Premenstrual Dysphoric Disorder has more severe symptoms than ordinary PMS, in particular those of mood.
There is no laboratory test that identifies PMS symptoms or PMDD. The diagnosis is made from the patient’s reporting of their symptoms on a daily basis for 2 or more menstrual cycles. These daily symptom records must demonstrate a cyclic symptom pattern, with the greatest severity in the week preceding menses and major reduction or elimination of the symptoms after the menstrual period.
The most frequently reported PMS symptoms include irritability, fatigue, anxiety, nervous tension, mood swings, depression, feeling overwhelmed or out of control, physical symptoms of swelling or bloating of the abdomen or extremities, appetite changes and food cravings, aches, and breast tenderness. These symptoms may occur for several days to 2 weeks before menses but subside with the onset of the menstrual period. When these symptoms, especially those of mood, are severe, a diagnosis of PMDD (premenstrual dysphoric disorder) may be made.
In making a diagnosis of PMS or PMDD, the critical elements are the relationship to menses and the degree of functional impairment. Women who seek medical treatment usually describe multiple symptoms, but their most distressing problems often are the mood and behavioral symptoms more than the physical symptoms like breast tenderness and swelling. PMS symptoms are clinically significant only when the symptoms are severe enough to interfere with relationships and life activities.
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