To establish the necessary elements of a program of evaluation and treatment of premenstrual syndrome, the medical and psychologic characteristics of 68 consecutive women presenting because of premenstrual symptoms were determined and compared with those of a similar group of 34 women without premenstrual symptoms (control group). Women with premenstrual symptoms exhibited a significantly greater frequency of previously undetected medical, psychologic, and marital problems than did controls. These findings demonstrate the need for a multidisciplinary comprehensive program of evaluation and treatment of the medical, psychologic, and mental health of women who present because of moderate-to-severe premenstrual symptoms.