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Saturday, September 8, 2007

premenstrual syndrome

If you think you might have premenstrual syndrome or PMS, you are not alone. In fact, about three-quarters of all girls and women experience PMS during their reproductive lives. A syndrome is a group of symptoms that occur together and that are characteristic of a disease or condition. Premenstrual syndrome is present when certain physical and / or emotional signs or symptoms occur.

PMS Diagnostic Criteria

The University of California, San Diego has developed the most widely used and accepted diagnostic criteria for diagnosing PMS. Although over 150 symptoms have been associated with PMS, women must self-report at least one of the following physical symptoms of PMS and at least one of the following mental symptoms of PMS. Additionally, these symptoms must occur during the five days before menstruation begins to meet the diagnostic criteria for premenstrual syndrome.

The Physical Symptoms of PMS

  • Sore, tender breasts
  • Headache
  • Abdominal bloating (the most common physical symptom)
  • Swelling of the extremities

Mental Symptoms of PMS

  • Fatigue (the most common mental symptom)
  • Angry outbursts or mood swings
  • Irritability
  • Confusion
  • Social withdrawal

All symptoms must disappear by Day 4 of the menstrual cycle and must not occur before Day 14 (of the average 28-day menstrual cycle) to meet the criteria for a diagnosis of PMS. The final requirement for a diagnosis of PMS is that symptoms must be present in the absence of any pharmacological treatments, hormone ingestion, or drug or alcohol use.

A true diagnosis of PMS causes identifiable dysfunction in social or economic performance and includes at least one of the following:

  • Marriage or relationship problems which are confirmed by the partner of the woman seeking diagnosis of PMS
  • Parenting difficulties
  • Decreased performance and / or attendance problems, including being late, at school or work
  • Less than normal amount of social activity during the premenstrual period of the menstrual cycle
  • Legal issues
  • Suicidal thoughts, words, or actions
  • Seeking medical attention for physical symptoms of PMS

Some girls and women experience a more severe form of PMS called premenstrual dysphoric disorder, or PMDD. The diagnostic criteria for PMDD includes the above criteria as well as the presence of additional symptoms.

If you think, you have the symptoms of premenstrual syndrome see your physician for diagnosis and treatment. Getting a diagnosis of PMS requires keeping a menstrual cycle calendar for two or three menstrual cycles to reflect a pattern of symptoms.


The American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington, DC, American Psychiatric Association 1994.

Robert F Casper, MD. Patient information: Premenstrual syndrome and premenstrual dysphoric disorder (PMDD), Clinical manifestations and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder, UpToDate [online]; accessed 10/24/2006.