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Back to Premenstrual syndrome

Self-assessment test: How severe is your premenstrual syndrome?

Answer this questionnaire about your last cycles and you will instantly get an assessment of the complexity and severity of your premenstrual syndrome; we will also email it to you.

Your answers, without your name or email address, support the research on PMS and PMDD that the doctor carries out with DISFEM.

It is a guidance tool: it does not replace a medical assessment.

About you

You can use a name or a nickname; the email address must be correct, though, because that is where we will send your result. If it does not arrive, check your spam folder.

Which of the following symptoms have you suffered from in your last cycles?

Tick all that apply.

How much discomfort, disability or suffering are you experiencing due to the symptoms you have selected?
0 · No discomfort at all10 · Extreme suffering
How many days per month on average have you suffered those symptoms in your last cycles?
days per month
Which of the following minor symptoms have you suffered from in your last cycles?

Tick all that apply. If you have had none, leave it blank.

Have you had self-inflicted injuries, suicide attempts or suicidal thoughts during the premenstrual phase of your last cycles?
Some patients schedule their lives or activities on the basis of PMS symptoms. To what extent is this true in your case?
0 · I don't have my symptoms in mind10 · PMS completely determines my life
To what extent do your symptoms affect your social, family or work relations?
0 · My relations are normal10 · My symptoms completely distort my relations
Are you forced to stop attending your work or studies due to your symptoms?
How would you rate your overall sexual desire? Consider 5 as the normal average.
0 · Absent10 · Extreme
During which phase of your menstrual cycle do you feel most sexually excited?
How many orgasms per month on average have you had in the last months? (any kind of stimulation counts)

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