What are the clinical guidelines for diagnosing Premenstrual Dysphoric Disorder (PMDD)?

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From the Guidelines

Premenstrual Dysphoric Disorder (PMDD) is characterized by a pattern of mood, somatic, or cognitive symptoms that occur several days before the onset of menses and improve within a few days after the onset of menses.

Key Diagnostic Features

  • The symptoms must begin several days before the onset of menses
  • The symptoms start to improve within a few days after the onset of menses
  • The symptoms become minimal or absent within 1 week following the onset of menses

Common Symptoms

  • Mood symptoms (e.g., depressed mood)
  • Somatic symptoms (e.g., overeating)
  • Cognitive symptoms (e.g., forgetfulness) as described in the study 1.

From the Research

Clinical Guidelines for Diagnosing Premenstrual Dysphoric Disorder (PMDD)

The diagnosis of PMDD is based on specific clinical criteria, including:

  • Symptoms that occur during the luteal phase of the menstrual cycle and remit within a few days of menses onset 2, 3, 4
  • At least five symptoms, including one of the following: marked affective lability, marked irritability or anger, marked depressed mood, or marked anxiety 2, 4
  • Symptoms that interfere with daily life and relationships 2, 4
  • Symptoms that are not better explained by another mental disorder 2, 4

Diagnostic Tools and Procedures

Several diagnostic tools and procedures have been developed to aid in the diagnosis of PMDD, including:

  • The Daily Record of Severity of Problems (DRSP) 2
  • The Carolina Premenstrual Assessment Scoring System (C-PASS) 2
  • Clinical interviews and physical examinations 3, 4
  • Laboratory tests to rule out other medical conditions 3, 4

Research Perspectives and Future Directions

Research on PMDD is ongoing, and future studies should focus on:

  • Developing more effective diagnostic criteria and tools 2, 3, 5
  • Investigating the underlying pathophysiology of PMDD 2, 4
  • Evaluating the efficacy of different treatments, including serotonergic therapy, hormonal treatment, and lifestyle modifications 4, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical diagnostic criteria for premenstrual syndrome and guidelines for their quantification for research studies.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2007

Research

The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder--clinical procedures and research perspectives.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2004

Research

Premenstrual Syndrome: Evidence-based Evaluation and Treatment.

Clinical obstetrics and gynecology, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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