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Menstruation & cycle

PMS and PMDD.

How we find out whether your symptoms are linked to your cycle.

What are PMS and PMDD?

Many women notice that their body and mood change in the days before their period. For some it is easy to live with. For others the symptoms are so strong that they affect work, relationships and everyday life.

PMS (premenstrual syndrome) is the milder and more common form. PMDD (premenstrual dysphoric disorder) is the severe form. The emotional symptoms are so pronounced that they can resemble depression or anxiety, but they appear only in the days before your period and ease once it has started.

What defines it is the pattern: the symptoms appear in the time before your period, ease within a few days after it has started, and are gone or very mild for the rest of your cycle.

Which symptoms can it be?

The most common symptoms fall into two groups. You do not need to have all of them.

Mental and emotional

  • Mood swings, being tearful or sensitive to rejection
  • Irritability and anger
  • Low mood, sadness or hopelessness
  • Anxiety, restlessness and tension
  • Less interest in what you usually enjoy
  • Difficulty concentrating
  • Feeling overwhelmed or out of control

Physical

  • Tiredness and lack of energy
  • Increased appetite or food cravings
  • Sleeping more or less, or trouble sleeping
  • Tender breasts, bloating, headache and joint or muscle pain

How the diagnosis is made

There is no blood test or scan that can show PMS or PMDD. The diagnosis is made from the pattern of your symptoms.

That is why I often ask you to record your symptoms every day for at least two full menstrual cycles. Looking back, we often remember symptoms differently from how they were. In a diary we can see when the symptoms appear, how strong they are and whether they go away after your period.

Other conditions, for example depression or anxiety, can look like PMS and PMDD or get worse in the days before your period. That is why I look at the whole picture, and finding out whether the symptoms really follow your cycle is an important part of the assessment.

Track your symptoms with the DRSP form

The most widely used form is called the Daily Record of Severity of Problems, or DRSP. It was developed by Jean Endicott and colleagues and is built on the criteria for PMDD.

The form has 11 symptoms and 3 questions about how the symptoms affect your work, your interests and your relationships. Every evening you rate how much you have felt each symptom during the day, from 1 (not at all) to 6 (extreme).

The record is for you, but it is a great help when we talk about your symptoms together.

How to record

  1. Fill in the form every evening. It takes a few minutes.
  2. Mark the days you have your period (M) and days with spotting (P).
  3. Keep going for at least two full months, including the days when you feel well. It is the difference between the good and the bad days that shows the pattern.
  4. Bring the record to the consultation, so we can see together whether the symptoms follow your cycle.

Fill in the form in the app

I recommend that you fill in the form daily in the Mit Kvindeliv app, under My page. The app collects your answers and shows how they develop through your cycle, so we can see together whether the symptoms follow it.

You use the app as my patient. If you are not a patient yet, you can book a free call and I will help you get started.

Open My page

Prefer paper?

If you do not want to use the app, you can download the form as a PDF, print it and fill it in by hand. Print as many sheets as you need: one sheet covers a month. Write the month and year, and mark which weekday each date is.

Download the form

Danish translation by K.H. Reveles Jensen, adapted from Endicott J, Nee J, Harrison W: Daily Record of Severity of Problems (DRSP): reliability and validity. Archives of Women’s Mental Health, 2006.

When to seek help

It is a good idea to talk to a doctor if:

  • your symptoms affect your work, your studies, your relationships or your everyday life
  • you have strong mood swings, anxiety or low mood in the days before your period
  • you are unsure whether your symptoms are caused by PMS, PMDD or something else

How I can help

At Mit Kvindeliv I offer specialist assessment, advice and treatment for PMS, PMDD and other cycle-related symptoms. I start from your symptoms, their pattern through the cycle and how they affect your everyday life.

You do not need to have filled in the form to book a free call. We can also talk about how to get started with tracking.

Book a free call