Premenstrual Syndrome (PMS)

Diagnosis

Your doctor will ask you about your PMS symptoms, the timing of these symptoms in relation to your menstrual period and the regularity of symptoms (every month, every other month, etc.). Your doctor also will ask about the general quality of your life. Questions may include:

• Are you feeling sad, tense, or anxious lately?

• Do you notice mood swings? Fatigue? Difficulty concentrating?

• Are you having relationship difficulties with your spouse, family members or coworkers?

• Are you so rushed that you sleep poorly and skip meals?

• Do you live a sedentary life with little exercise?

• Do you smoke cigarettes?

• Do you drink alcohol or caffeinated beverages?

• Is your diet high in red meat, salty foods or sugar?

After asking you about your PMS symptoms and lifestyle, your doctor will review your medical history and ask about any medications that you are taking. Next, your doctor will examine you, and will do a pelvic exam with a Pap smear. Although no single physical finding can confirm the diagnosis of PMS, a thorough physical exam can check for other medical problems, such as low levels of thyroid hormone (hypothyroidism) or a tumor of the breast, brain or ovary. In a similar way, although no single laboratory test can confirm that you have PMS, blood tests can rule out medical disorders such as hypoglycemia or hypothyroidism, or other hormonal problems as the cause of your symptoms.

If there are no physical findings and your laboratory test results are normal, then your doctor may ask you to keep a daily record of your PMS symptoms for two or three months. This record will include the type of symptoms, the severity of symptoms, the timing of your menstrual periods and a description of any special stresses that have affected your life. Once this two- or three-month record is complete, your doctor will review the information that you've collected. If your symptoms follow a pattern that is consistent with PMS, then this will help to establish the diagnosis.

Generally, premenstrual symptoms must be absent for about two weeks, from shortly after the start of menstruation until the next ovulation, to qualify for the diagnosis of PMS.

Expected Duration

PMS can be a long-term condition. In some women, symptoms of PMS flare up before every menstrual period, and this pattern continues until menopause (the age-related end to menstrual cycles). In other women, PMS symptoms seem to decrease after age 35.