PMS (Premenstrual Syndrome) Diagnostic Criteria and Self-Checklist: Which Department to Consult and Insurance Coverage

"Every month before my period, I feel awful. Is this PMS?" "How do I get diagnosed with PMS?" "I don't know which department to go to." If you have these questions, doctors from Jujo Station Haru Internal Medicine & Dermatology Clinic will explain the diagnostic criteria for PMS, self-check methods, departments to visit, and the diagnostic process at the hospital.

👉 Same-day visits without appointments are also possible. Please feel free to consult us first.

What is PMS? - Before considering a diagnosis

PMS (Premenstrual Syndrome) is a general term for physical and mental symptoms that begin 3 to 10 days before menstruation and improve once menstruation starts. The most distinctive feature is its cyclical nature: it appears before menstruation and disappears once menstruation begins. This cyclical pattern is the most important diagnostic point for differentiating PMS from other conditions. Approximately 70-80% of Japanese women experience some kind of discomfort before their period, but PMS is diagnosed when these symptoms reach a level that interferes with daily life, work, and relationships.

Medical diagnostic criteria for PMS

PMS has internationally established diagnostic criteria. The following three conditions must be met:

In addition, "symptoms that interfere with daily life, work, school, or relationships" are also important criteria for doctors when making a diagnosis. There are said to be over 200 types of symptoms, and the symptoms can vary completely from person to person. There is no fixed pattern of "this is a PMS symptom."

PMS Self-Checklist

Please check any items that apply to you. The key is whether the symptoms "appear before your period and disappear when your period starts."

Physical Symptoms

• Lower abdominal pain, heaviness, or bloating
  
• Headaches or migraines
  
• Breast tenderness and swelling
  
• Swelling in hands, feet, or face
  
• Weight gain (fluid retention)
  
• Strong fatigue or sluggishness
  
• Skin breakouts or acne
  
• Sudden increase in appetite (especially cravings for sweets)
  
• Constipation, diarrhea, or intestinal discomfort

Mental Symptoms

• Irritability or easily angered
• Feeling down or depressed
• Increased anxiety
• Tendency to cry easily
• Reduced concentration or increased mistakes at work
• Insomnia or oversleeping
• Not wanting to socialize

How to interpret your check

If you experience multiple symptoms from either the physical or mental categories, and this cycle of "appearing before your period and alleviating when your period starts" has continued for 3 months or more, you may have PMS. However, this checklist is merely a guideline. A definitive diagnosis is made through a doctor's interview and examination.

What type of PMS do you have? — 4-type diagnosis

PMS symptom patterns are broadly categorized into four types. Understanding your type can help you choose more effective coping strategies.

Type A (Anxiety/Tension Type)

Irritability, anxiety, tension, easily angered by minor things. Often caused by estrogen excess and progesterone deficiency.

Treatment: Low-dose birth control pills and magnesium supplementation are effective.

Type C (Sweet Cravings/Fatigue Type)

Intense cravings for sweets, fatigue, headaches. Related to rapid fluctuations in blood sugar.

Treatment: Blood sugar control through diet is important. Limit refined sugars and caffeine.

Type D (Depression/Downturn Type)

Depressed mood, tendency to cry, lethargy. Related to progesterone excess and estrogen deficiency.

Treatment: For severe cases, SSRIs and counseling are options. Consult an internal medicine doctor or psychosomatic medicine specialist first.

Type H (Edema/Breast Tenderness Type)

Main symptoms are swelling, breast tenderness, and weight gain. Related to aldosterone excess and vitamin B6 deficiency.

Treatment: Yaz (drospirenone/ethinyl estradiol) (with anti-aldosterone action) is particularly effective. Salt restriction is also important.

Many people experience a combination of types. If you are unsure which type you are, feel free to consult us; the doctor will determine it during the interview.

Conditions that are often mistaken for PMS

There are conditions with symptoms similar to PMS. It is important to consult a doctor instead of self-diagnosing.

"Every month, I feel awful only before my period" → High possibility of PMS. "I always feel awful, regardless of my period" → Possibility of depression, anxiety disorder, etc.

Which department should I consult?

The department to consult for PMS depends on whether the symptoms are primarily physical or mental.

PMS can be diagnosed and treated at an internal medicine clinic.

