Materiały źródłowe

• #1 Premenstrual syndrome (PMS) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

  There are no unique physical findings or lab tests to positively diagnose premenstrual syndrome. Your doctor may attribute a particular symptom to premenstrual syndrome (PMS) if it’s part of your predictable premenstrual pattern. […] To help establish a premenstrual pattern, your doctor may have you record your signs and symptoms on a calendar or in a diary for at least two menstrual cycles. […] Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

• #1 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as premenstrual syndrome (PMS). […] To diagnose PMS, an obstetrician-gynecologist (ob-gyn) must confirm a pattern of symptoms. A woman’s symptoms must […] be present in the 5 days before a period for at least three menstrual cycles in a row […] interfere with some normal activities. […] Keeping a record of your symptoms can help your ob-gyn understand if you have PMS. Each day for at least 2 to 3 months, write down and rate any symptoms you feel. Record the dates of your periods as well. […] Your ob-gyn will want to find out whether you have one of these conditions if you are having PMS symptoms. […] If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, your ob-gyn may recommend medication.

• #1 Premenstrual syndrome (PMS)

  https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome

  Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. […] Your doctor can help you find ways to relieve your symptoms. […] PMS is a combination of physical and emotional symptoms that many women get after ovulation and before the start of their menstrual period. […] Severe PMS symptoms may be a sign of premenstrual dysphoric disorder (PMDD). […] PMS goes away when you no longer get a period, such as after menopause. […] PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. […] PMS stops after menopause when you no longer get a period. […] You probably have PMS if you have symptoms that: Happen in the five days before your period for at least three menstrual cycles in a row, End within four days after your period starts, Keep you from enjoying or doing some of your normal activities.

• #1 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/419

  Premenstrual syndrome (PMS) is characterized by repetitive, cyclical, physical, and behavioral symptoms occurring in the luteal phase of the normal menstrual cycle. Symptoms may extend into the first few days of menses. The symptoms cannot be an exacerbation of another disorder, and they must interfere with some aspects of the woman’s life. […] PMS and PMDD are diagnoses of exclusion, confirmed by a prospective symptom diary that verifies their repetitive, cyclical nature. Physical exam and limited laboratory testing are typically normal. […] The criteria for PMS were outlined by the International Society for Premenstrual Disorders in 2011. They recognize over 150 different psychological, physical, and behavioral symptoms that may be associated with PMS. Symptoms must not be present at other times through the cycle, must also cause significant impairment, and must not represent an exacerbation of another disorder, and at least one symptom-free week must be present.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html

  Prospective questionnaires are the most accurate way to diagnose PMS and PMDD because patients greatly overestimate the cyclical nature of symptoms, when in fact they are erratic or simply exacerbated during their luteal phase. […] The Daily Record of Severity of Problems (DRSP) is a valid and reliable tool that can be used to diagnose PMS or PMDD. […] Establishing the timing of symptoms is essential when evaluating for PMS and PMDD. Symptoms must occur during the luteal phase and resolve shortly after the onset of menstruation. […] Treatment of PMS and PMDD focuses on relieving physical and psychiatric symptoms. Many of the medications used address the body’s hormonal activity through suppression of ovulation, whereas others affect the concentration of neurotransmitters such as serotonin, norepinephrine, or dopamine in the brain. […] SSRIs are first-line treatment for severe symptoms of PMS and PMDD. […] Oral contraceptives provide benefit when treating physical and psychiatric symptoms of PMS or PMDD. […] Cognitive behavior therapy may improve PMS and PMDD symptoms.

• #1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  This activity is a review of the existing literature on premenstrual syndrome (PMS). It summarizes the management of PMS by outlining the importance of taking a comprehensive history and performing a detailed physical examination and makes a note of necessary diagnostic tests to be done to rule out other conditions that may present with similar symptoms. Moreover, it describes the role of the interprofessional team in the diagnosis and providing the best possible care for the patient. […] To establish a diagnosis of PMS and PMDD, a variety of other disorders, both physical and psychiatric, needs to be excluded. The three elements that confirm the diagnosis are (1) symptoms being consistent with PMS, (2) the symptoms should occur consistently only during the luteal phase of the menstrual cycle, and (3) negative impact on the patient’s function and lifestyle. Once the physician is highly suspicious of the diagnosis, patients should be advised to keep a diary for premenstrual symptoms for consecutive months to assess for cycle-to-cycle variability.

• #1 Premenstrual Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/953696-clinical

  The diagnosis of premenstrual syndrome (PMS) is made based on patient history. Because of recall bias, patients are typically asked to evaluate at least two cycles prospectively for symptoms. A patient’s self-reported symptoms and the timing of those symptoms are the basis for diagnosis. To meet the diagnosis of PMS, symptoms should be cyclical, present for some portion of the 2-week luteal phase leading up to menstruation, and resolve with onset of menses or shortly thereafter. Symptoms should be present for most cycles, commonly two out of three, and cause some degree of distress or impairment. […] Although a number of different scales have been proposed to diagnose PMS, the International Society for Premenstrual Disorders (ISPMD) endorses the use of the Daily Record of the Severity of Problems (DRSP). […] Physical examination findings are not typically helpful in establishing the diagnosis of PMS.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p918.html

  The American College of Obstetricians and Gynecologists suggests diagnosing PMS based on prospective symptom diaries; many women will have nonluteal-phase symptoms consistent with other medical or psychological disorders. […] Administering the Daily Record of Severity of Problems on the first day of menses is not sufficient for making a diagnosis (positive predictive value = 53.8 percent), but the tool can accurately exclude patients who are unlikely to have PMS or PMDD because of its negative predictive value (83.4 percent). […] Because the etiology of PMS and PMDD is not clear, symptom relief is the goal of treatment. General strategies address the proposed physiologic causes of symptoms, such as the ovulatory hormonal cyclicity of menstruation or the central nervous system neurotransmitters affecting mood (e.g., serotonin).

