Utilize and download this PMDD test to track your patient’s symptoms and their severity to determine if they have a premenstrual dysphoric disorder.

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What is a PMDD Test?

PMDD, or premenstrual dysphoric disorder, is a condition in which a woman experiences physical and behavioral symptoms more severe than those with PMS. Some of them are severe depression, anxiety, and constant irritability. Similar to those with PMS, the symptoms occur a week before menstrual bleeding and usually disappear or lessen in severity a few days after their period begins. Here’s a list of possible symptoms your client may experience:

  • Depression
  • Anxiety
  • Nervousness
  • Mood Swings
  • Insomnia
  • Cramps
  • Severe Fatigue
  • Anger
  • Confusion

There’s no single cause for premenstrual dysphoric disorder. It can be a mix of the chemicals in one brain and hormones in one’s body as well as other factors such as alcohol or substance abuse, weight, family medical history, and poor lifestyle.

Currently, no physical exam, lab test, or standardized test can diagnose PMDD. However, it is possible to rule out other diagnoses with a symptom tracker, such as our template.

Our version of a “PMDD test” comes complete with questions on diet, lifestyle, and medical history, as well as a symptom checker and tracker. And though it can’t be used to diagnose the disorder, you can use it as a resource to require your patient to do further examination, testing, etc.

Printable PMDD Test

Download this PMDD Test to assess your patients for premenstrual dysphoric disorder.

How does this PMDD Test work?

Step One. Download the Template

Click the “Download template” or “Use Template” button located above or search for “PMDD Test” in Carepatron’s template library on the app or website. 

Step Two. Fill Out the Needed Information

At the top, don’t forget to write down the following information: date, patient’s name, date of birth, age, gender, and the physician’s name. 

Step Three. Conduct a Short Interview

You may conduct a short interview during the initial consultation to partially fill out the template. We’ve provided guide questions to help you gather information regarding their diet, lifestyle, and medical history. 

Step Four. Provide Instructions to the Patient

Once you’re finished with your interview, you may give the template to your patient and give the following instructions:

  • Under the symptom checklist, tick the symptoms you are experiencing, whether that’s mild or severe. 
  • Proceed to the symptom chart and write down the start date. 
  • Write down the symptoms you checked previously under the symptom column. 
  • Track your symptoms as soon as your period begins. Score them according to the scoring guide provided. Do this every day. 
  • After you’ve filled out the table, set another consult appointment to go over the results. 

PMDD Test Scoring

Each number in the symptom scoring table is equivalent to a certain pain severity. To score, simply choose the number equal to the pain level you’re experiencing per symptom and write it down on the symptom row and the corresponding day.

PMDD Test Example

Here’s a PMDD test example you and your patient can use as a guide for filling out your own template.

Download this PMDD Test Example (Sample) here:

PMDD Test Example

When to use this PMDD Assessment?

There are several situations where you can utilize this PMDD assessment template. However, before you administer one, it’s ideal that your patient meets at least one of the following criteria: 

  • Expressing concerns about experiencing PMS symptoms or worse.
  • They’ve done a complete physical exam, including a pelvic exam, tested their thyroid, and undergone a mental health evaluation.
  • When they have a family history of PMS/PMDD, mood disorders more specifically depression, and if they have the inclination to use substances such as cigarettes and tobacco. 

Though it is ideal, you can still administer the test wherever you see fit. 

Do remember that this PMDD is a tracker and should not be used as the sole resource for diagnosing PMDD. It’s best to ask your patient to do additional consultation or do further tests to eliminate other possible diagnoses. 

Who is this PMDD test PDF for?

This test is for anyone who thinks that answering it may help explain the symptoms they are experiencing. Medical practitioners who may use this as a base or additional resource and benefit from it are:

  • Gynecologists
  • Physician’s Assistants
  • Primary Care Doctors
  • Nurse Practitioners
  • Mental Health Physicians
  • Endocrinologists

Aside from them, since this test doesn’t necessarily have to be answered by the practitioner alone, aside from the patient, their loved ones, such as their partner, friends, or family may answer on the patient’s behalf in situations when the partner needs assistance.

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Commonly asked questions

How to interpret the PMDD Test?

Interpretation of the individual scores is dependent on the patient’s understanding of the symptom scoring. The scores and their corresponding severity are written down in the table on the template. Generally, the higher the number, the more painful the symptom is and the more it interferes with daily life.

What does PMDD Test measure?

Aside from gathering information on one’s medical history, the PMDD test we’ve created measures the pain severity of the symptoms the patient is experiencing.

How to administrate PMDD Test?

One can begin the process of administering the PMDD test during the first consultation. However, unlike other tests, it can only be deemed finished if the patient fills up the 30 or 31 days religiously and comes back for a consultation where you, the practitioner, and the patient go over the results.

Benefits of Free PMDD Test

Monitor Severity of Symptoms

One of the main components of our PMDD test template is our symptom chart. On it, you or your patient can easily and efficiently monitor the severity of the symptoms experienced. 

Improve Communication

When patients are unsure where to start when talking about themselves or their experience, having a guide with prompts, such as the PMDD test, can be helpful. They’re more likely to open up and share exactly what you need to help them with a possible treatment plan. 

Early Detection and Prevention

Tests with questions and trackers such as ours can be helpful in early detection and prevention, especially for conditions that don’t have standardized tests yet. And even though the test is not a diagnostic tool, it’s still helpful in determining whether or not the patient needs intervention and how to go about doing that. 

Fully Digital

Trackers come in many forms, such as printed sheets, notebooks, and even apps. The benefit of having a fully digital PDF test like ours is that it doesn’t use much storage and is easily editable on Carepatron or a PDF editor. Moreover, it’s accessible anytime and anywhere on any gadget you have on hand. 

Saves Time and Money

For practitioners, our template saves you both time and money because you don’t have to start from scratch, and everything you need to edit and store the results of this form is available for free on Carepatron. 

For patients, on the other hand, there’s no need to pay to sign up on an additional app or even buy a notebook and create a tracker from scratch. 

Why use this PMDD Test app

We understand that balancing information gathering, connection building, and delivering patient care can be challenging for practitioners all over the world. But it doesn’t have to be, especially if you automate administrative tasks and streamline both clinical and business processes using Carepatron.

Carepatron is a leading practice management software in the healthcare industry available as an app you can download on your desktop and mobile devices. In this single app, you can:

  • Discover, use, and edit over 100 free, editable PDF templates of tests, surveys, forms, and assessments, including the PMDD test.
  • Store your digital medical notes, medical bills, and other needed documents in a HIPAA-compliant and secure EHR.
  • Set up an automated payment system for your client.
  • Integrate and access your favorite scheduling and telehealth software applications.

Get access to all these means, tools, and features for free if you sign up at Carepatron today!

Electronic Health Records Software
How to interpret the PMDD Test?
How to interpret the PMDD Test?
Written by
Patricia Buenaventura
Patricia Buenaventura

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