Many people feel "embarrassed to go to a gynecologist" or that "gynecology clinics are intimidating," but internal medicine clinics can also diagnose PMS and prescribe low-dose birth control pills.

At our clinic (Jujo Station Haru Internal Medicine & Dermatology Clinic), after a medical interview and blood pressure measurement, we prescribe LEP (low-dose estrogen-progestin combined pills) for dysmenorrhea and PMS, covered by insurance. If you find "gynecology clinics difficult to access," please feel free to consult us.

How PMS is diagnosed at a hospital — Consultation flow

① Medical Interview

The doctor will confirm the following:

• Nature of symptoms and when they start

• Relationship with menstrual cycle

• Whether symptoms disappear after menstruation begins

• Impact of symptoms on daily life

Having a "basal body temperature record" or "symptom diary" before your visit can improve diagnostic accuracy.

② Blood Pressure Measurement & Physical Examination

If low-dose birth control pills are to be prescribed, blood pressure measurement is necessary to check for the risk of blood clots.

③ Blood Tests, if necessary

Blood tests may be conducted to rule out conditions such as thyroid disease, anemia, or hormonal imbalances. While specific blood tests are not required for PMS diagnosis, they may be performed to differentiate it from other conditions.

④ Diagnosis and determination of treatment plan

Based on the medical interview, if it is confirmed that "it can be diagnosed as PMS," treatment will proceed. Prescription can be issued on the day of the initial consultation.

When to seek medical attention — Consult early if any of these apply

If any of the following apply to you, we recommend seeking medical attention in addition to self-care.

• Every month, for 3-10 days before your period, you find "work, school, or daily life difficult."

• You can't do without over-the-counter pain relievers.

• The same symptom cycle has been repeating for "3 months or more."

• Mental symptoms are severe, and you're making more mistakes at work or having more trouble in relationships.

• It's affecting your relationship with your partner or family.

• You endure it, thinking "it's just something I have to put up with every month."

"Enduring it as a matter of course" is not necessary. In most cases, monthly symptoms can be controlled with low-dose birth control pills or herbal medicines.

PMS Treatment Options

Frequently Asked Questions

Q. Can PMS be diagnosed with a blood test?

No. There are no specific abnormal hormone levels unique to PMS, so PMS cannot be definitively diagnosed with a blood test. Diagnosis is made through a medical interview and confirmation of the cyclical nature of symptoms. Blood tests may be performed to differentiate from other conditions such as thyroid disease.

Q. Is it PMS even if I only feel irritable before my period?

Even if irritability is the only symptom and there are no other symptoms, it can be diagnosed as PMS if it meets the conditions of "appearing before menstruation and disappearing with menstruation," "recurring for 3 months or more," and "affecting daily life."

Q. Can I get birth control pills prescribed at an internal medicine clinic?

Yes. Low-dose birth control pills (LEP) can be prescribed by internal medicine doctors. Our clinic provides prescriptions covered by insurance for the purpose of dysmenorrhea and PMS.

Q. What is the difference between PMS and PMDD?

PMDD is a severe form of PMS, specifically referring to cases where mental symptoms (severe depression, anger, hopelessness) significantly interfere with daily life, work, and relationships. Antidepressants (SSRIs) can be effective for PMDD, and diagnosis and treatment by a psychosomatic medicine specialist are necessary.

Q. Is basal body temperature necessary for PMS diagnosis?

It is not essential, but it can improve the accuracy of the diagnosis. Records from a period tracking app can also be used. The most important thing is a record of "when symptoms started and when they disappeared."

Consultation Hours and Access

Item	Content
Clinic Name	Jujo Station Haru Internal Medicine & Dermatology Clinic
Consultation Hours	Monday - Sunday 9:00 - 21:00
Closed	None (Irregular holidays)
Location	J&MALL 1F, 2-27-1 Kami-Jujo, Kita-ku, Tokyo 114-0034
For those coming by train/on foot	Approximately 1-2 minutes walk from JR Saikyo Line "Jujo Station", J&MALL 1st floor
For those coming by bus	Right in front of the Kokusai Kogyo Bus "Jujo Station" bus stop
For those coming by car	Please use nearby coin parking facilities
Contact	TEL: 03-6698-2509 / Official LINE: https://lin.ee/AL0fp3z