How to Use Floriva for PMDD Tracking and Documentation

PMDD diagnosis under DSM-5 requires prospective daily data across 2 cycles. How to use Floriva to log what clinicians need and export it for an appointment.

PMDD is a DSM-5 diagnosis that requires prospective, daily, symptom-severity data across at least two cycles. Retrospective recall is not sufficient. The criteria specifically require documented improvement in the follicular phase compared to the luteal phase. Floriva's daily logging and cycle-phase tracking creates exactly this record. This guide covers how to configure your symptom fields, what severity scale to use, and how to organize the data for a clinical appointment.

Why Daily Data Is the Clinical Requirement

PMDD carries a stigma of being dismissed, classified as "just PMS," treated as normal emotional variation, or attributed to stress. One reason clinicians sometimes hesitate is the absence of documented evidence. The DSM-5 diagnostic criteria directly address this by requiring prospective daily symptom ratings across two cycles. That's not a bureaucratic hurdle; it's the evidence base.

When you bring two cycles of consistent, daily, phase-annotated symptom data to a psychiatric or gynecological appointment, you are providing exactly what the diagnostic standard asks for. That shifts the appointment from "patient reports feeling bad before her period" to "documented luteal-phase symptom elevation with follicular remission across two cycles."

Floriva stores that data on your device. No third party holds your psychiatric symptom history.

What the DSM-5 Criteria Actually Require

For PMDD, the DSM-5 specifies:

Five or more of eleven listed symptoms, with at least one being a core affective symptom (mood lability, irritability/anger, depressed mood, or anxiety/tension)
Symptoms present in most menstrual cycles during the past year
Symptoms that improve within a few days after menstruation onset
Symptoms that become minimal or absent the week post-menses (the follicular phase)
Symptoms severe enough to cause clinically significant distress or functional impairment
Confirmed by prospective daily ratings for at least two symptomatic cycles

The follicular remission requirement is what distinguishes PMDD from persistent depression with premenstrual worsening. Your Floriva data needs to capture both the luteal peak and the follicular baseline.

Step 1: Configure Your Symptom Fields

In Floriva's symptom settings, create fields for each of the DSM-5 PMDD symptom categories you experience. The eleven DSM-5 symptoms are:

Marked affective lability (mood swings, sudden sadness, tearfulness)
Marked irritability, anger, or interpersonal conflict
Markedly depressed mood, hopelessness, or self-deprecating thoughts
Marked anxiety or tension ("on edge" feeling)
Decreased interest in usual activities
Difficulty concentrating
Fatigue or lack of energy
Appetite changes, food cravings, or overeating
Hypersomnia or insomnia
Feeling overwhelmed or out of control
Physical symptoms: breast tenderness, bloating, joint/muscle pain, weight gain feeling

You don't need to create all eleven fields if you only consistently experience six or seven. Create fields for the symptoms that are part of your regular luteal experience. Add a "functional impairment" field as well, note whether symptoms affected work, relationships, or daily activities on that day.

Step 2: Set a Consistent Severity Scale

Every symptom field should be logged on the same numerical scale. Use 0-3:

0: Absent, symptom not present
1: Mild, present but not disruptive
2: Moderate, noticeably affects functioning or mood
3: Severe, significantly impairs functioning

Log this scale every day for each symptom you're tracking, even on follicular days when all scores are 0. The follicular 0s are not empty data, they are the comparison baseline the diagnosis requires. A chart that shows ten days of 0s followed by twelve days of 2s and 3s followed by two more days of 0s is the visual representation of PMDD that a clinician is looking for.

Step 3: Log Every Day, Same Time

Daily consistency is the entire point of prospective tracking. Missing days introduces gaps that weaken the data. Set a recurring reminder in your phone, evening is often easiest, when you can reflect on how the day went.

Log even on days when symptoms are zero. Log even when you're traveling or busy. A 60-day log with three missed days is still clinically usable. A 60-day log with gaps clustered around menstruation or around your best follicular days can create a misleading picture.

If you miss a day, add a retroactive entry with a note flagging that it was logged the following day. This transparency makes the data more credible, not less.

Step 4: Mark Cycle Phase Transitions

Floriva annotates your daily entries with cycle phase based on your logged period dates. When your period starts, log it immediately. This marks the transition from luteal to menstrual phase and starts the follicular clock. When your period ends, log that too.