• #1 Premenstrual Syndrome Differential Diagnoses

  https://emedicine.medscape.com/article/953696-differential

  It is important to rule out other conditions that may also present with menstrual exacerbations. Some conditions to be considered in the differential diagnosis of premenstrual syndrome (PMS) include the following: Dysmenorrhea, Depression and anxiety disorders, Premenstrual dysphoric disorder (PMDD), Menstrual migraine, Cyclic mastalgia. […] It is also important to rule out other conditions that cause erratic or dysphoric behavior before diagnosing PMS. Rare conditions, such as temporal lobe epilepsy, may cause behavioral changes consistent with PMS. However, these behaviors should not cluster during the luteal phase. Screening for depression and anxiety with validated screening tools may be useful when affective symptoms appear throughout the menstrual cycle. The American College of Obstetricians and Gynecologists (ACOG) advocates for incorporation of screening for suicidal ideation into the evaluation of PMS to assist in identifying risk for self-harm. […] Differential Diagnoses: Anxiety Disorders, Depression, Dysmenorrhea, Migraine Headache, Pain Somatoform Disorder, Premenstrual Dysphoric Disorder.

• #1 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Premenstrual Syndrome (PMS) is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. […] It is important for clinicians to distinguish between PMDD and other medical and psychiatric conditions. Medical illnesses such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome and migraine disorder can have features that overlap with PMDD. Additionally, psychiatric illnesses such as depression or anxiety disorders can worsen during the premenstrual period and thus may mimic PMDD. […] The best way to confirm the diagnosis of PMDD is by prospective daily charting of symptoms. Women with PMDD will experience a symptom-free interval between menses and ovulation (the proliferative phase).

• #1 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/419

  The American College of Obstetricians and Gynecologists defines PMS as the cyclic recurrence of symptoms that occur in the luteal phase of the menstrual cycle, are variable in intensity and effect on daily life, and cease shortly after the onset of menstruation. […] PMDD, the more severe form of the disorder, is classified in the DSM-5-TR as a mental illness. The criteria for PMDD require that the woman experience at least 5 of 11 cognitive-affective, behavioral, and physical symptoms during the final week of the luteal phase that resolve with or near the onset of menses. Symptoms must also remit post-menses, and not represent an exacerbation of another psychiatric disorder. […] 1st tests to order: prospective symptom diary. […] Tests to consider: thyroid function tests, follicle-stimulating hormone levels, depression screening, CBC.

• #1 What are the differences between PMDD and PMS?

  https://www.icliniq.com/qa/pmdd/how-are-pmdd-and-pms-diagnosed-and-treated

  PMDD is characterized by depressed or labile mood, anxiety, irritability, anger, and other symptoms occurring exclusively during the two weeks preceding menses. […] Diagnosis: Thyroid function tests. […] Complete blood count (CBC). […] Follicle-stimulating hormone (FSH) level. […] Treatment is by hormones: […] Diuretics. […] Nonsteroidal anti-inflammatory drugs (NSAIDs). […] Anxiolytics, antidepressants, and mood stabilizers. […] Premenstrual syndrome (PMS) is a recurrent luteal-phase condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in the deterioration of interpersonal relationships and normal activity. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS. […] Medical care for PMS is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. Selective serotonin reuptake inhibitors (SSRIs) are commonly considered suitable first-line therapy for premenstrual disorders.

• #1 Premenstrual Syndrome (PMS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/premenstrual-syndrome-pms

  Premenstrual syndrome (PMS) is a recurrent luteal-phase disorder characterized by irritability, anxiety, emotional lability, depression, edema, breast pain, and headaches, occurring during the 5 days before and usually ending a few hours after onset of menses. […] Diagnosis is clinical, often based on the patients daily recording of symptoms. […] PMS is 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. […] If PMDD is 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. […] 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.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p918.html

  Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. Women with premenstrual dysphoric disorder experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. The disorder affects 3 to 8 percent of premenopausal women. […] Premenstrual syndrome (PMS) is clinically diagnosed if certain symptoms that impair some facet of a woman’s life occur only during the luteal phase of the menstrual cycle (one week before menstruation), and if other diagnoses that may better explain the symptoms are excluded. […] Clinical history is key to the diagnosis of PMS or PMDD. Other affective disorders such as depression and anxiety may have premenstrual cyclic worsening, but do not have the symptom-free interval during the mid-follicular phase (days 6 through 10 of the menstrual cycle) needed for the clinical diagnosis of PMS or PMDD.

• #1 Clinical manifestations and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder

  Clinical manifestations and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder […] The premenstrual syndrome (PMS) is characterized by the presence of both physical and behavioral (including affective) symptoms that occur repetitively in the second half of the menstrual cycle and interfere with some aspects of the woman’s life. […] The American Psychiatric Association (APA) defines premenstrual dysphoric disorder (PMDD) as a severe form of PMS in which symptoms of anger, irritability, and internal tension are prominent. […] Clinically significant PMS is defined by the American College of Obstetricians and Gynecologists (ACOG) as at least one symptom associated with „economic or social dysfunction” that occurs during the five days before the onset of menses and is present in at least three consecutive menstrual cycles.

