Symptoms:

A wide range of physical or emotional symptoms have been associated with PMS. By definition, symptoms are considered to be PMS-related if they occur during the second half of the menstrual cycle (14 days or more after the first day of the menstrual period) and are absent for about 7 days after a menstrual period ends (during the first half of the menstrual cycle).

The most common symptoms include:

• Headache
• Swelling of ankles, feet, and hands
• Backache
• Abdominal cramps or heaviness
• Abdominal pain
• Abdominal fullness, feeling gaseous
• Muscle spasms
• Breast tenderness
• Weight gain
• Recurrent cold sores
• Acne flare-ups
• Nausea
• Bloating
• Constipation or diarrhea
• Decreased coordination
• Food cravings
• Less tolerance for noises and lights
• Painful menstruation

Other symptoms include:

• Anxiety or panic
• Confusion
• Difficulty concentrating
• Forgetfulness
• Poor judgment
• Depression
• Irritability, hostility, or aggressive behavior
• Increased guilt feelings
• Fatigue
• Slow, sluggish, lethargic movement
• Decreased self-image
• Sex drive changes, loss of sex drive
• Paranoia or increased fears
• Low self-esteem

Signs and tests:

There are no physical examination findings or lab tests specific to the diagnosis of PMS. It is important that a complete history, physical examination (including pelvic exam), and in some instances a psychiatric evaluation be conducted to rule out other potential causes for symptoms that may be attributed to PMS.

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