The criteria that physicians need to diagnose Premenstrual Syndrome (PMS) are as follows: Five (or more) of the following symptoms must occur during the premenstrual phase and be absent after menstruation. Also, at least one symptom must be from Group A.
- Depressed mood, feelings of hopelessness
- Anxiety, tension
- Sudden and dramatic mood swings
- Anger, irritability
- Decreased interest in usual activities
- Difficulty in concentrating
- Fatigue, lack of energy
- Change of appetite, overeating, food cravings
- Sleep disturbances
- Sense of being overwhelmed
- Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle aches, bloating, weight gain
In addition, for a positive diagnosis of PMS, it is crucial that these disturbances interfere markedly with work, school or personal relationships. The cyclic nature of these symptoms cannot be relied upon from memory. You must chart them on a daily basis for at least two to three months.
Finally, these symptoms cannot be a worsening of a psychiatric disorder such as Major Depression or Anxiety Disorder. Only 50% of women who visit their physicians believing that they have PMS actually meet the above criteria and have the diagnosis of PMS confirmed.
If you suspect you have PMS, it is imperative to relate the occurrence of the symptoms to the menstrual cycle. However, it is equally important for you to evaluate the stresses in your professional and personal life, since these may have a significant impact on how premenstrual symptoms are expressed.
Some women experience very severe PMS. Symptoms of serious psychiatric problems, such as depression or panic attacks, are often most extreme during the premenstrual phase each month. Studies have shown that women's suicide attempts, psychiatric hospital admissions and violent criminal acts are most likely to occur in the premenstrual days. If you feel that you may hurt yourself or someone else, you should seek immediate medical attention. Fortunately, this is extremely rare.
