PMDD is diagnosed based on a history of severe, cyclic PMDD symptoms that are not caused by an underlying condition. To meet the PMDD criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there must be at least 5 specific PMDD symptoms present, one of which must be a key major mood symptom, and these symptoms must both cause significant distress or interference with daily activities and occur during the late luteal phase of most menstrual cycles over the previous year.[1] Prospective documentation using a validated questionnaire for at least two symptomatic cycles is also required.[2]
Additional tests, like laboratory tests, a pelvic exam, and imaging, are not necessary for a PMDD diagnosis, but they are used to rule out other conditions that cause similar symptoms.