PMS vs PMDD: what's the difference?

PMS vs PMDD: what's the difference?

Summary: PMS and PMDD share many symptoms, but they differ in intensity and impact. While premenstrual syndrome (PMS) affects up to 75% of people with periods and often causes mild to moderate mood and physical changes, premenstrual dysphoric disorder (PMDD) is a more severe, clinically recognised condition that can cause extreme emotional distress, depression, anxiety, and even suicidal thoughts. Both conditions are driven by hormonal changes in the luteal phase, but PMDD disrupts daily life in a profound way. Understanding your symptoms, tracking their timing, and seeking medical advice are key steps toward getting the right diagnosis and support.


What is PMS?

PMS, also known as premenstrual syndrome, is clinically defined as a range of physical, psychological, and behavioural symptoms that occur in the luteal phase of the menstrual cycle (the two weeks before our period). There are thought to be over 150 symptoms, which disrupt the way we function and interfere with our daily lives, work, school, or relationships. Symptoms typically resolve a few days after we get our period.


What is PMDD?

 

What are the symptoms of PMS vs PMDD?

Each person's experience of PMS and PMDD will be different. The following list covers the most common symptoms but it is not exhaustive.

Physically, PMS or PMDD can manifest as: 

  • Hunger and food cravings
  • Hot flushes
  • Intensive period pains
  • Headaches, dizziness and fainting
  • Cramps, bloating and constipation
  • Heart palpitations
  • Bruising and numbness in arms and legs
  • Nausea
  • Acne or aggravation of existing skin problems

Psychologically, symptoms range from extreme tiredness and body dysmoprhia to anger and anxiety. Here are a few of the key ones to look out for: 

  • Irritability
  • Difficulty concentrating
  • Feelings of depression
  • Feelings of anxiety
  • Confusion and forgetfulness

Behaviourally, symptoms range from disrupted sleep to social withdrawal, and can include: 

  • Lack of sleep or insomnia
  • Social withdrawal
  • Lack of sex drive or libido
  • Appetite changes
  • Emotional sensitivity and crying

The key difference between PMS and PMDD is that, with PMDD, the symptoms are more intense. Painful cramps can become debilitating, food cravings manifest as insatiable hunger, and low mood can feel like depression or extreme anxiety.

Perhaps the most terrifying symptom of all is feeling suicidal or having suicidal thoughts or ideations. People who experience PMDD are at a 7X higher risk of suicide attempt than those with the condition. 

If you or someone you know is experiencing any symptoms that are significantly affecting your/their quality life, it's important to seek help from a GP. If you're having suicidal thoughts and arae worried you may act on them, you should call 999, go to A&E, or contact the Samaritans.


What is the difference in prevalence?

PMS - Up to 75% of people with periods experience PMS symptoms. However, because PMS is under-researched and there’s no physical test for it, studies looking at the prevalence of PMS return different results: ranging from 32% to 90%. 

PMDD - is less common, and studies also report varying prevalence rates, ranging from 2% to 8%. Regardless of the exact numbers, it’s important to remember that you’re not alone if you’re feeling the effects of PMS or PMDD.

 

How are PMS and PMDD diagnosed?

Currently, PMS is diagnosed by your GP after you’ve evidenced that you experience PMS symptoms one to two weeks before your period, consistently for two months, that affect your daily life and subside once you get your period.

The diagnosis for PMDD is similar, however, people must evidence a particular combination of symptoms (a minimum of five symptoms, one of which must be psychological).

If you think you have PMS or PMDD, start noting down the symptoms you experience, when they happen, and how bad they feel. Take this record to your GP who can discuss diagnosis and treatment options with you.

 

What are the treatments for PMS and PMDD?

The good news is that treatments for PMS and PMDD are out there. However, finding the right one for you can be a trial-and-error process, so don’t be worried if it takes a little time to find what’s best for you. Treatments can vary between PMS and PMDD, that is, people with PMDD are more likely to be offered anti-depressants as a first line of treatment. For people with PMS, contraceptives or alternative therapies may initially be recommended.

Non-medical treatments include:

  • Changes in diet and decreasing sugar, caffeine and alcohol intake
  • Introducing regular exercise into your routine
  • Practising methods of stress management, like meditation or yoga
  • Taking vitamin supplements (the most frequently suggested include vitamin B6, calcium and magnesium)
  • Evelyn's hormone-free, clinically approved supplement for PMS and PMDD: The Evelyn Routine

Medical treatments include

  • Talking therapies, such as cognitive behavioural therapy (CBT)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Combined oral contraceptives
  • Anti-inflammatory medicines
  • Water pills (diuretics)

Alternative therapies include

  • Aromatherapy
  • Acupuncture
  • Reflexology

 

Final thoughts

Even though PMS and PMDD aren’t always easy to diagnose, the symptoms are very real and experienced by many people worldwide. If you can relate to some of the symptoms discussed here, and you know that they occur before you get your period, you might have PMS or PMDD. Remember, you’re not alone, and there are treatment options to help relieve your pain or discomfort. For more information, check out our articles on PMS, PMDD, and visiting a healthcare professional.

 

Disclaimer: This content is for informational purposes only and is not intended as medical advice. Always speak to a qualified healthcare professional about any health concerns.

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