Investigations

1st investigations to order

prospective symptom diary

Test
Result
Test

If cyclical symptoms are not found, physician should consider other diagnoses such as mood and affective disorders or substance abuse.

Result

symptom predominance in the luteal phase and symptom-free interval between menses

Investigations to consider

thyroid function tests

Test
Result
Test

Should be a routine screening test.

Result

normal

follicle-stimulating hormone levels

Test
Result
Test

Indicated if menopause or perimenopause is a differential diagnosis, although interpretation is limited due to variability during the perimenopause.

Result

normal

depression screening

Test
Result
Test

Use of a validated depression screening questionnaire such as the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression (HAD) Scale, or Beck Depression Inventory can help assess for the presence and severity of symptoms of depression.

Result

may indicate depression

FBC

Test
Result
Test

FBC may be considered if fatigue is a major symptom, especially in women who have heavy menstrual bleeding.

Result

normal (anaemia should be corrected)

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