Premenstrual syndrome is characterized by cyclical physical and behavioral symptoms occurring in the luteal phase of the normal menstrual cycle.
Premenstrual dysphoric disorder is a more severe variant that includes at least 1 affective symptom. Affective symptoms such as anger, irritability, and/or internal tension occur during the second half of the menstrual cycle, and sometimes extend into the first few days of menses.
PMS is a diagnosis of exclusion. Physical symptoms are abdominal bloating (most common), breast tenderness, and headaches.
Treatment comprises lifestyle modification, pharmacologic interventions, and, in severe cases, surgery.
Premenstrual syndrome (PMS) is characterized by cyclical physical and behavioral symptoms occurring in the luteal phase of the menstrual cycle (the time period between ovulation and onset of menstruation). Premenstrual dysphoric disorder (PMDD) is a more severe variant that includes at least 1 affective symptom. DSM-5 criteria require 5 or more physical and behavioral symptoms from a prespecified list to be recorded using a diary.  The University of California, San Diego criteria recommend prospective reports by women during several consecutive cycles, with the exclusion of psychiatric conditions. 
Editor in Chief
European Menopause and Andropause Society
Reader Emeritus in Reproductive Medicine
University of Oxford
Women's Centre, John Radcliffe Hospital
Faculty of Medicine
University of Glasgow
Adjunct Associate Professor
Robert Wood Johnson Medical School
MR declares that she has no competing interests.
Professor Margaret Rees would like to gratefully acknowledge Dr Desiree Lie, the previous contributor to this monograph. DL declares that she has no competing interests.
Department of Obstetrics and Gynecology
University of California Irvine Medical Center
JT declares that she has no competing interests.
Consultant in Perinatal Mental Health
Liverpool Women's NHS Foundation Trust
CH declares that she has no competing interests.
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