Your doctor will ask you about:
Your PMS symptoms
The timing of these symptoms in relation to your menstrual period
The regularity of symptoms (every month, every other month, etc.)
Your doctor also will ask about the general quality of your life. Questions may include:
Are you feeling sad, tense, or anxious lately?
Do you notice mood swings? Fatigue? Difficulty concentrating?
Are you having difficulties with your spouse, family members or coworkers?
Are you so rushed that you sleep poorly and skip meals?
Do you live a sedentary life with little exercise?
Do you smoke cigarettes?
Do you drink alcohol or caffeinated beverages?
Is your diet high in red meat, salty foods or sugar?
Next, your doctor will review your medical history. He or she will ask about any medications that you are taking.
Then, your doctor will examine you. He or she will do a pelvic exam with a Pap smear.
No single physical finding can confirm the diagnosis of PMS. But a thorough physical exam can check for other medical problems. These may include hypothyroidism or a tumor of the breast, brain or ovary.
Similarly, no single laboratory test can confirm that you have PMS. But blood tests can rule out medical disorders. These may include hypoglycemia, hypothyroidism or other hormonal problems that may be causing your symptoms.
If there are no physical findings and your laboratory test results are normal, then your doctor may ask you to keep a daily record of your PMS symptoms. You will do this for two or three months. This record will include:
Type of symptoms
Severity of symptoms
Timing of your menstrual periods
A description of any special stresses that have affected your life
Once this record is complete, your doctor will review the information. If your symptoms follow a pattern that is consistent with PMS, then this will help to establish the diagnosis.
Generally, premenstrual symptoms must be absent for about two weeks to qualify for the diagnosis of PMS. Symptoms will be absent from shortly after the start of menstruation until the next ovulation.