With their similar acronyms, it’s easy to get premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) confused. While these two conditions share distinct similarities, they differ from each other in important ways. Specifically, PMDD is considered a more severe form of PMS that can drastically affect a person’s quality of life. Understanding the difference between the two is key to recognizing whether you may suffer from one or the other.
Many women begin to feel different a week before they get their period. They may experience mood swings, suffer from breakouts, have tender breasts, feel more tired, and experience bloating. Women that experience these symptoms around the same time each month, right before their period, may be struggling with PMS. However, if the side effects are so extreme that they prevent you from doing normal things, such as completing your work or relating to people, then you may be suffering from PMDD.
According to WebMD, while mild PMS affects up to 75% of women, only 3-8% of women suffer from PMDD, making it rarer and more difficult to spot. Below we discuss the key differences between PMS and PMDD and treatment options available to address both conditions.
PMS & PMDD Share Many Of The Same Symptoms
It can be difficult to differentiate between the two because they share many of the same physical and emotional symptoms. According to WebMD, these include:
- Bloating or feeling of heaviness
- Mood swings or changes
- More easily tired
- Headaches or migraines
- Tenderness in breasts
- Joint or muscle pain
- Food cravings
- Difficulty sleeping
How PMS & PMDD Differ
The main difference between the two is that the feelings associated with PMDD are considered more extreme. BabyGaga had the chance to speak with Jessica Ryniec, MD, a Reproductive Endocrinology & Infertility specialist for CCRM Boston. She provided insight into the main differences between PMS and PMDD.
“It’s true that the two are very similar. Both start about seven to ten days before your period and typically resolve within the first day or two of getting your period,” Dr. Ryniec explained.” And both are characterized by the presence of physical, behavioral, or psychological symptoms that interfere with some aspects of life. But PMDD is a more severe form in which the symptoms of anger, irritability, internal tension or feelings of hopelessness are more common.”
“Most differentiate PMDD by having mostly mood symptoms (compared with more physical symptoms in PMS), as well as a more profound impact on every day activities and relationships,” Dr. Ryniec continued.
According to Mayo Clinic, women with PMDD may experience the following emotional and behavioral symptoms:
- Sadness, hopelessness
- Anxiety, stress, or tension
- Intense, unpredictable mood swings
- Unexplained anger or irritability
“Even though PMDD is characterized by having more mood symptoms, still the most common symptoms of PMDD are the physical symptoms such as bloating, fatigue, hot flushes, and headaches,” Dr. Ryniec added. “The mood symptom that is the most common is premenstrual irritability. Others would include mood swings, sudden sadness, anger, tension and feeling on edge. A less common symptom would be suicidal thoughts although this would be very concerning and something to watch out for.”
It’s typical to feel sad or depressed during PMS, however, with PMDD, these emotions are amplified. Women suffering from PMDD may feel sadness that is so extreme that feel hopeless. Suicidal thoughts and idealizations have been reported in women with PMDD.
The same goes with anxiety, is common with PMS but can feel more overwhelming with PMDD. “Some women with PMDD describe feeling very tense of on edge,” WebMD explains. Mood swings can also become more volatile. While it’s common to go from happy to sad or vice versa with PMS, the feelings can be more intense with PMDD. Women have reported feeling angry or irritated at small things that wouldn’t usually affect them. Individuals with PMDD may feel more argumentative or confrontational, even if this typically isn’t their personality.
Finally, women suffering from PMDD may have more extreme feelings about their life. They may feel as though their life is out of control. While PMS will typically make a woman feel detached from her normal routine, with PMDD, she may stop caring about regular things, such as her hobbies, job, and relationships, which is a sign of detachment and depression.
The Difference In Treating PMS & PMDD
Given that PMS and PMDD have so many similarities, it’s unsurprising that they share some of the same treatment options. But what must be first emphasized is that there are treatment options. Too many women suffer from undiagnosed PMD or PMDD, believing their symptoms are usual side effects of their menstrual cycle. If you believe you are suffering from one of these conditions, please speak to your doctor. Finding the correct treatment option can greatly improve your life.
Treatment For PMS
There is no single cure for PMS. But incorporating the following into your lifestyle and making different changes, at the recommendation of a doctor, can help mitigate and prevent the symptoms:
Pain Medication: consuming pain medication such as ibuprofen and aspirin can help uncomfortable symptoms such as headaches, cramping, and muscle aches.
Supplements: Vitamin B has specifically been proven to help reduce the symptoms of PMS.
Lifestyle changes eating a balanced diet, complete with fruits and vegetables, can help with energy levels, Healthline explains. Make sure to consume plenty of fluids, which can reduce abdominal bloating. Reduce your intake of alcohol, coffee, and cut out smoking. Ensure you’re getting a proper night’s sleep and reduce your stress as much as possible.
Cognitive Behavioral Therapy: Healthline adds that there is some research so suggest cognitive behavioral therapy can help reduce PMS.
Treatment For PMDD
Treatment for PMDD is aimed to minimizing or preventing symptoms. There are a wide range of options a woman may try, some of which overlap with PMS treatments, and these include:
Antidepressants: these can reduce a variety of emotional and behavioral symptoms, such as fatigue, mood swings, sleep problems, and more. Your doctor can prescribe these if they believe it is a good course of action.
“If someone is looking for treatment for PMDD but does not want hormonal contraception, the other main option for treatment is selective serotonin reuptake inhibitors (SSRIs) which are commonly used for depression and anxiety,” Dr. Ryniec explained. “These can be used continuously, only during the luteal phase, or only when symptoms start.”
Nutritional Supplements: Mayo Clinic explains that taking 1,200 milligrams of calcium per day has been proven to reduce the side effects of PMDD. The publication also recommends Vitamin B-6, magnesium, and L-tryptophan, though they caution women should speak to their doctors beforehand.
Birth Control Pills: these can help mitigate the severity of symptoms. There is a wide variety of birth control pills on the market and your lifestyle and hoped for outcome will determine which is right for you. Dr. Ryniec spoke about the benefit of taking birth control pills for PMDD. “Even though they are the same hormones that your body makes, they likely work for PMDD by stopping the fluctuations in hormone levels that occur in a regular cycle,” she explained. “Symptoms should be monitored as you can potentially switch to a different formulation if symptoms do not resolve or another medication can be added.”
Herbal Remedies: some herbal solutions like chasteberry have been found to reduce symptoms like irritability, mood swings, tender breasts, and more in relation to PMDD, Mayo Clinic explains.
Lifestyle Changes: making changes in your diet and lifestyle can have a huge improvement on your symptoms. Getting regular exercise and stopping bad habits like smoking, alcohol, and cutting back on caffeine can help. Ensuring you’re getting a good amount of sleep and practicing relaxation techniques, such as mindfulness or yoga, have also been proven to help.
Of course, before making any drastic changes to your lifestyle or diet, or if you have any questions about the above-mentioned treatments for PMS and PMDD, you should speak with your doctor. PMS and PMDD can only be diagnosed through a medical professional, who can also explain to you all of your treatment options and their side effects once a diagnosis has been made.
Sources: Healthline, Mayo Clinic, WebMD, Contemporary OB/GYN, Embry Women’s Health,