ABSTRACT
Controversy and debate have accompanied the diagnosis of premenstrual syndrome (PMS) ever since the first clear description of the syndrome by Frank (1). However, recent research and agreement on diagnostic criteria has led to greater understanding and unanimity of approach. Much of the controversy among women and clinicians has been about whether PMS should be considered as a disease or as a normal phenomenon not usually needing treatment. This has been largely due to the failure to appreciate that severity of the presentation varies tremendously. Although most women experience mild mood and somatic symptoms premenstrually, a small but significant number are severely disabled by the disorder. Furthermore, scientists in the field of PMS have not agreed on which terminology to use. With the diagnostic criteria published by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), a severe form of PMS with mood symptoms has been defined as premenstrual dysphoric disorder (PMDD).
