Red Flags & When to Go In Person for Premenstrual Syndrome (PMS) / PMDD - Management

Audience: adult

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are common conditions that affect many people before their menstrual periods. Symptoms can include mood changes, irritability, fatigue, and physical discomfort. Most people manage these symptoms with lifestyle changes and over-the-counter remedies. However, some symptoms may signal a need for in-person medical care. This guide helps you understand when to seek urgent or routine care in person. Telemedicine can support education, symptom tracking, and some management advice, but it cannot replace a full physical exam or urgent evaluation. Knowing the red flags and how telemedicine fits into your care can help you get the right support when you need it.

Red flags — go in person / ER

• Severe depression or suicidal thoughts — seek emergency care immediately.
• Sudden worsening of symptoms that disrupt daily life — arrange urgent in-person evaluation.
• New symptoms like chest pain, fainting, or severe headaches — seek emergency medical attention.

What telemedicine can do

• Education about PMS and PMDD
• Symptom tracking and monitoring
• Guidance on lifestyle changes and over-the-counter treatments
• Routine follow-up and medication management advice

What telemedicine cannot do

• Emergency evaluation of severe symptoms
• Physical examination and diagnostic testing
• Management of suicidal ideation or severe mental health crises
• Treatment requiring immediate medical intervention

Understanding PMS and PMDD

PMS includes a variety of physical and emotional symptoms that occur in the days before your period. PMDD is a more severe form of PMS with significant mood changes that affect daily life. Symptoms often improve once your period starts. Common signs include irritability, sadness, anxiety, bloating, breast tenderness, and fatigue. These symptoms typically follow a pattern linked to your menstrual cycle.

When to Use Telemedicine for PMS/PMDD

Telemedicine can help you learn about PMS and PMDD, track your symptoms, and discuss lifestyle changes or over-the-counter options. It is useful for routine follow-ups and managing mild to moderate symptoms. Your healthcare provider may suggest ways to reduce stress, improve sleep, or adjust diet and exercise through virtual visits.

Red Flags That Need In-Person Care

Certain symptoms require prompt in-person evaluation. These include:

If you experience any of these, seek emergency or urgent care immediately.

Preparing for Your Telemedicine Visit

Before your telemedicine appointment, prepare by:

After Your Telemedicine Visit

After your visit, follow your provider’s advice carefully. This may include:

When to Seek Routine In-Person Care

If symptoms persist despite treatment, or if your provider suspects other health issues, an in-person visit may be needed for:

How to prepare for your tele-visit

• Keep a detailed symptom diary including mood and physical symptoms with dates.
• List all current medications and supplements.
• Prepare any questions or concerns to discuss.
• Find a quiet, private space for your telemedicine visit.
• Test your device’s camera and microphone before the appointment.

After your tele-visit

• Follow your healthcare provider’s recommendations carefully.
• Implement suggested lifestyle changes such as stress reduction and sleep improvement.
• Take medications as prescribed and report any side effects.
• Schedule follow-up visits as advised.
• Seek in-person care promptly if red flag symptoms develop or worsen.

FAQs

What is the difference between PMS and PMDD?

PMS includes mild to moderate physical and emotional symptoms before your period. PMDD is a more severe form with intense mood changes that significantly affect daily life and functioning.

Can telemedicine help me manage my PMS symptoms?

Yes, telemedicine can provide education, help track your symptoms, and guide lifestyle changes or medication management for mild to moderate symptoms.

When should I see a doctor in person for PMS or PMDD?

You should seek in-person care if your symptoms suddenly worsen, do not improve with treatment, or if you experience severe depression, suicidal thoughts, or other serious symptoms like chest pain or fainting.

Are there effective treatments for PMDD?

Yes, treatments may include lifestyle changes, medications such as antidepressants or hormonal therapies, and counseling. Your healthcare provider can help determine the best approach.

Is PMS a mental health condition?

PMS includes both physical and emotional symptoms. PMDD has a stronger mood component and may require mental health support, but PMS itself is not solely a mental health disorder.

Sources

1. Premenstrual Syndrome (PMS) — MedlinePlus, U.S. National Library of Medicine.
2. Premenstrual Dysphoric Disorder (PMDD) — Mayo Clinic.
3. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) — Centers for Disease Control and Prevention (CDC).
4. Premenstrual Syndrome (PMS) and PMDD: Treatment and Management — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience severe symptoms or emergency signs, seek immediate medical attention in person.