faqs":[],"keyPoints":[],"titles":[],"descriptions":[],"socialPosts":{"email":[],"linkedin":[],"twitter":[],"facebook":[],"instagram":[]}},"created":"2026-03-01 04:11:08","updated":"2026-09-15 00:22:17","focus_keyword":"SPM","additional_keywords":null,"truseo_locale":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t<a href=\"https:\/\/cliniqueomicron.ca\/en\" title=\"Accueil\">Accueil<\/a>\n<\/span><span class=\"aioseo-breadcrumb-separator\">\u203a<\/span><span class=\"aioseo-breadcrumb\">\n\tSyndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron\n<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Accueil","link":"https:\/\/cliniqueomicron.ca\/en"},{"label":"Syndrome pr\u00e9menstruel (SPM) et TDPM : diagnostic et traitement | Clinique Omicron","link":"https:\/\/cliniqueomicron.ca\/en\/syndrome-premenstruel\/"}],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24987"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987\/revisions"}],"predecessor-version":[{"id":31601,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24987\/revisions\/31601"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}