Most women experience some physical or emotional changes before their period. For many, these symptoms are mild and manageable. However, for others they can become severe enough to affect relationships, work, family life and mental wellbeing.
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are medical conditions that deserve more recognition, understanding and appropriate treatment. While both are linked to the menstrual cycle, PMDD is a much more severe condition that can have a profound impact on quality of life.
Understanding the difference between PMS and PMDD is the first step towards getting the right support.
What is PMS?
Premenstrual Syndrome refers to a collection of physical, emotional and behavioural symptoms that occur during the second half of the menstrual cycle, usually resolving shortly after a period begins [1].
Common symptoms include:
- Mood swings
- Irritability
- Anxiety
- Breast tenderness
- Bloating
- Headaches
- Food cravings
- Fatigue
- Difficulty concentrating
Symptoms vary between women and can change over time.
What is PMDD?
Premenstrual Dysphoric Disorder is a much more severe form of premenstrual disorder. It is less common than PMS but still impacts around 1 in 20 women in the UK and over 31 million women worldwide.
It can have a significant effect on daily life and yet still often goes under-recognised, undiagnosed and un-treated. We want to change that.
And the first step is recognition. Symptoms often include:
- Severe depression
- Extreme anxiety
- Intense irritability or anger
- Feelings of hopelessness
- Emotional overwhelm
- Difficulty functioning at work or home
- Problems with concentration
- Sleep disturbance
Symptoms improve after menstruation begins, helping distinguish PMDD from ongoing mood disorders [2].
Why Do PMS and PMDD Happen?
Current evidence suggests that women with PMS or PMDD are not producing abnormal hormone levels. Instead, they appear to have an increased sensitivity to the normal hormonal fluctuations that occur after ovulation [3].
These hormonal changes influence brain chemicals such as serotonin and GABA, which help regulate mood, sleep and emotional wellbeing.
This helps explain why symptoms occur in a cyclical pattern.
How Are PMS and PMDD Diagnosed?
Diagnosis is based largely on symptom history.
Healthcare professionals often recommend keeping a symptom diary for at least two menstrual cycles to identify whether symptoms consistently occur during the luteal phase and improve after menstruation begins [1].
This pattern is an important part of distinguishing PMS or PMDD from anxiety, depression or other medical conditions.
Treatment Options
Treatment depends on symptom severity and individual circumstances.
Options may include:
Lifestyle measures
Regular exercise, good sleep, balanced nutrition and stress management can improve symptoms for many women.
Cognitive Behavioural Therapy (CBT)
CBT has been shown to help some women manage the emotional impact of PMS and PMDD [4].
Hormonal treatments
For women with more severe symptoms, hormonal treatments that suppress ovulation or stabilise hormone fluctuations may be considered under our specialist guidance.
Antidepressant medication
Selective serotonin reuptake inhibitors (SSRIs) are an evidence-based treatment for PMDD and may be prescribed continuously or during the luteal phase [2].
Living Well with PMS or PMDD
Many women feel isolated because their symptoms are invisible and often misunderstood.
Recognising patterns, seeking specialist advice and developing an individualised treatment plan can make a significant difference.
No one should feel they simply have to “put up with” severe cyclical symptoms.
Support at The Menopause Medic
At The Menopause Medic, we understand the impact that hormonal changes can have throughout a woman’s reproductive life, not just during menopause. We offer evidence-based assessment and personalised treatment for PMS, PMDD and perimenopause in Berkhamsted and St Albans, with virtual consultations available across the UK.
References
[1] NICE Clinical Knowledge Summary. Premenstrual Syndrome.
https://cks.nice.org.uk/topics/premenstrual-syndrome/
[2] Royal College of Obstetricians and Gynaecologists. Premenstrual Syndrome.
https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/
[3] National Association for Premenstrual Syndromes.
https://www.pms.org.uk/ [4] NHS. Premenstrual Syndrome (PMS).
https://www.nhs.uk/conditions/pre-menstrual-syndrome/