PMDD symptoms checklist
and how diagnosis works

By Ben Jonas Goedeke · 6 min read · checked against its sources · updated 13 Oct 2026

Premenstrual dysphoric disorder, PMDD, is described by IAPMD as a cyclical, hormone-based mood disorder. Hormone levels in people with PMDD are typical; what differs is how the brain reacts to their normal rise and fall after ovulation. The US Office on Women’s Health says it affects up to 5% of women of childbearing age.

PMDD is listed in the DSM-5, the manual doctors use to diagnose mental health conditions. This page puts its criteria into plain words, as IAPMD, the Office on Women’s Health and researchers summarize them. Use it to prepare for a conversation with a doctor. It isn’t a way to diagnose yourself.

The symptoms, area by area

There are eleven symptom areas. Four of them are about mood, and they carry the most weight:

The other seven:

This list follows IAPMD’s symptom list and the Office on Women’s Health. IAPMD also marks feeling out of control as a core emotional symptom.

How many symptoms count

A diagnosis needs at least five of the eleven, and at least one of them has to come from the four mood areas. The Office on Women’s Health puts it as five or more symptoms including one about mood, and the C-PASS paper, which turns the DSM-5 criteria into a scoring method, says the same. So someone with strong cramps, bloating and tiredness but no change in mood would not meet the criteria, however rough those days are.

The timing rule

Timing is what makes PMDD what it is. As the C-PASS authors quote the criteria, symptoms are present in the week before the period, start to improve within a few days after it begins, and are minimal or gone in the week after. This has to hold in the majority of cycles. IAPMD describes the same shape: symptoms in the one to two weeks before a period that consistently resolve shortly after bleeding starts.

A symptom-free stretch after the period is part of the picture. If there is never a week when you feel like yourself, a doctor will look for other explanations.

It has to affect your life

The symptoms must cause real distress, or get in the way of work, school, usual social activities or relationships. That is the wording the C-PASS paper quotes from the criteria. Feeling a bit flat before a period is common; PMDD is when the week changes how you function.

It has to show up in daily ratings

This is the part people often don’t expect. The criteria say symptoms should be confirmed by prospective daily ratings during at least two symptomatic cycles. IAPMD calls this a requirement of the DSM-5 and recommends the DRSP, a daily chart. There are no lab tests for PMDD: blood, saliva, urine and hormone tests can’t show it.

You can start with our printable PMDD chart, and why doctors ask for two cycles explains the reasoning.

What a doctor rules out

Signs it may be something else

Going by the criteria above, PMDD is less likely if your symptoms are the same all month, if they don’t ease after your period starts, or if they are only physical. Period pain on its own isn’t part of it either: IAPMD notes that PMDD does not cause heavy periods, cramps or period pain, although cramping and bloating before a period are common. None of this means your symptoms don’t matter. It means a doctor should look in a different direction.

When it gets dark

Low mood in PMDD can be severe. IAPMD says PMDD can lead to suicidal thoughts and behaviors. If you are in danger right now, call or text 988 in the US, or your local emergency number. A plan for the darkest days shows how to prepare on a good day.

What to do with this checklist

If several of these sound familiar, try the PMDD self-check, then start rating your days. When you see a doctor, bring the record and this list. Treatment options are covered in what doctors suggest for PMDD.

Keep the record your doctor needs. Tideline is a period and mood tracker for iPhone: write or say one sentence a day, and after two cycles it puts the week before your period next to days 4 to 10. No account, no ads, and your entries stay on your phone. Logging is free; the doctor’s report is part of Tideline Plus, a paid subscription with a free trial.
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Common questions

What are the DSM-5 criteria for PMDD?

At least five of eleven symptoms, at least one of them about mood (mood swings, irritability or anger, depressed mood, anxiety), present in the week before the period, improving within a few days after it starts and minimal in the week after, in most cycles. They must cause distress or disrupt daily life, and be confirmed by daily ratings over at least two cycles.

How many symptoms do you need for PMDD?

Five or more, including at least one mood symptom, according to the US Office on Women’s Health and IAPMD.

Can a blood test diagnose PMDD?

No. IAPMD says there are no lab tests for PMDD. Tests may be used to rule out other conditions, such as thyroid problems, but the diagnosis rests on daily symptom ratings across at least two cycles.

Is PMDD in the DSM-5?

Yes. PMDD is a DSM-5 diagnosis, and IAPMD notes that the DSM-5 requires daily tracking across at least two cycles to confirm it.

Keep reading

Sources

© 2026 Ben Jonas Goedeke · Tideline keeps a record. It does not diagnose, treat or prevent any condition.