Self-Screening Quiz

University of Pennsylvania Health System
Premenstrual Syndrome Program

Call today to receive more information
and to see if you qualify!

(215) 662-3329 or (800) 662-4487

Self-Screening Quiz

FIRST: Note all the symptoms from both the A-list and the B-list that you experience during the 1-2 weeks before your menstrual period starts:

A-List Symptoms

		I feel much more depressed, down, tearful, sad or hopeless
		I feel anxious, tense, nervous, “keyed up” or “on edge”
		I feel hypersensitive to rejection, or, My emotions feel very unstable and unpredictable
		I feel much more irritable or I get angry easily


B-List Symptoms
		I am much less interested than usual in my hobbies and daily activities
		I find it much harder to concentrate
		I feel much more tired and low in energy
		I tend to crave carbohydrates, feel hungry all the time, or eat more than usual
		I find myself tired, oversleeping or taking naps, or, I’m not sleeping well at night
		I feel very overwhelmed or out of control, like things are too much for me
		I am bothered by any of the following physical symptoms:
		Breast tenderness or swelling Increased headaches Joint or muscle pain Bloating or water retention Weight gain

SECOND: Answer YES or NO to the following 4 questions:
	1)	Does the number of A-list symptoms PLUS the number of B-list symptoms you noted add up to 5 or more?
	2)	Is at least one of the symptoms you noted on the A-list?
	3)	Do most of the symptoms you noted disappear by the end of your period?
	4)	When you are having these symptoms do they interfere or cause problems in your day-to-day activities or relationships?

If you answered YES to ALL 4 of the above questions, you may have PMDD.

Women who do not meet criteria for PMDD but are bothered by some of the above symptoms premenstrually may have PMS.

The PMS Program at Penn is currently enrolling study patients

for PMS and PMDD treatment research studies.
To receive more information and have one of our clinicians

conduct a FREE screening evaluation for PMS/PMDD,

CALL:

(215) 662-3329 or (800) 662-4487

University of Pennsylvania Health System
Premenstrual Syndrome Program

(215) 662-3329 or (800) 662-4487


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