The diagnosis of premenstrual syndrome can only be made from the history (story). There are no symptoms that are exclusively associated with PMS every PMS symptom can occur in other situations and there is no test that can distinguish between those who have PMS and those who do not. Caution is required in making the diagnosis. A chart may help to distinguish whether or not the symptoms are of a cyclical nature or not (Figure 25.1). The symptoms of PMS disappear completely when menstruation stops and they do not recur until ovulation two weeks before the next period.

Some women have underlying psychological problems such as depression or anxiety that become more noticeable in the premenstrual phase (secondary premenstrual syndrome). In these women not all their symptoms disappear after the period. Treatment of PMS in these circumstances may only partially overcome their problems although this may at times be enough to make their lives more tolerable.

PMS and Behavioural Problems - Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome, afflicting 3% to 8% of women. It is associated with the luteal phase of the menstrual cycle. There can be severe effects on behaviour. In rare instances it has been associated with suicide and acts of aggression. It has been cited in legal defence of murder.
A woman pleaded guilty to road traffic offences and was sentenced to be disqualified for holding or obtaining a driving licence for six months. Her appeal against that sentence was allowed on the basis that she was suffering from premenstrual tension at the time of the offences, and that the disqualification imposed was neither necessary nor appropriate.0901

Women's Health

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Women's Health

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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

David Viniker retired from active clinical practice in 2012.
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