Symptoms:

PMS refers to a set of physical, behavioral, or emotional symptoms that tend to:

• Start during the second half of the menstrual cycle (14 days or more after the first day of your last menstrual period)
• Go away 4 - 7 days after a menstrual period ends (during the first half of the menstrual cycle)

It is important to keep a daily diary or log to record the type of symptoms you have, how severe they are, and how long they last. You should keep this "symptom diary" for at least 3 months. It will help your doctor make an accurate PMS diagnosis and recommend appropriate treatment.

The most common physical symptoms include:

• Abdominal fullness, feeling gaseous
• Bloating of the abdomen
• Breast tenderness
• Clumsiness
• Constipation or diarrhea
• Food cravings
• Headache
• Less tolerance for noises and lights

Other symptoms include:

• Confusion
• Difficulty concentrating
• Fatigue
• Feelings of sadness or hopelessness (See also: Premenstrual dysphoric disorder)
• Feelings of tension, anxiety, or edginess
• Forgetfulness
• Irritable, hostile, or aggressive behavior, with outbursts of anger toward self or others
• Loss of sex drive (may be increased in some women)
• Mood swings
• Poor judgment
• Poor self-image, feelings of guilt, or increased fears
• Sleep problems (sleeping too much or too little)
• Slow, sluggish, lethargic movement

Signs and tests:

There are no physical examination findings or lab tests specific to the diagnosis of PMS. To rule out other potential causes of symptoms, it is important to have a:

• Complete medical history
• Physical examination (including pelvic exam)
• Psychiatric evaluation (in some cases)

A symptom calendar can help women identify the most troublesome symptoms and confirm the diagnosis of PMS.