Is premenstrual syndrome (PMS) a recognized medical condition?

Yes, Premenstrual Syndrome is a Recognized Medical Condition

Premenstrual syndrome (PMS) is an established medical diagnosis characterized by recurrent moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal phase of the menstrual cycle and resolve within a few days of menstruation. 1

Prevalence and Clinical Recognition

• PMS affects 30-40% of reproductive-age women, making it a common condition 1
• Premenstrual dysphoric disorder (PMDD), a severe form of PMS, affects 3-8% of women and was formally recognized as a distinct diagnostic category in ICD-11 2
• PMDD is characterized by mood symptoms (depressed mood), somatic symptoms (overeating), or cognitive symptoms (forgetfulness) that begin several days before menses, improve within a few days after onset of menses, and become minimal or absent within 1 week following menses 2

Formal Medical Recognition

The condition has been formally recognized in multiple ways:

• Women with menstrual disorders, including premenstrual syndrome, have a documented higher risk of developing hypertension and other cardiometabolic risk factors 2
• The condition is associated with increased premenstrual symptoms in women with long COVID, indicating its recognition as a distinct clinical entity 2
• Research on ME/CFS shows associations between chronic fatigue and premenstrual dysphoric disorder, further validating PMS as a recognized medical condition 2

Diagnostic Approach

The diagnosis is made entirely on clinical grounds using prospective symptom tracking for at least two menstrual cycles 3, 4:

• The Daily Record of Severity of Problems is the validated diagnostic instrument of choice 1, 3, 4
• Symptoms must occur consistently during the luteal phase and resolve during or within one week of menstruation 1, 3
• For PMDD diagnosis specifically, symptoms must substantially interfere with work, school, social activities, or relationships 3
• No laboratory tests or imaging studies are required for diagnosis 5

Established Treatment Options

The medical recognition of PMS is further validated by evidence-based treatment guidelines:

• Selective serotonin reuptake inhibitors (SSRIs) are established as first-line pharmacologic treatment for both PMS and PMDD 1, 3, 6, 4
• SSRIs demonstrate rapid onset of improvement and are effective for both physical and mood symptoms 1, 6
• Combined oral contraceptives are recognized as effective primarily for physical symptoms 1
• Calcium supplementation has demonstrated consistent therapeutic benefit 6, 4
• Cognitive behavioral therapy, exercise, and acupuncture are recognized non-pharmacologic interventions 3

Clinical Significance

The condition carries real clinical implications beyond just symptom burden:

• Women with epilepsy and menstrual irregularities should be evaluated for reproductive endocrine disorders given the higher prevalence of associated conditions 7
• The week before menstruation has been identified as a trigger for relapses of long COVID symptoms 2
• Menstrual alterations and increased premenstrual symptoms are more likely in women with long COVID 2

The term "premenstrual tension" is an older, less precise term that has been replaced by the more accurate medical terminology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in modern medical practice. 2, 1