Diagnosis of PMS
PMS is difficult to diagnose because there is not a clear cause and the symptoms are varied and are found in other disorders. The cyclical pattern is crucial for a diagnosis: symptoms appear prior to menstruation and resolve when bleeding begins.
The medical history and physical examination involve an evaluation of the symptoms and when they occur in relation to menstruation. Many health care providers advise women to keep a diary of menstrual cycles and the physical and psychological changes they experience over the course of several months. The menstrual diary provides clues to the physician and helps women understand and cope with the changes.
Thyroid function tests and other tests that evaluate the production of hormones are used to rule out other medical disorders.
Tests may be done to rule out dysmenorrhea (menstrual-related pain that occurs just before and during menstruation) and endometriosis.
Because depression is a common feature of PMS, some women undergo psychological counseling as part of the diagnostic procedure. Psychologists, who are professionally trained to recognize depression and other mood disorders, may be able to differentiate the cyclical pattern of depression associated with PMS from the psychiatric disorder.