At a similar time each month, irritability or anxiety can increase, and things you could usually cope with may feel overwhelming. There is no need to see these changes only as a problem of personality or willpower. You should also not conclude that every emotional change is due to your period.
What pattern does premenstrual syndrome show?
Premenstrual syndrome (PMS) is diagnosed by looking at a pattern in which physical and emotional symptoms repeat before a period and affect daily life. Besides sensitivity, low mood, and anxiety, breast discomfort, abdominal bloating, fatigue, and changes in sleep or appetite can appear as well.
Rather than confirming it from one difficult month alone, we look at when it starts and when it lessens. If, regardless of your period, you are depressed or anxious all month long and it gets worse before a period, it should also be checked whether a worsening of another condition is overlapping.
How can you record this so it helps your visit?
Writing briefly every day across at least two menstrual cycles helps identify a repeating pattern. The record does not need to be perfect. Rather than filling missed days in at length from memory, continue from the days you can.
| What to write down | Simple examples |
|---|---|
| Relationship to your period | Period start date, the day bleeding ended |
| Mood and body discomfort | Anxiety, irritability, low mood, sleep, breast discomfort, bloating |
| Effect on daily life | Stopped work, canceled a plan, got through the day as usual |
| What changed along with it | All-nighter, alcohol, a change in medicine, an especially difficult event |
Leaving one line about a change in daily life, such as "I had trouble concentrating in a meeting," makes the degree easier to explain than writing only scores. Days without symptoms also need to be written down so that the interval when you recover can be seen.
Can you tell from one test?
PMS is not confirmed by one specific hormone level. The relationship between the cycle and the symptoms, the effect on daily life, and the possibility of other causes are considered together. When needed, thyroid problems, depressive and anxiety disorders, medicines being taken, or sleep problems are looked at as well.
If mood symptoms are especially severe, enough that it is hard to maintain work or relationships, whether it is premenstrual dysphoric disorder (PMDD) can also be assessed. Rather than attaching a symptom name yourself, please tell your clinician what has become difficult. There are also cases in which assessment by obstetrics and gynecology and by psychiatry together is helpful.
How are management and treatment chosen?
You can try keeping your hours of sleep steady, regular exercise that does not strain you, and balanced meals. If these adjustments are not enough, other options such as cognitive behavioral therapy or medication are discussed. Which medicine is chosen, and how it is taken, are decided by considering the symptoms, existing conditions, and the need for contraception, among other things.
Do not start or stop hormonal medicines or antidepressants on your own. Side effects and conditions of use differ for each medicine, and supplements can also interact with other medicines. It is best not to choose based only on an explanation that "it is a natural ingredient, so it is safe for everyone."
You can start a consultation in Care guide for changes in periods. For the course of diagnosis, we referred to the American College of Obstetricians and Gynecologists guide to PMS, and for recording and treatment choices, we referred to the NHS guide to PMS.