• #1 Table 1, Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD) – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279045/table/premenstrual-syndrom.table1diag/

  Timing of symptoms: In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses. […] Symptoms: One or more of the following symptoms must be present: 1) Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection) 2) Marked irritability or anger or increased interpersonal conflicts 3) Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts 4) Marked anxiety, tension, and/or feelings of being keyed up or on edge. […] Severity: The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others.

• #1 Table 1, Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD) – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279045/table/premenstrual-syndrom.table1diag/

  Confirmation of the disorder: Criterion A should be confirmed by prospective daily ratings during at least 2 symptomatic cycles (although a provisional diagnosis may be made prior to this confirmation). […] Exclude other Medical Explanations: The symptoms are not attributable to the physiological effects of a substance (e.g., drug abuse, medication or other treatment) or another medical condition (e.g., hyperthyroidism).

• #1 Diagnosis of premenstrual dysphoric disorder – GPnotebook

  https://gpnotebook.com/pages/gynaecology/premenstrual-syndrome/diagnosis-of-premenstrual-dysphoric-disorder

  Premenstrual dysphoric disorder (PMDD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as occurring when a woman suffers from at least five distinct psychological premenstrual symptoms. Severe PMS is referred to as premenstrual dysphoric disorder (PMDD). […] A diagnosis of PMDD must be confirmed prospectively by means of daily diary ratings of symptoms – this is undertaken over at least two consecutive cycles. […] Diagnostic criteria for premenstrual dysphoric disorder DSM-V diagnostic criteria for premenstrual dysphoric disorder include; the diary should show reveal evidence of worsening during the 14 days preceding onset of menses (i.e. in the luteal phase) with at least 1 week free from symptoms in the follicular phase. […] It is important to exclude premenstrual exacerbations of other disorders such as major depression or anxiety disorders, which commonly co-exist with PMDD. […] Prospective diary records will usually distinguish PMDD from major depression, since only in PMDD do the symptoms remit completely during the follicular phase of the cycle.

• #1 Exploring diagnosis and treatment of premenstrual dysphoric disorder in the U.S. healthcare system: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02334-y

  Premenstrual Dysphoric Disorder (PMDD) is a premenstrual condition that affects 38% of the US population, yet knowledge on treatment and consistent diagnostic testing is lacking. […] The aim of this study was to explore the diagnostic and treatment experiences of PMDD patients in the U.S. healthcare system and identify barriers to diagnosis and treatment. […] This study presents a PMDD Care Continuum that represents the timeline of participant experiences beginning from symptom onset towards official diagnosis, treatments, and ongoing management of the condition. […] Further research is needed to refine and operationalize diagnostic criteria and treatment guidelines for PMDD. […] There are disparities in diagnostic tools and methods for PMDD, creating issues for diagnosis and proper treatment.

• #1 Exploring diagnosis and treatment of premenstrual dysphoric disorder in the U.S. healthcare system: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02334-y

  There is no universal standardized diagnostic measuring tool assessing for PMDD. […] It takes an average of 20 years for women to be accurately diagnosed and treated for PMDD. […] Individuals with undiagnosed PMDD report impairment in work productivity, lost wages, and higher medical expenses. […] To develop an understanding of PMDD from the patients perspective, this study uses approaches from feminist phenomenology to explore the lived experiences of individuals who identify as having PMDD. […] The aim of this study is to identify barriers to diagnosis and successful treatment of PMDD in the US healthcare system. […] Many patients presented their symptoms to providers, but providers failed to recognize PMDD symptoms and would tell patients that it was in their head. […] Overall, nine participants experienced misdiagnoses, five of whom experienced later PMDD self-diagnosis, and the rest were diagnosed officially with PMDD later by a provider.

• #1 Exploring diagnosis and treatment of premenstrual dysphoric disorder in the U.S. healthcare system: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02334-y

  Many patients described receiving an official diagnosis as a validating experience. […] Many patients found a doctor to diagnose, but had to switch providers to receive treatment. […] Patients described the power dynamic between doctor and patient as a barrier, which resulted in many providers not listening to the patient. […] Many patients felt that they must prove to doctors how severe their symptoms were in order to be taken seriously. […] Participants had varying experiences with types of treatment they received for PMDD over the course of their PMDD care continuum. […] Most participants who were able to successfully manage PMDD still experienced a monthly hell week that interfered with daily functioning. […] This study concludes that patients with PMDD experience numerous barriers to diagnosis and treatment in the U.S. healthcare system.

• #1 Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01100-8

  Premenstrual dysphoric disorder (PMDD) is a complex and disabling condition that affects women of reproductive age, characterised by severe physical and psychological symptoms that occur cyclically and remit following the onset of menses. […] Therefore, this study aimed to explore womens experiences of both having PMDD and of receiving this diagnosis. […] The findings of this study highlight the critical importance of the accurate and timely detection of PMDD, with the aim of preventing women from experiencing severe and prolonged psychological distress. […] In order to achieve this, there needs to be a greater understanding and awareness of PMDD within both the medical and lay communities, alongside training for healthcare practitioners in PMDD assessment. […] In the absence of a definitive biological marker for PMDD, diagnosis currently relies on the knowledge and expertise of treating healthcare professionals. […] When PMDD is accurately diagnosed, there are treatment options available to manage symptoms, including ovulation suppression with a GnRH agonist and hysterectomy combined with bilateral oophorectomy as a last resort option.

