Questionnaire/history: Psychological symptoms (eg mood swings, irritability, depressed mood, anxiety, feeling out of control, poor concentration, change in libido and food cravings)? Physical symptoms (eg breast tenderness, bloating, headaches, backache, weight gain, acne or gastrointestinal disturbance)? Behavioural symptoms (eg reduced visio-spatial and cognitive ability, aggression and increase in incidents)? Timing of symptoms in relation to the menstrual cycle? Presence of symptoms before, during and after pregnancy? Severity of symptoms and degree of impact on daily activity, in particular, effect on work, school, family life and interpersonal relationship? Past medical history (eg any underlying chronic illness (such as diabetes, depression, epilepsy, asthma or migraine) and whether symptoms of the illness significantly worsen prematurely, mood disorder, surgical procedures (such as hysterectomy or endometrial ablation))? Family history (eg PMS)? Current medication (eg contraceptives)? Risk factors (eg cigarette smoking, alcohol, sexual abuse and/or trauma, weight gain or stress)? Examination: As indicated by the women's age and routine gynaecological and medical recommendations? Full physical examination (including an abdominal and pelvic examination) if pelvic pain or abdominal swelling? Diagnosis: Record of daily symptoms diary for two to three cycles (eg by using the Daily Record of Severity of Problem (DRSP) and review after that? Diagnosis of PMS if symptoms diary shows prominence of symptoms during the luteal phase of the menstrual cycle, which resolve with the onset of menses or soon after, followed by a symptom-free week? Symptoms severe enough to affect daily functioning or interfere with the woman's work, school, performance or interpersonal relationships? Core premenstrual disorders (PMDs) as no other underlying disorder present? Referral to secondary care if completed symptom diary alone is inconclusive, also to consider 3 months use of gonadotrophin-releasing hormone (GnRH) agonists to see if resolution of symptoms after ovarian suppression as diagnostic for PMS? Management Reference(s): NICE CKS: Premenstrual syndrome