An experienced nurse first asks when the symptoms occur, not simply which symptoms are present. Premenstrual disorders are defined by timing and functional effect. Symptoms should appear in the luteal phase, improve within a few days after menstruation begins, and be followed by a symptom-free interval during the follicular phase. Possible affective symptoms include irritability, anger, affective lability, anxiety, depressed mood, reduced interest, or feeling overwhelmed. Cognitive and somatic symptoms may include difficulty concentrating, fatigue, sleep disturbance, breast tenderness, bloating, headache, joint or muscle pain, food cravings, and perceived weight gain. None of these somatic symptoms is independently diagnostic without the characteristic cyclical pattern. PMS may include recurrent emotional and physical symptoms that cause meaningful distress or interference but do not meet the full criteria for PMDD. PMDD is the more severe, predominantly affective disorder. DSM-5/DSM-5-TR criteria require at least five symptoms during the final week before menses, including at least one core affective symptom: - marked affective lability; - marked irritability or anger; - markedly depressed mood; or - marked anxiety or tension. The symptoms must cause clinically significant...