Diagnosis of Premenstrual Syndrome

Premenstrual syndrome is diagnosed clinically (i.e. based on history and physical examination). There is no test or procedure to diagnose premenstrual syndrome (PMS). In fact, many women are able to correlate their physical and other symptoms as being related to menstrual cycle, however, if you have bothersome symptoms, consult a doctor.

Medical history and physical examination: Your doctor may ask you questions, such as:

• How long have you had the symptoms?
• Do the symptoms improve after your periods start?
• What improves or worsens your symptoms?

The doctor may advice you to keep a record of your symptoms and menstrual cycle every month. Note the day the PMS symptoms start, when they disappear and the day your period starts and ends. This can help to identify exactly what symptoms you have, the severity of symptoms and the relation to your menstrual cycle. You may have to maintain this record for at least two months so that your doctor can identify possible symptom pattern and their relation to your menstruation.

Complete a questionnaire: You may be given a questionnaire to be filled on the first day of your period.  It contains questions regarding PMS symptoms you experienced in the past few days. It is helpful to determine if you may benefit from further evaluation.

Tests: In most women, no tests are done to diagnose premenstrual symptoms. Instead, tests may be done to rule out other possible causes of your symptoms.

Premenstrual dysphoric disorder: Women with severe symptoms suggestive of premenstrual dysphoric disorder (PMDD), should consult a doctor. Your doctor can evaluate your symptoms and diagnose the cause. During your appointment, the doctor will take a detailed medical history, do medical examination and if needed, take a blood test or urine test. You may be referred to a mental health specialist if your emotional and cognitive symptoms are severe. The mental health specialist may evaluate if your symptoms are caused because of PMDD or some other mental health problem. The doctor may recommend treatment based on the cause of your symptoms.