Symptoms of PMDD must be present the week prior the the onset of menses, start to dissipate two to three days into menses, and resolve in the week post menses. These symptoms include:

• Marked affective lability (ex: mood swings, feeling suddenly sad or tearful, or increased sensitivity )
• Marked irritability or anger or increased interpersonal conflicts
• Depressed mood, feelings of hopelessness, or self-deprecating thoughts
• Anxiety, tension, and/or feelings of being on edge
• Decreased interest in usual activities
• Difficulty in concentration
• Lethargy, easy fatigability, or lack of energy
• Change in appetite; overeating or specific food cravings
• Hypersomnia or insomnia
• A sense of being overwhelmed or out of control
• Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain Note: At least five of these symptoms must be present