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Premenstrual Syndrome (PMS) (cont.)

What Are the Signs and Symptoms of Premenstrual Syndrome (PMS)?

Patient Comments

Premenstrual syndrome (PMS): A woman with PMS will have monthly cycles of symptoms in mood, behavior, and/or physical functioning. Though bothersome, these symptoms are usually not severe enough to interrupt a normal lifestyle. Most women who experience PMS symptoms cope with symptoms at home. A few may seek medical care for very severe symptoms. These symptoms affect the following:

Premenstrual dysphoric disorder (PMDD): This is a more severe condition than PMS. It is only diagnosed when symptoms are so bad that they make it hard for a woman to function normally. While the mood symptoms are similar to the mood symptoms of PMS, they are worse and cause more problems. The physical symptoms of PMS may or may not be present.

Like PMS, the symptoms of PMDD start 7-14 days before a woman's period and go away once the period starts. Unlike PMS, PMDD can seriously affect a woman's daily activities. PMDD is diagnosed as a mental health disorder.

A woman may have PMDD if she has five or more of the following symptoms during the premenstrual week and for most cycles during the past year:

  • Depression (feeling despair or hopelessness, not just sadness)
  • Anxiety (keyed up, on edge)
  • Severe mood swings (feeling suddenly sad or extremely sensitive to rejection)
  • Anger or irritability
  • Decreased interest in usual activities (work, school, friends, hobbies)
  • Difficulty concentrating
  • Decreased energy
  • Appetite changes (overeating or cravings for certain foods)
  • Sleep problems (can't sleep or wake up early, or oversleeping)
  • Feeling overwhelmed or out of control
  • Physical symptoms, such as bloating, breast tenderness or headaches
  • If these symptoms do not occur in sync with the menstrual cycle, the woman may have some other medical or mental health condition.
  • The symptoms of PMDD end with menopause, when menstruation stops and the levels of hormones that regulate menstruation no longer rise and fall each month.

How Can I Tell If It's PMS or If I'm Pregnant?

Some symptoms of PMS, particularly breast tenderness, mood changes, bloating and fatigue, can also occur in early pregnancy. Sometimes these PMS symptoms can be confused with symptoms of pregnancy. The only way to tell if you are pregnant, if you have not gotten your menstrual period, is to take a pregnancy test.

When to Seek Medical Care for PMS

If a woman has symptoms of PMS that do not go away within 3-4 days of the start of her period, call a doctor. The woman may have a different medical problem.

When the typical symptoms of PMS become so severe that lifestyle is drastically altered, talk with a doctor.

  • 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.
  • Serious signs may also signify other mental or medical problems. Psychiatric diagnoses such as chronic depression, anxiety disorders, and personality disorders may overlap with the diagnosis of PMDD. Medical considerations include hormone imbalances, thyroid problems, electrolyte problems, and low levels of red blood cells. The doctor will want to rule out these more serious medical problems.
  • If the patient has such serious mood changes or behavior changes that she feels she may hurt herself or another person, seek medical care immediately at a hospital's emergency department.

Is There a Test to Diagnose Premenstrual Syndrome (PMS)?

The health-care professional will talk with the patient about her symptoms and when they occur each month. Keep track of symptoms, particularly noting when they occur during the menstrual cycle. The health care practitioner may ask the patient to keep accurate records or diary of symptoms throughout the next month or two. These records give the patient and health-care professional a better understanding of the symptoms and how they relate to the patient's menstrual cycle.

  • There are no lab tests that can confirm a diagnosis of PMS.
  • A health-care professional may perform various blood tests to rule out other illnesses.
  • Imaging tests may also be ordered to rule out other causes of the symptoms.
  • The health-care professional may also ask the patient to see a mental health professional to rule out a mental health disorder or to confirm the diagnosis of PMDD.
Medically Reviewed by a Doctor on 11/17/2016

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Read What Your Physician is Reading on Medscape

Premenstrual Syndrome »

Premenstrual syndrome (PMS) is a recurrent luteal phase condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in deterioration of interpersonal relationships and normal activity.

Read More on Medscape Reference »

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