1- Encourage the woman to complete a menstrual chart over two cycles recording the frequency and severity of symptoms. A popular one is the Daily Record of Severity of Problems or there is menstrual chart that can be downloaded from the NAPS website. www.pms.org.uk/support/menstrualdiary There are phone apps that can track symptoms, for example, Pre MentricS These can be very useful not only in clinching the diagnosis but also monitoring response to treatment
2- Over two hundred different symptoms have been described and both physical and psychological are weighted equally in the Montreal Consensus.
3- All women should be advised of general lifestyle changes that could improve symptoms Including good nutrition, regular meals and exercise
4- Cognitive Behavioural Therapy has been shown to be effective in the treatment of PMDs.
5- Agnus Castus has been shown to be effective in some women.
6- Evidence-based therapies include certain combined hormonal contraceptives, transdermal estradiol, selective serotonin re-uptake inhibitors (SSRIs) and GNRH analogues
7- Progestogens and progesterone can induce symptoms in sensitive women
8- Any specific treatment may take up to three months to be effective. If a woman’s symptoms are severe refer for specialist support.
9- GNRH analogues and the ultimate, hysterectomy and bilateral oophorectomy can be offered in resistant cases
10- The National Association for Premenstrual Syndrome provides support for sufferers, their personal carers and the health professionals who care for them