If you observe ovulation signs (a BBT thermal shift, a positive LH strip, egg-white cervical mucus), log them. This anchors the luteal phase start to a real event rather than an estimate. For PMDD documentation, knowing exactly when your luteal phase begins and how many days into it symptoms start is clinically relevant data.

Step 5: Note Functional Impairment Specifically

Symptom severity alone meets one part of the diagnostic criteria. Functional impairment meets another. When symptoms are at moderate or severe levels, add a short notes entry describing the impairment: missed a work deadline, canceled plans with friends, had a significant conflict that felt uncharacteristic, couldn't complete routine tasks.

This qualitative data sits alongside your severity scores. A day logged as 3/3/2/3 across four symptom fields, combined with a note that you left work early and couldn't complete a presentation, builds a clinical picture that numerical scores alone don't fully convey.

Step 6: Prepare a Follicular vs. Luteal Comparison for Your Appointment

Before your clinical appointment, pull two cycles of data from Floriva and prepare a comparison table. For each cycle, list:

Cycle length and period dates
Luteal phase days (from estimated or confirmed ovulation to period start)
Average symptom severity in the follicular phase (days 6-12 or similar)
Average symptom severity in the late luteal phase (5 days before period through day 1)
Days with noted functional impairment

Present this as a table on paper or printed from a screenshot. Two cycles of this comparison is the minimum. Three is cleaner for establishing a pattern.

Also note whether the PMDD pattern was present in both cycles or just one. If it appeared in both, the consistency strengthens the diagnostic picture.

PMDD vs. PME: What the Data Shows

If your follicular-phase scores are consistently 0 or 1 across all symptom fields, your data is consistent with PMDD, symptoms are genuinely absent or minimal outside the luteal window.

If your follicular-phase scores are 1-2 for mood, anxiety, or concentration on most days, even if luteal scores are significantly higher, your data pattern is more consistent with Premenstrual Exacerbation. This distinction is important to flag with your clinician because it changes the treatment approach: PME often requires treating the underlying condition more directly, not just addressing the premenstrual window.

Your Floriva data can show this distinction clearly. Don't interpret it yourself before the appointment. Bring the data and describe what you observe.

What This Means for You

PMDD can be genuinely disabling, and it's often under-diagnosed or misidentified. Two cycles of prospective daily symptom data in Floriva gives you the specific type of evidence the DSM-5 diagnostic standard requires. That data is not clinical advice and it doesn't replace a diagnosis, but it is the foundation that makes a confident diagnosis possible.

All of it stays on your device. Your symptom severity logs, your functional impairment notes, and your luteal vs. follicular comparison all exist only on a device you control.

Quick answers to the obvious questions.

Why does PMDD require prospective data rather than just describing symptoms to a doctor?

The DSM-5 criteria for PMDD require that symptoms are confirmed by prospective daily ratings for at least two symptomatic cycles. This requirement exists because research shows people systematically overestimate premenstrual symptoms when asked to recall them after the fact, especially after a difficult cycle. Prospective logging means recording symptoms each day as they happen, which controls for that bias. A doctor cannot make a confident PMDD diagnosis from verbal description alone. The data record is part of the diagnostic process.

What is the difference between PMDD and PME?

PMDD is a primary condition where symptoms appear only in the luteal phase and resolve after menstruation begins. Premenstrual Exacerbation (PME) describes an underlying condition such as depression, anxiety, or ADHD that worsens premenstrually but is present throughout the cycle. The distinction matters clinically because treatments differ. The follicular-phase data in your Floriva log is what separates the two. If symptoms are absent or minimal in the follicular phase, the pattern is consistent with PMDD. If symptoms persist in the follicular phase at a lower but still significant level, PME is more likely.

How many cycles of data do I need before seeing a doctor about PMDD?

Two complete cycles of prospective daily data meets the DSM-5 minimum. Three cycles is more persuasive because it reduces the chance that the second cycle's pattern was an outlier. If you've already tracked one cycle and noticed a clear luteal pattern, continue logging through at least one more complete cycle before bringing data to an appointment. Start now. Every day you don't log is a day you'll have to repeat.

Can I use this data to support a medication request?

Yes. Documented prospective data showing consistent luteal-phase symptom elevation with follicular-phase remission is strong clinical support for PMDD treatment discussions. SSRIs, particularly fluoxetine and sertraline, are first-line treatments for PMDD and are often prescribed on a luteal-phase dosing schedule. Talk to your prescriber about what the data shows. Severity and timing are the two variables that guide dosing decisions.