DIAGNOSING PMS

 

Since there is no definitive laboratory test or specific physical measurement which can determine that PMS exists, diagnosis is usually done by using various methods of ruling out other possibilities which could be causing the symptoms and then applying several key tests to the symptoms.

For a woman who believes she may have premenstrual syndrome symptoms, she should track the progress of her symptoms on one of the major standardized instruments which helps define frequency and severity of symptoms. Three such popular forms  include the Calendar of Premenstrual Syndrome Experiences (COPE), the Prespective Record of the Impact and Severity of Menstruation (PRISM) and the Visual Anague Scales (VAS). 

By tracking symptoms for a minimum of two months, it can be determined that the symptoms are related to the menstrual or luteal cycle and that they must be recurring in nature. During the recording period, the woman should identify the symptoms, the level of severity and when in the menstrual cycle they occurred.  In other words if the symptoms occur throughout the month, not just in the days before the menses begin, the symptoms can be real, but they are not considered to be a feature of PMS.

The second factor which is shown by keeping a detailed record is the symptoms' severity.  To be considered premenstrual syndrome, the symptoms must be strong enough to interfere with the day-to-day activities of the woman, either at home or at work, or both.

Various medical conditions can demonstrate symptoms which grow worse during the time just prior to and during menstruation.  This characteristic is known as 'menstrual magnification'.  Such diseases or conditions include depression, migraine, seizures,chronic fatigue, irritable bowel, asthma and allergies. If these symptoms are present during other parts of the woman's cycle, and not just in the time frame just prior to menstruation, they are not considered to point to premenstrual syndrome.

Before proceeding with treatment for premenstrual syndrome, a doctor will also work to rule out the existence of other physical ailments which might be creating the symptoms.  These symptoms may cause a women to believe she is suffering from PMS, when in fact the cause of the ill health may be something else entirely.  Since treatment would differ for some of the other conditions, it's important to come to a correct diagnosis before continuing with treatment. .

Once the doctor has reviewed the premenstrual syndrome logs created and maintained by the patient he or she can then rule out any underlying causes which are not part of the syndrome and begin the process of treatment.

It is also critically important to gain an understanding that premenstrual syndrome cannot be dealt with as a set of individual symptoms to be checked off with various treatment modes.  If only the physical side or only the emotional side is considered, treatment of one may even act to worsen other symptoms.  For example, if a woman receives a diuretic to alleviate water retention, but still has migraine type headache, her stress level may increase because nothing appears to be helping.