Clinical evaluation of PMS

A. PMS involves an assortment of disabling physical and emotional symptoms that appear during the luteal phase and resolve within the first week of the follicular phase. Symptoms of PMS fall into four main categories: mood, somatic, cognitive, and behavioral.

B. No specific serum marker can be used to confirm the diagnosis. Premenstrual dysphoric disorder is diagnosed when mood symptoms predominate symptoms of PMS.

C. The differential diagnosis includes hypothyroidism, anemia, perimenopause, drug and alcohol abuse, and affective disorders. Common alternative diagnoses in patients complaining of PMS include affective or personality disorder, menopausal symptoms, eating disorder, and alcohol or other substance abuse. A medical condition such as diabetes or hypothyroidism, is the cause of the symptoms in 8.4%, and 10.6% have symptoms related to oral contraceptive (OC) use.

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