The prevalence and symptoms of premenstrual syndrome (PMS) were studied in a survey using a random selection of fertile women (n = 1,852). The prevalence of PMS was 72.8%. 7.5% of the women with PMS felt they needed to see a physician. The survey responses from this latter group were compared with the answers from the remaining women with PMS. The symptoms differ significantly in many respects between the groups. Women who want to see a physician report, to a greater extent, symptoms during the premenstrual period which are seen in depressive states. Oral contraceptives do not seem to affect premenstrual symptoms in this group. The results suggest that severe premenstrual symptoms of predominantly depressive nature are probably a manifestation of an underlying depressive disorder.