gynecology and obstetrics
Premenstrual Syndrome (PMS)
Diagnosis of PMS
For PMS, patient’s report of symptoms Sometimes a depression inventory For PMDD, clinical criteria PMSis diagnosed based on physical symptoms (eg, bloating, weight gain, breast tenderness, swelling of hands and feet). Women may be asked to record their symptoms daily. Physical examination and laboratory testing are not helpful. IfPMDDis suspected, women are asked to rate their symptoms daily for≥2 cycles to determine whether severe symptoms occur regularly. For PMDD to be diagnosed, women must have≥5 of the following symptoms for most of the week before menses, and symptoms must become minimal or absent during the week after menstruation. Symptoms must include ≥ 1 of the following: Marked mood swings (eg, sudden sadness) Marked irritability or anger or increased interpersonal conflicts Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts Marked anxiety, tension, or an on-edge feeling In addition, ≥ 1 of the following must be present: Decreased interest in usual activities, possibly causing withdrawal Difficulty concentrating Low energy or fatigue Marked changes in appetite, overeating, or specific food cravings Insomnia or hyperinsomnia Feelings of being overwhelmed or out of control Physical symptoms associated with PMS (eg, breast tenderness, edema) Also, the symptom pattern must have occurred for most of the previous 12 months, and symptoms must be severe enough to interfere with daily activities and function. Patients with symptoms of depression are evaluated using a depression inventory or are referred to a mental health care practitioner for formal evaluation. 