PMS vs PMDD

If you’ve ever felt bloated, irritable, a smidge more tired than usual, or just not quite your usual self in the days leading up to your period, worry not, you aren’t alone. 

An estimated 80% of menstruators experience premenstrual symptoms throughout their cycle, but for some, these symptoms go a little further than a bit of moodiness or discomfort – and that’s where Premenstrual Syndrome (aka PMS) and Premenstrual Dysphoric Disorder (aka PMDD) come in. 

While these two conditions sound similar, they have very different symptoms, causes, and impacts on our bodies and lives. Understanding their differences is the key to identifying what it is you may be facing, and how you can manage it. 

Ready to understand exactly what it is that sets these two conditions apart? Let’s get started. 

What is PMS? 

Premenstrual Syndrome, or PMS, is what many of us can likely agree feels like an unwanted guest that appears before your period does. We like to think of PMS as a mix of emotional, behavioural, and physical symptoms that signify that your period is on its way, occurring during the late luteal phase of the menstrual cycle. Symptoms typically begin to ease after the onset of menstruation. 

While PMS is common, it’s important to note that its symptoms vary from person to person, with some experiencing mild discomfort and others experiencing more severe symptoms. Studies have found that there are more than 200 (yep, you read that right!) symptoms of varying severity that have been associated with PMS. 

If you’re experiencing PMS symptoms that are disrupting your daily life, it could be a sign of something more serious. If something doesn’t feel right, we recommend reaching out to an expert in women’s health for a second opinion. 

What is PMDD? 

Meet Premenstrual Dysphoric Disorder, or PMDD — a severe and clinically recognised condition that affects up to 8% of the population and can impact personal relationships, work, and more. 

While PMS affects menstruators in the weeks or days leading up to their periods, PMDD is a mood disorder that causes significant physical, behavioural and emotional symptoms, such as extreme range and anger, hopelessness, and even suicidal thoughts. Believed to be triggered by an extreme sensitivity to hormonal shifts during the luteal phase, PMDD can make even the most mundane everyday task feel impossible. 

Unlike PMS, symptoms of PMDD can remain long after your period arrives, having a lasting impact on your day-to-day life. Research has found that those living with PMDD experience an average of 6.4 days of severe symptoms per menstrual cycle – that’s roughly a whopping 21% of the month, and the equivalent of 8 total years of debilitating symptoms throughout the menstrual cycle.

If you suspect that your symptoms are going beyond PMS in the lead up to your period, trust your gut. Speaking to a women’s health expert can make all the difference. A second opinion from a specialist in PMDD and PMS can help you find the right treatment plan and get back to feeling like yourself again. 

PMS vs PMDD Symptoms 

While PMS and PMDD do share some similarities, the intensity of the symptoms experienced is what truly sets these two conditions apart. Let’s break it down a little more: 

Symptoms of PMS 

• Physical symptoms: including bloating, breast tenderness, mild headaches, fatigue, and lower back pain. 
• Mood changes: you may experience mood swings, heightened emotions, and mild irritability. 
• Energy levels: think a general lack of energy and feelings of tiredness.
• Behavioural changes: can include changes in appetite and sleeping patterns. 

Symptoms of PMDD 

• Physical symptoms: while you may experience similar symptoms to PMS, such as bloating, breast tenderness, and headaches, in PMDD these symptoms are often more severe, leading to extreme fatigue and pain. 
• Severe mood changes: intense irritability, sadness, or hopelessness that can feel overwhelming. Mood swings are typically more dramatic with a sudden onset and often feel uncontrollable. Feelings of extreme anger or rage can also occur. 
• Extreme fatigue: different from a slight lack of energy, extreme fatigue may leave you feeling drained and unable to function due to extreme tiredness.  
• Emotional distress: Depression and suicidal thoughts can be present, as well as feelings of worthlessness or detachment from reality, seriously impacting mental health and quality of life. 
• Other symptoms: Joint pain, migraines, difficulty concentrating (brain fog), sleep disturbances (such as insomnia or excessive sleep), and digestive issues like nausea or changes in appetite. 

While PMS symptoms are likely to make you feel uncomfortable and irritated, research has found that PMDD symptoms can seriously disrupt your daily life to the point it may be hard to work, engage in social activities, take care of yourself, or complete everyday tasks. 

