An estimated 8-out-of-10 women experience physiological premenstrual symptoms, 3–30% of these women suffer with symptoms of premenstrual syndrome (PMS) that interfere with daily life, with 1–10% of women suffering from severe PMS symptoms meeting the DSM-5 criteria for diagnosis of premenstrual dysphoric disorder (PMDD). PMDD can be considered a subdivision of PMS and is a combination of psychological, behavioural and physical symptoms that can vary in intensity and presents cyclically during the luteal phase of ovulatory menstrual cycles. The diagnosis of PMDD and PMS depends on the timing of symptoms, the severity of symptoms and their impact on quality of life. Physiological symptoms (feeling bloated, headache, acne, mood changes and constipation) that do not impact on daily activities and quality of life are considered to be physiological premenstrual symptoms rather than PMS. There is no association with age, educational status or employment for PMS or PMDD.
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