• #1 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Drugs that prevent ovulation, such as hormonal birth control methods, may lessen physical symptoms. But not all may relieve the mood symptoms of PMS. It may be necessary to try more than one of these medications before finding one that works. […] Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms. They can be used 2 weeks before the onset of symptoms or throughout the menstrual cycle. […] If anxiety is a major PMS symptom for you, an antianxiety drug can be tried if other treatments do not seem to help.

• #1 Premenstrual Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/doctor/premenstrual-syndrome-pro

  Ask the patient to keep a symptom diary over two complete cycles, to help with diagnosis. […] Management should be tailored to the severity and type of symptoms, the woman’s treatment preferences, and any desire to become pregnant. […] Review after two months to assess the effectiveness of the treatment. Effectiveness should be established using a validated symptom diary, such as the Daily Record of Severity of Problems (DRSP) questionnaire. […] Many treatments have been put forward but few have supportive evidence to justify their use. Treatment needs to be tailored to the severity of the PMS. […] In women with severe PMS symptoms, surgery (hysterectomy or bilateral salpingo-oophorectomy) may be considered in secondary care. […] Most women can find effective solutions to their symptoms. A small number of women continue to be affected severely with worsening symptoms until the menopause.

• #1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  The diagnosis of PMS is challenging due to the lack of explicit signs on physical examination and lack of diagnostic testing. Hence it requires the involvement of the patient, nurses, and physician to make a diagnosis. The role of the patients can include maintaining a diary which elaborates their symptoms and yield in early diagnosis whereas the nurses can be extremely helpful if they help in collecting a filled-in questionnaire from the patients during the monthly visit. Physicians on the other hand can use these tools in excluding other differentials which may produce better outcomes.

• #1 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/pms-diagnosis-aetiology-assessment-and-management/CD5DC674856C7AAE35B4EC7DF4D5FE7E

  Systematic reviews have shown progesterone and progestogens to be efficacious in treating premenstrual symptoms. […] Studies in both the USA and UK have shown a disparity between the evidence base and what is being prescribed by clinicians. […] Psychiatrists are well placed to assess and treat women with premenstrual syndrome.

• #1 Diagnosis of premenstrual syndrome (PMS) – Primary Care Notebook

  https://primarycarenotebook.com/pages/gynaecology/premenstrual-syndrome/diagnosis-of-premenstrual-syndrome-pms

  Diagnosis of premenstrual syndrome (PMS) […] When clinically reviewing women for PMS, symptoms should be recorded prospectively, over at least two cycles using a symptom diary, as retrospective recall of symptoms is unreliable. […] Several patient-rated questionnaires are available which can be used to record the symptoms: Daily Record of Severity of Problems (DRSP) […] provides a reliable and reproducible record of symptoms. […] Gonadotrophin-releasing hormone (GnRH) analogues may be used for 3 months for a definitive diagnosis if the completed symptom diary alone is inconclusive (specially in those patients with variant pre menstrual disorders). […] Laboratory studies may also be conducted in order to screen for medical conditions e.g. thyroid function tests, complete blood cell count and follicle-stimulating hormone level.

• #2 Premenstrual Syndrome (PMS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/premenstrual-syndrome-pms

  Premenstrual syndrome (PMS) is a recurrent luteal-phase disorder characterized by irritability, anxiety, emotional lability, depression, edema, breast pain, and headaches, occurring during the 5 days before and usually ending a few hours after onset of menses. […] Diagnosis is clinical, often based on the patients daily recording of symptoms. […] PMS is 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. […] If PMDD is 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. […] 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.

• #2 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html

  Premenstrual disorders affect up to 12% of women. The subspecialties of psychiatry and gynecology have developed overlapping but distinct diagnoses that qualify as a premenstrual disorder; these include premenstrual syndrome and premenstrual dysphoric disorder. […] Patient-directed prospective recording of symptoms is helpful to establish the cyclical nature of symptoms that differentiate premenstrual syndrome and premenstrual dysphoric disorder from other psychiatric and physical disorders. […] Premenstrual syndrome can be diagnosed if the patient reports at least one of the following affective and somatic symptoms during the five days before menses in each of the three previous menstrual cycles. […] ACOG has defined PMS as a condition in which a woman experiences at least one affective symptom and one somatic symptom that cause dysfunction in social, academic, or work performance. These symptoms must be cyclical, beginning after ovulation and resolving shortly after the onset of menstruation.

• #2 Premenstrual Syndrome | PMS | PMS Symptoms | MedlinePlus

  https://medlineplus.gov/premenstrualsyndrome.html

  Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. Most women have at least some symptoms of PMS, and the symptoms go away after their periods start. The symptoms may range from mild to severe. […] There is no single test for PMS. Your provider will talk with you about your symptoms, including when they happen and how much they affect your life. To be diagnosed with PMS, your symptoms must: […] Happen in the five days before your period for at least three menstrual cycles in a row […] End within four days after your period starts […] Keep you from enjoying or doing some of your normal activities. […] Your provider may wish to do tests to rule out other conditions which may cause similar symptoms.

• #2 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/419

  Premenstrual syndrome (PMS) is characterised by repetitive, cyclical, physical, and behavioural symptoms occurring in the luteal phase of the normal menstrual cycle. Symptoms may extend into the first few days of menses. The symptoms cannot be an exacerbation of another disorder, and they must interfere with some aspects of the woman’s life. […] PMS and PMDD are diagnoses of exclusion, confirmed by a prospective symptom diary that verifies their repetitive, cyclical nature. Physical examination and limited laboratory testing are typically normal. […] The criteria for PMS were outlined by the International Society for Premenstrual Disorders in 2011. They recognise over 150 different psychological, physical, and behavioural symptoms that may be associated with PMS. Symptoms must not be present at other times through the cycle, must also cause significant impairment, and must not represent an exacerbation of another disorder, and at least one symptom-free week must be present.

