Diagnosis and management of premenstrual disorders

#### Summary points Premenstrual disorders have a substantial social, occupational, academic, and psychological effect on the lives of millions of women (from menarche to menopause) and their families.1 Published criteria for diagnosis vary greatly between authoritative bodies, so the true prevalence rates are unknown. A new classification from the International Society for Premenstrual Disorders (ISPMD) will allow this to be resolved.2 It will also enable clinicians to provide accurate diagnosis and effective management.2 Little is known about what causes premenstrual syndromes, and the few treatments that are licensed are ineffective,3 4 5 although treatment can, however, be provided for most women with good effect using unlicensed approaches. In this article, we discuss the classification of premenstrual disorders, how to measure symptoms and diagnose the condition, and effective management strategies. This review is based on evidence from randomised placebo controlled trials where available, recent Cochrane reviews, Royal College of Obstetricians and Gynaecologists’ evidence based guidelines and published consensus statements and textbooks by internationally recognised experts. #### Sources and selection criteria We searched Medline, PubMed, evidence based specialty guidelines, and Cochrane reviews. In addition, we used the recently published consensus of the International Society for Premenstrual Disorders and a comprehensive textbook by globally recognised experts that reviewed the entire literature on premenstrual …