For many women, the days leading up to their period can be fraught with unwelcome physical and psychological symptoms. Fluid retention, mood changes, weight gain, breast tenderness and swelling -- these are just a few of the unpleasant features that can be associated with the menstrual cycle. Premenstrual Syndrome (PMS) is so prevalent in women that research shows around 90 percent of women experience at least one symptom of PMS every month and around 50 percent of women identify with having several symptoms. However, a significant number of menstruating women, between five to eight percent, experience much more severe symptoms during this time -- a condition that is now recognised as Premenstrual Dysphoric Disorder, also known as PMDD. The psychological symptoms of the disorder can be so debilitating that PMDD was recognised as a depressive disorder in the fifth edition of the Diagnostic And Statistical Manual of Mood Disorders (DSM-5), published by the American Psychiatric Association in 2013."I see often the worst cases. It's not unusual for a woman [with PMDD] to come in with a partner, to sit down and start weeping, and say 'I want everything out. Many women find it's difficult, if not impossible, to work. I want my uterus, tubes and ovaries out.'" Director of the WHRIA and Associate Professor of Reproductive Endocrinology at UNSW John Eden told Huff Post Australia."That's often the opening line, that's how desperate they are. It's really, really destructive."So what exactly is PMDD? In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This sheet talks about whether exposure to sertraline may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider. Sertraline is a medication that has been used to treat depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder (a severe form of premenstrual syndrome), and social phobia. Sertraline belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). While everyone breaks down medication at a different rate, on average sertraline has a half-life (time it takes to eliminate one half of the drug from the body) of 26 hours. Most of the drug will be out of your system 6 days after stopping sertraline. You should always discuss any changes in your dose or stopping your dose of sertraline with your health care provider. 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It's also often prescribed for people who've been diagnosed with panic disorder, a condition that causes frequent episodes of specific symptoms call panic attacks. If your doctor suggests you take Zoloft as part of a treatment plan for panic disorder, it can be helpful to learn how the drug might work to help you manage your symptoms. The more you understand about any medication you take, including how it affects the body and any potential side effects it might cause, the more comfortable you're likely to feel about taking it. The generic form of Zoloft, sertraline, has been used to treat anxiety orders since the mid-1990s. In that time many studies have found the drug to be highly effective for treating panic disorder as well. is a medication that is prescribed to treat mental illnesses like depression, obsessive-compulsive People who take Zoloft often report improvements in mood, appetite, sleep quality, energy level, and interest in daily life. I confronted this question last September, when I had breakfast with one of psychiatry's leading scholars and administrators. He was complaining about the influence of pharmaceutical houses on physicians. Why, he asked, did doctors prescribe the newer antipsychotics, like Abilify and Zyprexa, when studies showed that older and much cheaper drugs, like Trilafon and Haldol, were just as effective? I told my colleague that I shared his concern about the influence of drug companies, but I thought that clinicians had a tough choice. The side effects of the medications were so different that the new and old medications were finally not identical. All right, the colleague said, but what about antidepressants? Almost all those medications are available as generics, but at a disproportionate rate, doctors prescribe the one antidepressant that still has patent protection, Lexapro. 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Is one antidepressant more effective than another? A new summary of "horse race" studies favors Zoloft and Lexapro -- but the real winner is.