Along with the physical symptoms, the emotional toll of PMDD can also lead to feelings of isolation and helplessness. If your symptoms are feeling a little more severe than the usual PMS symptoms, we encourage you to speak to an expert who specialises in women’s health conditions. Because no one deserves to suffer in silence. 

Causes of PMS 

While the exact cause of PMS isn’t fully understood, studies have found that there may be a link between PMS symptoms and the hormonal changes we experience throughout our menstrual cycles.  

The nitty gritty? Every 28 or so days, our bodies experience fluctuations in our oestrogen and progesterone levels – the two main hormones responsible for regulating our cycles. As these two hormones rise and fall, they can have an effect on our brain chemicals, including serotonin, which helps to regulate mood and can lead to heightened anxiety and irritability. 

When serotonin levels drop in the luteal phase, it can lead to irritability, mood swings, changes in behaviour, and other emotional symptoms that we commonly associate with PMS.

But our hormones don’t just impact our emotions. Physical symptoms like bloating, breast tenderness, and fatigue are also suggested to be related to the hormonal shifts that occur during our luteal phase (the two weeks before our period). 

Beyond just our hormones, other factors that can contribute to PMS symptoms include: 

Diet and lifestyle

Poor nutrition, lack of exercise, and inadequate sleep can all play a part in worsening PMS symptoms. A diet high in sugar, salt, and caffeine, as well as a sedentary lifestyle, can contribute to bloating, mood swings, and fatigue. 

Incorporating consistent physical activity into your routine and consuming a nutrient-dense, balanced diet can help to alleviate some of these symptoms.

Genetics 

Research has shown that PMS may run in families, suggesting a genetic predisposition. If close family members experience PMS symptoms, it’s more likely that you may also experience similar symptoms throughout your cycle. 

Stress

Elevated stress levels can worsen PMS symptoms, including mood swings, irritability, and fatigue. Chronic stress may also contribute to hormonal imbalances, making it harder for the body to regulate the menstrual cycle and associated symptoms.

Causes of PMDD 

PMDD is even more complex, with researchers still working to fully understand its causes. Some theories have identified that the following key factors could be playing a more integral role in the condition than we might have initially thought. 

Hormonal fluctuations 

Similar to her sister-condition PMS, PMDD is also thought to be influenced by hormonal changes, particularly the dramatic shift in our oestrogen and progesterone levels during the luteal phase of our menstrual cycles. 

In PMDD, the body’s response to these hormones may result in severe mood changes, fatigue, emotional changes, and difficulties sleeping. 

Serotonin imbalances 

Serotonin (aka the brain’s feel-good messenger) plays a big role in mood regulation and is a key player in PMDD. Throughout our cycles as our hormone levels rise and fall, serotonin levels can also take a hit – dipping lower than usual. 

When serotonin levels take a hit, so does our mood. Cue intense mood swings, anxiety, sadness, irritability, and feelings of helplessness and sadness. 

Genetics 

If PMDD or PMS runs in your family, research suggests that your genetics could play a role in you experiencing similar symptoms.

Research has found that genetics can play a role in how our bodies respond to hormonal shifts – meaning your symptoms aren’t just in your head. They could very well be in your DNA. 

Lifestyle factors 

Whether it be excessive stress, a lack of sleep, consuming too much caffeine, or not moving your body enough, studies have found that your daily life can also impact the already crippling symptoms of PMDD.  

Existing mental health conditions 

PMDD doesn’t always show up alone. It can also be associated with mental health conditions like depression, anxiety, or bipolar disorder – which can make handling emotional symptoms even tougher to handle. Getting the right support not only benefits your mental health, but it can also make a huge difference in how you manage the symptoms of PMDD.

When to seek help from your doctor 

To make a long story short, both PMS and PMDD can make that time of the month feel extra challenging. But what exactly are the warning signs that show you what you’re experiencing could be more than just a rough cycle? 

When to seek help from your doctor for PMS: 

Wondering whether your PMS symptoms are considered ‘normal’, or could be something more? If any of these sound familiar, it could be time for you to book a doctor’s appointment.

• If your symptoms are becoming more intense month after month.
• If lifestyle changes such as managing your stress, dietary changes, or exercising more aren’t alleviating your symptoms. 
• If your symptoms begin to impact your everyday life and make it hard for you to function as you normally would.

When to seek help from your doctor for PMDD: 

Not sure if the symptoms you’re experiencing could be PMDD? Here’s when we recommend you consider seeking medical support. 

