In the majority of menstrual cycles, at least five symptoms must be :
present 1 week before menses
improve a few days after menses
leave in week after menses
1 or more of these must be present:
Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)
Marked irritability or anger or increased interpersonal conflicts
Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
Marked anxiety, tension, and/or feelings of being keyed up or on edge.
One or more of the following symptoms must additionally be present, to reach a total of five symptoms:
Decreased interest in usual activities
Subjective difficulty in concentration
Lethargy, easy fatigability, or marked lack of energy
Marked change in appetite; overeating; or specific food cravings
Hypersomnia or insomnia
A sense of being overwhelmed or out of control
Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of "bloating," or weight gain.