Topic overview

Start with the big picture

PMS involves recurring physical and/or affective symptoms in the luteal phase that resolve within four days after menstruation begins and are absent during the follicular phase. Confirmation relies on daily symptom recording across at least two consecutive cycles. PMDD is distinguished by a greater symptom burden, including at least one core mood symptom and marked impairment; other possible causes, such as depression, thyroid disease, or anemia, should also be considered. Management begins with lifestyle measures and may include symptom-directed medicines, SSRIs, or hormonal approaches. Treatment selection requires attention to response, contraindications, and precautions. Ongoing diary review helps track symptoms and evaluate whether management is effective.