How PMS and PMDD Are Diagnosed
If you experience mood swings, irritability, or physical symptoms that worsen before your period, you may have wondered whether this is premenstrual syndrome (PMS) or the more severe premenstrual dysphoric disorder (PMDD). Although there’s no single “blood test” for PMS or PMDD, doctors use a combination of symptom tracking, screening tools, and medical evaluation to reach a diagnosis. Here’s what you need to know.
Why Tracking Symptoms Is Essential
PMS and PMDD symptoms are cyclical, linked to the luteal phase of the menstrual cycle. To make a diagnosis, doctors need to confirm that symptoms:
Appear in the two weeks before menstruation
Improve or disappear once your period starts
Are recurrent over at least two menstrual cycles
Tracking your symptoms daily is the most important first step. Apps like Me v PMDD and Flo make this easy, while a paper calendar can also be effective.
🔗 You can also read my guide on cycle mapping to learn more about charting hormonal changes.
How Doctors Diagnose PMS vs PMDD
Doctors use criteria from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) to differentiate PMS from PMDD:
PMS diagnosis requires at least one physical or emotional symptom occurring in the luteal phase, severe enough to affect quality of life.
PMDD diagnosis requires at least five symptoms, with at least one being mood-related (e.g. irritability, depression, anxiety), and symptoms must cause significant distress or impairment in daily functioning.
Your doctor will ask about your cycle history, symptom severity, and how these impact work, relationships, and emotional wellbeing.
🔗 You can also read my guide on the differences between PMS and PMDD to learn more about what these different terms mean.
Screening Tools: PSST and DRSP
Several validated tools support diagnosis:
PSST (Premenstrual Symptoms Screening Tool): a questionnaire that screens for both PMS and PMDD, widely used in clinical practice.
Daily Record of Severity of Problems (DRSP): a daily charting tool that helps document the timing and severity of symptoms across multiple cycles.
These tools provide objective evidence for diagnosis and can help guide treatment decisions.
Ruling Out Other Medical Causes
Because PMS and PMDD symptoms overlap with other conditions, doctors will often rule out:
Thyroid disease
Mood or anxiety disorders
Endometriosis or pelvic pain syndromes
Perimenopause
This ensures your symptoms are truly cyclical and linked to hormonal fluctuations, not another underlying condition.
Conclusion
Getting a PMS or PMDD diagnosis can feel validating after years of being told symptoms are “just part of being a woman.” Accurate tracking, the right screening tools, and a thorough medical assessment can finally give you answers — and open the door to effective treatment.
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There is no single blood test. Diagnosis relies on daily symptom tracking, questionnaires like the PSST, and clinical evaluation over at least two menstrual cycles.
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Most doctors require symptom records for two consecutive cycles before confirming a diagnosis.
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PMS involves milder symptoms that may be physical or emotional. PMDD is more severe, with at least five symptoms (including mood-related ones), and significantly interferes with daily life.
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Yes. Thyroid disorders, depression, anxiety, and perimenopause can present with similar symptoms, so these are usually ruled out during assessment.