• #2 Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics

  Premenstrual syndrome (PMS) refers to a group of physical and behavioral symptoms that occur in a cyclic pattern during the second half of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is the severe form of PMS. Common symptoms include anger, irritability, depression, and internal tension that are severe enough to interfere with daily activities. […] There is no single test that can diagnose premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). The symptoms must occur only during the second half (luteal phase) of the menstrual cycle, most often during the five to seven days before the menstrual period, and there must be physical as well as behavioral symptoms. In women with PMS or PMDD, these symptoms should not be present between days 4 through 12 of a 28-day menstrual cycle.

• #2 Premenstrual Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/953696-clinical

  The diagnosis of premenstrual syndrome (PMS) is made based on patient history. Because of recall bias, patients are typically asked to evaluate at least two cycles prospectively for symptoms. A patient’s self-reported symptoms and the timing of those symptoms are the basis for diagnosis. To meet the diagnosis of PMS, symptoms should be cyclical, present for some portion of the 2-week luteal phase leading up to menstruation, and resolve with onset of menses or shortly thereafter. Symptoms should be present for most cycles, commonly two out of three, and cause some degree of distress or impairment. […] Although a number of different scales have been proposed to diagnose PMS, the International Society for Premenstrual Disorders (ISPMD) endorses the use of the Daily Record of the Severity of Problems (DRSP). […] Physical examination findings are not typically helpful in establishing the diagnosis of PMS.

• #2 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Premenstrual Syndrome (PMS) is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. […] It is important for clinicians to distinguish between PMDD and other medical and psychiatric conditions. Medical illnesses such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome and migraine disorder can have features that overlap with PMDD. Additionally, psychiatric illnesses such as depression or anxiety disorders can worsen during the premenstrual period and thus may mimic PMDD. […] The best way to confirm the diagnosis of PMDD is by prospective daily charting of symptoms. Women with PMDD will experience a symptom-free interval between menses and ovulation (the proliferative phase).

• #2 Diagnosis of premenstrual syndrome (PMS) – Primary Care Notebook

  https://primarycarenotebook.com/pages/gynaecology/premenstrual-syndrome/diagnosis-of-premenstrual-syndrome-pms

  Diagnosis of premenstrual syndrome (PMS) […] When clinically reviewing women for PMS, symptoms should be recorded prospectively, over at least two cycles using a symptom diary, as retrospective recall of symptoms is unreliable. […] Several patient-rated questionnaires are available which can be used to record the symptoms: Daily Record of Severity of Problems (DRSP) […] provides a reliable and reproducible record of symptoms. […] Gonadotrophin-releasing hormone (GnRH) analogues may be used for 3 months for a definitive diagnosis if the completed symptom diary alone is inconclusive (specially in those patients with variant pre menstrual disorders). […] Laboratory studies may also be conducted in order to screen for medical conditions e.g. thyroid function tests, complete blood cell count and follicle-stimulating hormone level.

• #2 Premenstrual Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/doctor/premenstrual-syndrome-pro

  Ask the patient to keep a symptom diary over two complete cycles, to help with diagnosis. […] Management should be tailored to the severity and type of symptoms, the woman’s treatment preferences, and any desire to become pregnant. […] Review after two months to assess the effectiveness of the treatment. Effectiveness should be established using a validated symptom diary, such as the Daily Record of Severity of Problems (DRSP) questionnaire. […] Many treatments have been put forward but few have supportive evidence to justify their use. Treatment needs to be tailored to the severity of the PMS. […] In women with severe PMS symptoms, surgery (hysterectomy or bilateral salpingo-oophorectomy) may be considered in secondary care. […] Most women can find effective solutions to their symptoms. A small number of women continue to be affected severely with worsening symptoms until the menopause.

• #2 Premenstrual syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Premenstrual_syndrome

  Premenstrual syndrome (PMS) is a disruptive set of emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. Symptoms resolve around the time menstrual bleeding begins. Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life. Emotional symptoms must not be present during the initial part of the menstrual cycle. No laboratory tests or unique physical findings exist to verify a PMS diagnosis. However, the three key features are noted: The chief complaint is one or more of the emotional symptoms associated with PMS. Irritability, tension, or unhappiness are typical emotional symptoms. Symptoms appear predictably during the luteal (premenstrual) phase, reduce or disappear predictably shortly before or during menstruation, and remain absent during the follicular (pre-ovulatory) phase. The symptoms must be severe enough to cause distress or interfere with everyday life. To document a pattern, potentially affected individuals may keep a prospective record of their symptoms on a calendar for at least two menstrual cycles. […] Additionally, other conditions that may better explain symptoms must be excluded, as a number of pre-existing medical conditions may be made worse at menstruation. This is known as menstrual exacerbation or premenstrual magnification. […] Severe symptoms may qualify as PMDD.

• #2 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  This activity is a review of the existing literature on premenstrual syndrome (PMS). It summarizes the management of PMS by outlining the importance of taking a comprehensive history and performing a detailed physical examination and makes a note of necessary diagnostic tests to be done to rule out other conditions that may present with similar symptoms. Moreover, it describes the role of the interprofessional team in the diagnosis and providing the best possible care for the patient. […] To establish a diagnosis of PMS and PMDD, a variety of other disorders, both physical and psychiatric, needs to be excluded. The three elements that confirm the diagnosis are (1) symptoms being consistent with PMS, (2) the symptoms should occur consistently only during the luteal phase of the menstrual cycle, and (3) negative impact on the patient’s function and lifestyle. Once the physician is highly suspicious of the diagnosis, patients should be advised to keep a diary for premenstrual symptoms for consecutive months to assess for cycle-to-cycle variability.

