Rest Of Each Cycle in Medicine / Internal Medicine — 34yo Woman | Psychiatry | SMLE Q#11244

SMLE Question #11244

Medicine / Internal Medicine Psychiatry

Objective: OBJ-253

Last updated: February 2026
A 34-year-old woman reports 6 months of recurrent symptoms that begin 5–7 days before menstruation: throbbing bifrontal headaches, marked irritability, breast tenderness, bloating, and difficulty concentrating. Symptoms resolve within 1–2 days after menstrual bleeding starts, and she feels well for the rest of each cycle. Her menses are regular every 28 days, and a urine pregnancy test is negative. What is the most likely diagnosis?

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