Diagnosis of premenstrual syndrome (PMS)

Most women experience at least mild 'physiological' premenstrual symptoms at some time in their lives

• however more troublesome symptoms are generally termed 'premenstrual syndrome' (PMS)
• women should be advised to record the symptoms in a symptom diary for two cycles (1)

A wide range of emotional, behavioural and physical symptoms are ascribed to PMS

• physical - fluid retention and weight gain, breast tenderness and fullness, back pain, abdominal pain & bloating, swelling of extremities, change in bowel habit, muscle and joint pain
• psychological - irritability, anxiety, depression, tension, mood swings, lack of concentration, confusion, forgetfulness, restlessness, loneliness, decreased self-esteem, changes in sleep, appetite and libido; tiredness
• behavioural - reduced visuospatial and cognitive ability, more prone to accidents, suicides, criminal activity (1,2)

The most common are:

• irritability, depression, and anxiety
• abdominal bloating
• breast swelling, tenderness and pain

Oedema may be severe, some women gaining up to 1 Kg in weight in the latter part of the menstrual cycle.

Reference:

• 1. Royal College of Obstetricians and Gynaecologists (RCOG) 2007. Management of premenstrual syndrome
• 2. Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. Am Fam Physician. 2003;67(8):1743-52
• 3. Drug and Therapeutics Bulletin (2002); 40(9):70-2.