How is PMS diagnosed?

What is PMS

Pre-menstrual syndrome (PMS) is a cluster of symptoms, ranging from emotional, behavioural and physical, that can affect women and those assigned females at birth (AFABs) one to two weeks before their period shows up. 

Do you think you have PMS? Have you ever felt moody, tired or bloated in your luteal phase? (which is the 2 weeks before your periods, more on the phases of your menstrual cycle here) 90%¹ of you are probably nodding your head behind the screen! While 9 out of 10 of us experience pre-menstrual symptoms before our periods, only 20-40%² of us will have symptoms classed as PMS and 5-8%³ experience PMS so severely they are diagnosed with severe PMS or PMDD (pre-menstrual dysmorphic disorder). 

How to prepare for a doctor’s appointment

Before you can express what you are going through to a doctor, you have to get to know your body on a more personal level. 

Keep a PMS diary 

Recording your PMS symptoms and severity in a diary for at least 2 menstrual cycles⁴ will allow your doctor to determine a pattern of how the symptoms affect you. There is a handy questionnaire called “The Daily Record of Severity of Problems” to make your note-taking a little easier. 

What your doctor is looking for at your appointment

There is no quick tool or test to diagnose PMS. Your doctor will ask you questions about your menstrual cycle, to describe your symptoms and how the symptoms affect you on a day-to-day basis. They will also ask you about your medical history and medication history to ensure it excludes any other causes. 

Conditions such as an underactive thyroid, pregnancy, perimenopause, or other mental health conditions could mimic PMS symptoms but these would be present all the time, not just during the luteal phase before your period. So your doctor might also do some blood tests or other investigations to rule out other causes⁴. 

They will then put all the pieces together (yes, like a detective) and see if it meets the criteria for PMS diagnosis. 

PMS diagnosis criteria 

In the UK, the criteria for PMS diagnosis is slightly different from the USA. The PMS criteria for diagnosis in the UK includes⁵:

• Symptoms must be present only during the luteal phase (one to two weeks before your period)
• Symptoms interfere with your day-to-day activities during this timeframe (eg. ability to work, study, and maintain healthy relationships)
• As you get closer to your period, your symptoms gradually reduce and disappear
• No symptoms are present for a week after the first day of your period 
• It occurs usually with each menstrual cycle 

As long as these general criteria are met in the UK, it does not matter which or how many pre-menstrual symptoms you have. 

Interestingly in the US, you should have these symptoms for a minimum of 5 days before your period and these symptoms need to completely resolve after the first 4 days of your period. You also need you to track your symptoms for at least 2 to 3 cycles⁶. 

Summary 

Yes, it is tempting for people to throw around the word PMS as an insult or joke, but it is a real syndrome that can severely impact a person’s quality of life. 

In the US, a study found that PMS sufferers lose on average 6.4 days a month to debilitating symptoms. So after some (not so) quick maths, that means over our reproductive life, we lose 8 years to these symptoms⁷. That is quite shocking! 

Getting a diagnosis is a good start in your journey to find a solution. Our lovely in-house women’s health GPs at the Lowdown can offer you early appointments and a safe space to share more about your experiences. We know how you feel and will never belittle or dismiss your symptoms. 

If you are keen to know the treatment options before your appointment, we have everything you need to know just a click away!