• #2 Premenstrual Syndrome Differential Diagnoses

  https://emedicine.medscape.com/article/953696-differential

  It is important to rule out other conditions that may also present with menstrual exacerbations. Some conditions to be considered in the differential diagnosis of premenstrual syndrome (PMS) include the following: Dysmenorrhea, Depression and anxiety disorders, Premenstrual dysphoric disorder (PMDD), Menstrual migraine, Cyclic mastalgia. […] It is also important to rule out other conditions that cause erratic or dysphoric behavior before diagnosing PMS. Rare conditions, such as temporal lobe epilepsy, may cause behavioral changes consistent with PMS. However, these behaviors should not cluster during the luteal phase. Screening for depression and anxiety with validated screening tools may be useful when affective symptoms appear throughout the menstrual cycle. The American College of Obstetricians and Gynecologists (ACOG) advocates for incorporation of screening for suicidal ideation into the evaluation of PMS to assist in identifying risk for self-harm. […] Differential Diagnoses: Anxiety Disorders, Depression, Dysmenorrhea, Migraine Headache, Pain Somatoform Disorder, Premenstrual Dysphoric Disorder.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Premenstrual-Syndrome-(PMS)-and-Premenstrual-Dysphoric-Disorder-(PMDD).aspx

  PMS or premenstrual syndrome is a condition that manifests as emotional, physical and behavioral symptoms and affects women between their late 20s to early 40s. […] Diagnosis of PMS and PMDD is usually made by looking at the symptom diary that the patient is asked to maintain over a period of three months. Clinical symptoms, onset day, duration and severity are recorded in the diary. […] Diagnosis is also dependent on other medical conditions like migraine and asthma that are aggravated by PMS. A complete physical examination including examination of the pelvis is made. […] The diagnosis of PMDD is made based on the guidelines laid by the Diagnostic and Statistical Manual of Mental Disorders Text Revision IV (DSM-IV-TR). These include: In most of the menstrual cycles over last 5 years or more symptoms like the following must be present during the last week before periods: Markedly depressed mood, feelings of hopelessness, Marked anxiety, tension or edginess, Marked teariness or lability, Marked anger or aggression, Lack of interest, difficulty concentrating, Lethargy, tiredness, Change of appetite increase or decrease and specific food cravings, Too much or too little sleep, Feeling overwhelmed, Physical symptoms of headaches, breast pain and swelling, joint and muscle pain, bloating etc.

• #2 Diagnosis of premenstrual dysphoric disorder – GPnotebook

  https://gpnotebook.com/pages/gynaecology/premenstrual-syndrome/diagnosis-of-premenstrual-dysphoric-disorder

  Premenstrual dysphoric disorder (PMDD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as occurring when a woman suffers from at least five distinct psychological premenstrual symptoms. Severe PMS is referred to as premenstrual dysphoric disorder (PMDD). […] A diagnosis of PMDD must be confirmed prospectively by means of daily diary ratings of symptoms – this is undertaken over at least two consecutive cycles. […] Diagnostic criteria for premenstrual dysphoric disorder DSM-V diagnostic criteria for premenstrual dysphoric disorder include; the diary should show reveal evidence of worsening during the 14 days preceding onset of menses (i.e. in the luteal phase) with at least 1 week free from symptoms in the follicular phase. […] It is important to exclude premenstrual exacerbations of other disorders such as major depression or anxiety disorders, which commonly co-exist with PMDD. […] Prospective diary records will usually distinguish PMDD from major depression, since only in PMDD do the symptoms remit completely during the follicular phase of the cycle.

• #2 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/419

  The American College of Obstetricians and Gynecologists defines PMS as the cyclic recurrence of symptoms that occur in the luteal phase of the menstrual cycle, are variable in intensity and effect on daily life, and cease shortly after the onset of menstruation. […] PMDD, the more severe form of the disorder, is classified in the DSM-5-TR as a mental illness. The criteria for PMDD require that the woman experience at least 5 of 11 cognitive-affective, behavioral, and physical symptoms during the final week of the luteal phase that resolve with or near the onset of menses. Symptoms must also remit post-menses, and not represent an exacerbation of another psychiatric disorder. […] 1st tests to order: prospective symptom diary. […] Tests to consider: thyroid function tests, follicle-stimulating hormone levels, depression screening, CBC.

• #2 Premenstrual dysphoric disorder: Symptoms, causes, and diagnosis

  https://www.medicalnewstoday.com/articles/308332

  Premenstrual dysphoric disorder is a severe form of premenstrual syndrome. […] This article examines the causes, symptoms, and diagnosis of this debilitating condition, along with the treatment options that are available for people who are affected by it. […] The symptoms of PMDD can be similar to those of other conditions, so health care providers will likely perform a physical exam, obtain a medical history, and order certain tests to rule out other conditions when making a diagnosis. […] Guidelines from the American Psychiatric Association (APA) Diagnostic and Statistical Manual 5th Edition (DSM-V) require that the symptoms of PMDD be present for a minimum of two consecutive menstrual cycles before making a diagnosis of PMDD. […] For a PMDD diagnosis to be made, a patient must experience at least five symptoms, including at least one of the following: feelings of sadness or hopelessness, feelings of anxiety or tension, mood changes or increased sensitivity, feelings of anger or irritability. […] Other physical symptoms of PMDD can include breast tenderness or swelling, headaches, joint or muscle pain, bloating, and weight gain.

