Symptoms used to diagnose
The ruleAt least 5 symptoms in the final week before menstruation in most cycles over the past year, improving within days of starting and minimal the week after. Confirmed by 2 cycles of daily ratings.
Core symptoms
- Marked mood swings or sudden sadness
- Marked irritability or anger
- Marked low mood or hopelessness
- Marked anxiety or tension
Other symptoms
- Less interest in usual activities
- Difficulty concentrating
- Fatigue
- Appetite change or cravings
- Sleep change
- Feeling overwhelmed or out of control
- Breast tenderness, bloating, joint pain
How diagnosis works
- At least 5 symptoms in the final week before menses, improving within days of onset, including at least one of: mood swings, irritability, low mood, anxiety.
- Confirmed by daily symptom ratings over at least 2 cycles.
A diagnosis is made by a qualified clinician after a full assessment — this summary is to help you understand it, not to self-diagnose.
Commonly used medications
Therapies & support
- CBT
- Hormonal treatments (with a GP/gynaecologist)
- Lifestyle changes
Good to know
- SSRIs can be taken only in the second half of the cycle for some people.
Sources
- 01Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)
American Psychiatric Association, 2022
- 02ICD-11 for Mortality and Morbidity Statistics — Chapter 6: Mental, behavioural or neurodevelopmental disorders
World Health Organization, 2022
- 03The Maudsley Deprescribing Guidelines
Horowitz & Taylor, Wiley-Blackwell, 2024