A. Presence of five of 11 depressive, anxiety, cognitive or physical symptoms, with at least one of four specific symptoms experienced in most of the menstrual cycles for the past year. The symptoms may begin a week before menses and must completely remit within a few days after the onset of menses.
Depressive symptoms	Anxiety symptoms	Cognitive symptoms	Physical symptoms
Markedly depressed mood, feelings of hopelessness, self-deprecation† Suddenly feeling sad or tearful, with increased sensitivity to personal rejection† Decreased interest in usual activities Lethargy, fatigue, marked lack of energy Marked changes in appetite and cravings for certain foods Insomnia or hypersomnia	Marked anxiety, tension, feeling of being “keyed up” or “on edge”† Persistent or marked irritability, anger, increased interpersonal conflicts† Feeling overwhelmed or out of control	Subjective sense of having difficulty concentrating	Breast tenderness or swelling, headaches, joint or muscle pain, weight gain, “bloated” feeling
B. Symptoms interfere with social, occupational, sexual or school functioning.
C. Symptoms are discretely related to menstrual cycle and are not merely worsening of preexisting depression, anxiety or personality disorder.
D. Criteria A, B and C must be confirmed prospectively by daily ratings for at least two consecutive menstrual cycles.