• #2 Premenstrual syndrome, a common but underrated entity: review of the clinical literature – Journal of the Turkish-German Gynecological Association

  https://www.jtgga.org/articles/premenstrual-syndrome-a-common-but-underrated-entity-review-of-the-clinical-literature/doi/jtgga.galenos.2021.2020.0133

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are characterized by somatic and psychologic symptoms that arise at the luteal phase of the menstrual cycle and subside with menstruation. […] For definitive diagnosis prospectively self-reported symptoms should demonstrate a cyclic pattern and other psychological pathologies and thyroid dysfunction, that may present with similar symptoms, should be excluded. […] The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) established seven criteria (A through G) for the diagnosis of PMDD and at least five of these symptoms should be present, and should include one of the first four (A-D). […] Definitive diagnosis is based on prospective self-reporting of the symptoms. […] ACOG describes symptoms consistent with PMS as: 1- The symptoms should be restricted to the LPMC; 2- The symptom pattern should be confirmed by prospective evaluation; 3- symptoms should cause functional impairment; and 4- other diagnoses that could better explain the symptoms should be excluded.

• #2 Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01100-8

  Premenstrual dysphoric disorder (PMDD) is a complex and disabling condition that affects women of reproductive age, characterised by severe physical and psychological symptoms that occur cyclically and remit following the onset of menses. […] Therefore, this study aimed to explore womens experiences of both having PMDD and of receiving this diagnosis. […] The findings of this study highlight the critical importance of the accurate and timely detection of PMDD, with the aim of preventing women from experiencing severe and prolonged psychological distress. […] In order to achieve this, there needs to be a greater understanding and awareness of PMDD within both the medical and lay communities, alongside training for healthcare practitioners in PMDD assessment. […] In the absence of a definitive biological marker for PMDD, diagnosis currently relies on the knowledge and expertise of treating healthcare professionals. […] When PMDD is accurately diagnosed, there are treatment options available to manage symptoms, including ovulation suppression with a GnRH agonist and hysterectomy combined with bilateral oophorectomy as a last resort option.

• #2 Exploring diagnosis and treatment of premenstrual dysphoric disorder in the U.S. healthcare system: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02334-y

  There is no universal standardized diagnostic measuring tool assessing for PMDD. […] It takes an average of 20 years for women to be accurately diagnosed and treated for PMDD. […] Individuals with undiagnosed PMDD report impairment in work productivity, lost wages, and higher medical expenses. […] To develop an understanding of PMDD from the patients perspective, this study uses approaches from feminist phenomenology to explore the lived experiences of individuals who identify as having PMDD. […] The aim of this study is to identify barriers to diagnosis and successful treatment of PMDD in the US healthcare system. […] Many patients presented their symptoms to providers, but providers failed to recognize PMDD symptoms and would tell patients that it was in their head. […] Overall, nine participants experienced misdiagnoses, five of whom experienced later PMDD self-diagnosis, and the rest were diagnosed officially with PMDD later by a provider.

• #2 Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01100-8

  However, owing to the complexity of diagnosis and poor understanding of PMDD by most health professionals, women can experience many years of unrecognised and untreated symptoms, and mental health misdiagnoses. […] The analysis produced 95 initial codes which were grouped into four main themes. Each main theme conceptualises a different aspect of these womens experiences and contains a number of subthemes. […] In order to prevent women with PMDD from experiencing prolonged periods of unnecessary psychological distress, accurate and timely diagnosis of this condition is paramount. […] It is vitally important that healthcare professionals are able to accurately distinguish the difference between PMDD and severe psychiatric disorders to ensure that women with this condition receive appropriate and timely support.

• #2 How Premenstrual Dysphoria Disorder (PMDD) Is Diagnosed

  https://www.verywellhealth.com/pmdd-diagnosis-4014087

  These symptoms must also interfere with your work or school, your relationships with family, friends, and/or coworkers and your usual social activities. […] PMDD presents with a combination of physical and psychological symptoms. […] The timing of PMS and PMDD are the same, however, PMS tends to include more physical symptoms, while the emotional symptoms of PMDD are more severe and debilitating. […] Getting the proper diagnosis of PMDD is the first step to feeling better. […] If you think you might have PMDD and you and your doctor don’t seem to be on the same page about this possibility and the severity of your symptoms, seek a second opinion.

• #2 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/pms-diagnosis-aetiology-assessment-and-management/CD5DC674856C7AAE35B4EC7DF4D5FE7E

  The diagnosis remained stable over 48 months and participants with premenstrual dysphoric disorder were more likely than those without to develop a new-onset depressive disorder. […] It is well recognised that 20-50% of women who experience premenstrual symptoms will not show them on prospective daily rating and some who do not present with symptoms will show changes when prospectively rated. […] Once the diagnosis is confirmed as premenstrual syndrome or premenstrual dysphoric disorder, a treatment plan must be negotiated with the woman. […] The efficacy of SSRIs in the treatment of both physical and psychological symptoms of premenstrual syndrome has been confirmed and studies have shown that these drugs also reduce functional impairment. […] The suppression of ovulation, for example by using gonadotrophin-releasing hormone analogues (GnRHa), is an efficacious means of abolishing premenstrual syndrome.

