PMS: How can my premenstrual syndrome be assessed?

Charts are available, which can assist you to record your PMS symptoms. They may help to prove or disprove the relationship between symptoms and the menstrual cycle. These charts can also be helpful in demonstrating whether treatments are providing benefit. Suitable charts are usually available on request in reproductive endocrinology clinics. Figure 25. 1shows a PMS chart used in my own clinic. This shows example cases to provide a guide for PMS patients and allows for the patients to assess their own symptoms on a severity level from 0 to 3.

Suppression of the menstrual cycle by gonadotrophin releasing analogues (e.g. Goserelin –gonadotrophins) has been described as a means of diagnosing PMS when there is doubt about the diagnosis. The menstrual cycle is suppressed for three cycles so that if symptoms are truly cyclically related they should disappear. The test has been advocated for evaluating the potential benefits of removing the ovaries for patients with possible PMS problems who are coming to hysterectomy(hysterectomy). From a practical point of view it is apparent that the “Goserelin test’ will create a temporary menopause-like state; many symptoms (e.g. depression and anxiety) which may be attributable to PMS can also occur with the menopause. This potential difficulty may be overcome by add-back therapy (HRT-Add-Back).

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