Premenstrual syndrome (PMS) is a heterogeneous concept that presents a challenge to researchers and clinicians alike, in terms of definition and treatment. This study explores the perceptions and beliefs of women who were seeking help for PMS. A wide range of symptoms and emotional experiences was described, and a high level of distress reported. Both psychological and hormonal causal attributions were acknowledged, and the women expressed preferences for both psychological and hormonal treatments from the clinic. A biopsychosocial model is advocated in the assessment and treatment of women who seek help for self-reported PMS.