How to diagnose PMS

Premenstrual syndrome, or PMS as it is commonly known, is a medical condition that can affect women who are in their childbearing years.  Unfortunately the term PMS has often been used in a derogatory fashion to describe the emotional state of women.

Although the cause is still relatively unknown there has been some link to the fluctuation in hormones present in the female body as it is ready to menstruate.  It is important to understand that not all women suffer from pre-menstrual syndrome and that the hormonal changes which occur in the body each month are normal.  It appears that only some women are predisposed to the emotional fluctuations that happen with those hormonal changes.

It is very important to get an accurate diagnosis from your physician before attempting treatment.  Because of the availability of a variety of treatments over-the-counter for the symptoms which are associated with premenstrual syndrome some women may be tempted to treat themselves without seeking advice from their physician.  Unfortunately, many diseases and other conditions share these common symptoms and, if you treat yourself for the wrong illness, you can delay legitimate treatment for a serious underlying problem.

Some of the symptoms of premenstrual syndrome can include bloating, breast tenderness, weight gain, emotional instability, trouble concentrating, headaches, acne breakouts, fatigue and anxiety.  At this time there is no simple single test to diagnose premenstrual syndrome but there are some strategies your physician can use to help with the diagnosis.

One of the first strategies that can be started even prior to seeing your primary care physician is keeping a calendar of symptoms.  By tracking these symptoms the primary care physician will be more accurately able to rule out other underlying medical causes.  There are two popular standardized calendars used to track menstrual symptoms which are the Calendar of Premenstrual Syndrome Experiences, and the Prospective Record of the Impact and Severity of Menstruation.

By tracking symptoms for at least two months the condition can be related to either the menstrual or luteal cycle and be determined if they are recurring in nature.  While recording her symptoms, the woman should identify the level of severity throughout the month and not just in the days before menses begins.

Before proceeding with any treatment for premenstrual syndrome your primary physician should also rule out the existence of other physical ailments that can create the same symptoms.  Your doctor will do this by reviewing the logs you provide and by recommending certain other testing.  The primary test that is used looks for appropriate levels of thyroid hormone in the blood.  Because thyroid disorders are common in women of childbearing age and shares some of the same symptoms with premenstrual syndrome, a test to evaluate thyroid functioning is important.  If thyroid disorder is the cause of symptoms than simple supplements on a daily basis can change the way in which the woman experiences her life.

When evaluating the diary provided of the symptoms over several months, the doctor will look for a pattern.  Some other diagnoses which can be considered are clinical depression, eating disorders and stress caused by abuse or personal conflicts.  Other diseases such as diabetes, chronic fatigue syndrome and anemia can also be the culprit.  Your primary care physician will ask questions about your reproductive history and include any chronic illnesses and medications which you may have had.

Women with premenstrual syndrome generally have two to four symptoms that have a mild to moderate effect on daily life and relationships.  These symptoms appeared to disappear once the menstrual period begins.  Unfortunately this is a diagnosis of exclusion because there is no laboratory tests which will accurately assess the presence of premenstrual syndrome.

Although the cause is not known and there is no specific test the condition is real.  If you believe that you may have premenstrual syndrome it is important to seek the advice of your primary care physician in order to decrease the symptoms that you experience on a monthly basis.  This will only help to improve the quality of your life and decrease the additional stress caused by the condition.

RESOURCES

Cleveland Clinic: PMS and PMDD

MedlinePlus: Premenstrual Syndrome

Association of Reproductive Health Professionals: Managing Premenstrual Symptoms

womenshealth.gov: Premenstrual Syndrome Fact Sheet