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Background
Premenstrual syndrome (PMS) is a condition in which various symptoms occur repeatedly 3–10 days prior to each menstrual bleeding cycle [1]. The most common symptoms include breast tenderness; bloating; headache; and mood-related changes such as mood swings, depression, anxiety, anger, and irritability. Premenstrual dysphoric disorder (PMDD), a severe form of PMS, is characterized predominantly by clinically significant emotional and affective symptoms, such as mood swings, depression, anxiety, anger, and irritability, that are not attributable to another psychiatric condition [2, 3]. PMS and PMDD are significant health problems in menstruating women. The American Psychiatric Association initially introduced PMDD as a research criterion in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1994 [4]. Subsequently, PMDD was categorized in the DSM-5 using depressive disorders as part of its diagnostic criteria [5]. PMS/PMDD symptoms fluctuate across cycles and require prospective tracking for an accurate diagnosis. Therefore, current guidelines recommend using a daily symptom chart recorded over at least two menstrual cycles [5, 6–7]. According to a recent meta-analysis, the global prevalence of PMS is high, and approximately half of the women of reproductive age experience PMS [8]. Global PMS/PMDD prevalence estimates vary significantly by study methodology. Western prospective studies report PMS around 20–30% and PMDD prevalence around 3–8% [9], reflecting the predominant research focus on these populations. Comparatively limited data exist for Asia; examples include Japan (5.3% moderate-to-severe PMS / 1.2% PMDD, retrospective) [10] and China (21.1% PMS / 2.1% PMDD, prospective) [11]. Although these Asian PMDD rates appear closer to the lower end of Western estimates, methodological variations (e.g., study design, questionnaires, recall period) and data scarcity prevent definitive conclusions regarding regional disparities [12]. Consistent, prospective research across diverse populations is therefore warranted.
The conditions of PMS/PMDD range from pre-treatment health problems to treatment-resistant serious illnesses, all of which reduce the health-related quality of life. Given the increasing availability of both medical and non-medical healthcare services for PMS/PMDD, as well as the fact that symptoms include psychological components, patient-reported outcomes have become vital for assessing symptom presentation, determining the necessity of therapeutic interventions, and evaluating their effectiveness. Various patient-reported outcome measures (PROMs) have been developed to evaluate PMS/PMDD in Japanese populations based on study objectives; however, neither the quality of...