FAQ: diagnosing PMDD

• Why is a medical/psychiatric history and physical examination necessary?
• What else will the doctor or nurse practitioner want to know?
• Why can't you just measure my hormone levels?
• Can other laboratory tests diagnose it?
• Why is a daily record necessary?
• Could it be another condition?

Why is a medical/psychiatric history and physical examination necessary?

Sometimes symptoms of another medical or psychiatric disorder can be confused with those of PMDD. Sometimes symptoms of an unrelated medical or psychiatric disorder may get worse during the premenstrual phase of the cycle, and this may be difficult to distinguish from PMDD. Sometimes a woman will have both PMDD and another medical or psychiatric disorder. For all these reasons, a complete history and physical examination make good sense.

What else will the doctor or nurse practitioner want to know?

Be sure to tell the doctor about any and all medical and emotional problems you might have. Don't leave anything out. Also be sure the doctor knows about all medications you are taking. This includes prescription and over-the-counter medications, as well as nutritional and herbal supplements. A doctor will also want to know about your diet and whether you smoke, drink alcohol, use street drugs or caffeine. You will quite likely be asked about your family history. This may seem like a lot of detail, but a comprehensive evaluation is the best way to get the right diagnosis and the most appropriate treatment.

Why can't you just measure my hormone levels and make the diagnosis?

Believe it or not, despite many research studies that have examined female hormone levels (like estrogen and progesterone) during the menstrual cycle in women with PMDD and in those without the disorder, no meaningful differences were found. Measuring levels of female hormones in blood or urine cannot diagnose PMDD.

Can other laboratory tests diagnose PMDD?

No. While some laboratory tests may be necessary to exclude other illnesses that could be confused with PMDD, there are simply no laboratory tests that can diagnose PMDD.

Why is keeping a daily record of symptoms necessary to make a diagnosis of PMDD?

A daily symptom diary kept over at least two cycles may not always be necessary to diagnose PMDD. However, it is the best way to confirm the diagnosis based on the type and severity of symptoms and their presence or absence across the various phases of the menstrual cycle. Surprisingly often, women who think they have PMDD learn through the use of a daily symptom diary that such is not the case.

Can other conditions be confused with PMDD?

You bet. Symptoms of unrelated medical or psychiatric disorders may vary in severity over time or even follow a cyclic pattern but one that is not linked to the menstrual cycle in the same way as PMDD. Sometimes symptoms of an unrelated disorder may worsen during the premenstrual phase of the cycle (premenstrual magnification) and be confused with PMDD. Remember that the symptoms of PMDD are gone completely during the week after menses.

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