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Premenstrual syndrome — DRCOG MCQ

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ModerateGynaecologyPremenstrual syndromeDRCOG

A 34-year-old woman reports severe irritability, bloating and breast tenderness for 8 days before each period. Symptoms resolve completely once bleeding starts. She has no symptoms between cycles and a negative pregnancy test. What is the most likely diagnosis?

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Correct answer: C — Premenstrual syndrome

Cyclical psychological and physical symptoms in the luteal phase with symptom-free intervals are typical of PMS. Major depressive disorder would not consistently remit after menstruation. Endometriosis usually causes pelvic pain and dysmenorrhoea rather than complete cyclical mood symptom resolution. The pearl is that a symptom diary over at least two cycles helps confirm the diagnosis and severity.

Reference: RCOG Green-top Guideline No. 48