• If your emotional symptoms feel all-consuming, you experience severe mood swings, hopelessness, depression, and anxiety, and everyday life feels like a struggle. 
• If you experience difficulty concentrating or feel mentally foggy. 
• If your physical symptoms are so intense that they prevent you from doing everyday activities like going to school or work or participating in social situations. 
• If you experience thoughts of suicide or harming yourself. It’s incredibly important to seek support immediately if you experience thoughts of this nature. Remember, you don’t have to go through it alone. 

Even if you’re unsure whether you could be experiencing symptoms of PMS or PMDD, we always recommend talking to a healthcare provider who specialises in Women’s Health. 

These experts can help identify exactly what’s going on, rule out any other conditions, provide you with a diagnosis, and establish a treatment plan that works for you. 

Remember, reaching out for help is never a sign of weakness. You deserve to feel like yourself again, and you deserve to access support when you need it most. 

Treatment and Management for PMS vs PMDD

Managing PMS and PMDD can look a little bit different for everyone. But the good news is that there are still ways you can take back control and start feeling like yourself again. 

Treatment and Management for PMS 

For many, PMS symptoms can be managed with lifestyle changes and treatments, including: 

Moving your body 

Regular exercise can help to boost your mood, lift your energy levels, and help keep your PMS symptoms in check. If joining a run club or completing a HIIT workout isn’t your thing, fear not. A short walk every day or even gentle stretches can work wonders. 

Fuel your body with nutrient-dense, whole foods 

Studies have shown that eating a balanced diet rich in whole foods, fibre, and healthy fats can stabilise your blood sugar and reduce symptoms of PMS. Reducing your caffeine, sugar, and salt can also ease bloating and symptoms. 

Manage your stress

We know, we know, stressing less is easier said than done. However, finding the time to relax (whether it’s for 5 minutes or 5 hours) can help reduce the emotional symptoms of PMS. Whatever your preference is, journalling, meditation, yoga, going for a walk, or cozying up with a good book, we recommend taking some time out of your day to wind down. 

Supplements 

You may find relief from fatigue and tiredness with magnesium, vitamin B6, or calcium supplements. As with every new medication, we recommend speaking with your doctor first before getting started on any supplements. 

Over-the-counter medications 

Over-the-counter painkillers such as Ibuprofen and Paracetamol can help to ease cramps and headaches. 

Treatment and management for PMDD

Treatment for PMDD often requires a combination of medical and lifestyle strategies to successfully manage your symptoms. These can include: 

Hormonal treatments 

Hormonal treatments, including hormonal contraception, can help to stabilise your hormones as they fluctuate throughout your cycle. Combined hormonal contraceptive pills have been shown to significantly improve the emotional and physical symptoms of PMDD in some patients. 

Antidepressants 

Since studies have linked PMDD to serotonin imbalances, medications like Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) may be beneficial for some people as they can help to regulate mood, ease depression, and alleviate symptoms of anxiety. 

Cognitive Behavioural Therapy (CBT) 

Speaking to a therapist or psychologist gives you a chance to share what’s on your mind with someone who truly understands women’s health, and what you’re going through. Cognitive Behavioural Therapy (aka CBT) is a form of talk therapy that can help you to manage stress, learn coping strategies, shift negative thought patterns, and manage the emotional rollercoaster of PMDD. 

The same lifestyle changes that help with PMS (think exercise, reducing stress, and practicing self-care) can also reduce the symptoms associated with PMDD. 

The truth is, managing PMS and PMDD can look a little different for everyone. But the good news is that with the right support system and treatment plan, you can find relief from your symptoms and get back to feeling like yourself again, faster. 

The Bottom Line 

Yes, PMS and PMDD may share some similar symptoms. But when it comes to their impact and how to manage them, that’s where the similarities end. While PMS is a common part of the menstrual cycle for many uterus-havers, PMDD is a more severe condition that has the ability to seriously impact your life. 

Whether it’s lifestyle tweaks, natural therapies, conventional medicines, speaking to a psychologist, or a different path there are ways to manage your symptoms and regain control of your symptoms, whether you’re facing PMS or PMDD. 

The most important thing we want you to remember is that you don’t have to just accept your symptoms as normal, or suffer alone in silence. If you suspect something just isn’t quite right, or you’re unsure if your symptoms could be associated with PMS or PMDD, we recommend reaching out for advice. 

You deserve support, you deserve answers – and you deserve it now. There’s no shame in seeking support to make that happen.