• #2 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html

  Prospective questionnaires are the most accurate way to diagnose PMS and PMDD because patients greatly overestimate the cyclical nature of symptoms, when in fact they are erratic or simply exacerbated during their luteal phase. […] The Daily Record of Severity of Problems (DRSP) is a valid and reliable tool that can be used to diagnose PMS or PMDD. […] Establishing the timing of symptoms is essential when evaluating for PMS and PMDD. Symptoms must occur during the luteal phase and resolve shortly after the onset of menstruation. […] Treatment of PMS and PMDD focuses on relieving physical and psychiatric symptoms. Many of the medications used address the body’s hormonal activity through suppression of ovulation, whereas others affect the concentration of neurotransmitters such as serotonin, norepinephrine, or dopamine in the brain. […] SSRIs are first-line treatment for severe symptoms of PMS and PMDD. […] Oral contraceptives provide benefit when treating physical and psychiatric symptoms of PMS or PMDD. […] Cognitive behavior therapy may improve PMS and PMDD symptoms.

• #2 Premenstrual syndrome Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/premenstrual-syndrome

  Premenstrual syndrome (PMS) can produce physical and emotional or behavioral symptoms in the days before menstruation. […] For a doctor to confirm a diagnosis of PMDD, a woman must have symptoms during the last week of the premenstrual phase and improve within a few days after menstruation starts. […] PMS is associated with the luteal phase of the menstrual cycle, after ovulation. […] The best method for determining your PMS patterns is to track your symptoms in a personal diary for 2 to 3 months. […] If the symptoms consistently resolve once menstruation begins, they are most likely caused by hormonal fluctuations. […] If they persist or do not appear to be associated with a regular cycle, other conditions may be causing them. […] The American Psychiatric Association has specific criteria that define premenstrual dysphoric disorder (PMDD). […] Symptoms must occur during the last week of the premenstrual (luteal) phase in most menstrual cycles. […] Your health care provider will ask about your symptoms and may ask you to fill out a questionnaire.

• #2 Premenstrual Syndrome (PMS) Symptoms, Treatments & Defintion

  https://www.emedicinehealth.com/premenstrual_syndrome_pms/article_em.htm

  Imaging tests may also be ordered to rule out other causes of the symptoms. […] The doctor will evaluate the patient’s symptoms for signs of premenstrual dysphoric disorder (PMDD), a mental health concern, which should be diagnosed and treated. […] Treatments demonstrated to be effective in PMS include medications that moderate the effects of the neurotransmitter serotonin. […] The selective serotonin reuptake inhibitor (SSRI) drugs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) have been shown to be effective in relieving many of the symptoms of PMS and PMDD including mood changes and anxiety. […] PMS can be treated by primary care providers, including pediatricians, internists, and family practitioners as well as gynecologists. […] The only definitive cure for PMS is removal of the ovaries, which may have many other complications and unwanted long- and short-term consequences.

• #2 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/pms-diagnosis-aetiology-assessment-and-management/CD5DC674856C7AAE35B4EC7DF4D5FE7E

  Systematic reviews have shown progesterone and progestogens to be efficacious in treating premenstrual symptoms. […] Studies in both the USA and UK have shown a disparity between the evidence base and what is being prescribed by clinicians. […] Psychiatrists are well placed to assess and treat women with premenstrual syndrome.

• #2 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as premenstrual syndrome (PMS). […] To diagnose PMS, an obstetrician-gynecologist (ob-gyn) must confirm a pattern of symptoms. A woman’s symptoms must […] be present in the 5 days before a period for at least three menstrual cycles in a row […] interfere with some normal activities. […] Keeping a record of your symptoms can help your ob-gyn understand if you have PMS. Each day for at least 2 to 3 months, write down and rate any symptoms you feel. Record the dates of your periods as well. […] Your ob-gyn will want to find out whether you have one of these conditions if you are having PMS symptoms. […] If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, your ob-gyn may recommend medication.

• #2 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/419

  Premenstrual syndrome (PMS) is characterized by repetitive, cyclical, physical, and behavioral symptoms occurring in the luteal phase of the normal menstrual cycle. Symptoms may extend into the first few days of menses. The symptoms cannot be an exacerbation of another disorder, and they must interfere with some aspects of the woman’s life. […] PMS and PMDD are diagnoses of exclusion, confirmed by a prospective symptom diary that verifies their repetitive, cyclical nature. Physical exam and limited laboratory testing are typically normal. […] The criteria for PMS were outlined by the International Society for Premenstrual Disorders in 2011. They recognize over 150 different psychological, physical, and behavioral symptoms that may be associated with PMS. Symptoms must not be present at other times through the cycle, must also cause significant impairment, and must not represent an exacerbation of another disorder, and at least one symptom-free week must be present.

• #2 Premenstrual syndrome, a common but underrated entity: review of the clinical literature – Journal of the Turkish-German Gynecological Association

  https://www.jtgga.org/articles/premenstrual-syndrome-a-common-but-underrated-entity-review-of-the-clinical-literature/doi/jtgga.galenos.2021.2020.0133

  PMDD, classified by the APA, should include five of the 11 symptoms required to meet the diagnostic criteria, defined in DSM-5 and at least one of these should involve mood swings. […] According to the DSM-5 criteria, one or more of the following must be present for the diagnosis of PMDD: a) anger/irritability b) sudden sadness, increased sensitivity, mood swings to rejection; c) tension and anxiety; and d) depressed mood, feeling hopeless, self-critical thoughts. […] The cyclic occurrence of symptoms should be confirmed by careful questioning. […] PMS can be diagnosed if the symptoms subside when ovarian hormonal suppression is obtained with GnRH analogues.

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