Treatment guidelines for premenstrual syndrome

National Association for Premenstrual Syndrome

Symptoms and diagnosis

  • More than 150 symptoms are reported to be associated with premenstrual syndrome (PMS), the number and type varying from individual to individual. Even within the same person, the severity of symptoms often varies from month to month. Diagnosis depends not on the type of symptom, but on the timing as symptoms usually arise during the luteal phase of the menstrual cycle. Symptoms present 1-14 days before menstruation and disappear at the onset or on the day of the heaviest flow. For the rest of the cycle – usually from the day of heaviest menstrual flow to approximate time of ovulation – the woman feels well. If behavioural symptoms persist throughout the cycle then a psychological or psychiatric disorder must be considered a possibility
  • There are no laboratory tests that make identification simple. Correct diagnosis is a prerequisite for successful therapy, and the best diagnostic tool is the menstrual chart, which provides the precise dates of menstruation and symptoms. The presence of symptoms before and their absence after menstruation are then easily determined. The chart should be maintained for at least two cycles, to demonstrate a pattern clearly. It is worth remembering that cycle lengths vary, with 28 days representing the average. In short cycles, the follicular phase may be only a few days long and symptoms are present for a greater proportion of the time

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