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Premenstrual Syndrome: A Clinician's Guide

Leslie Hartley Gise, MD
JAMA. 1990;264(1):95-96. doi:10.1001/jama.1990.03450010103044.
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Although some clinicians still doubt the existence of premenstrual syndrome (PMS), it is regarded as a legitimate medical condition. Furthermore, all practicing physicians, whatever the specialty, should know about the premenstrual syndromes, which can present with over 150 different symptoms that pertain to every specialty in medicine.

Unfortunately, the diagnosis of a PMS is complicated. First, it is made differently from the way we are used to making most of our diagnoses in clinical medicine. Second, there is a spectrum from normal premenstrual changes to a full-blown premenstrual disorder that interferes with functioning, so distinguishing the different types of syndromes may be difficult. Third, without knowing it, women frequently either exaggerate or underestimate their symptoms.

First, most diagnoses in clinical medicine are made retrospectively, that is, on the basis of a history, physical examination, and relevant laboratory tests. The diagnosis of a PMS, however, is not made on the basis


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