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PMS/PMDD Diagnosis

Many women get moody or irritable right before their periods, but how do you know if you have PMS (premenstrual syndrome) or it's more severe form, PMDD (premenstrual dysphoric dysfunction)?  If you think you may, start keeping a PMS Symptom Diary.  List the dates of your period, and which symptoms you have (and their severity) on the 10-14  days preceeding as well as the 5 days following your period.  After tracking your symptoms for at least 2 cycles, bring this diary with you when consult your physician, along with a list of all medications you are taking (including prescriptions, over-the-counter medications, herbs, vitamins, and supplements).  Your doctor will give you a complete history and physical exam to rule out other possibilities (such as hypothyroidism, hypoglycemia or depression); no specific physical findings or tests can confirm the diagnosis of PMS.

The diagnosis of PMDD is based upon having a combination of at least five of the following symptoms, including at least one of the first four (from the Diangostic and Statistical manual of Mental Disorders, 4th ed, 1994):

  • Very depressed mood, feeling hopeless
  • Marked anxiety, tension, edginess
  • Sudden mood shifts
  • Persistent, marked irritability, anger, increased conflicts
  • Loss of interest in usual activities
  • Difficulty concentrating and staying focused
  • Fatigue, tiredness, loss of energy
  • Marked appetite change, overeating, food cravings
  • Insomnia or sleeping too much
  • Feeling out of control or overwhelmed
  • Physical symptoms:  weight gain, bloating, breast tenderness or swelling, headache, and muscle or joint aches and pains.

If you are having premenstrual difficulties, it is not up to you to decide whether you have PMS or PMDD.  Discuss this with your physician, who will make the diagnosis and treatment recommendations.

For more information about depression or other mental health issues, click here.

Created: 10/6/2003  -  Donnica Moore, M.D.

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