PMS or PMDD? Know The Differences

Do you suffer with distressing symptoms of PMS? So much so that it affects your physical, social and mental health from one month to the next? How do you know if it is PMS or perhaps something more serious such as PMDD (Premenstrual Dysphoric Disorder)? 

Here, we explain the differences between PMS and PMDD and if you have symptoms of PMDD, how you can reach out for support. 


Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period. It is sometimes referred to as 'severe PMS'. 

While many people who are able to have periods may experience some mild symptoms of PMS, if you have PMDD these symptoms are much worse and can have a serious impact on your life. Experiencing PMDD can make it difficult to work, socialise and have healthy relationships. In some cases, it can also lead to suicidal thoughts.

Symptoms of PMS

  • mood swings

  • feeling upset, anxious or irritable

  • tiredness or trouble sleeping

  • bloating or tummy pain

  • breast tenderness

  • headaches

  • spotty skin or greasy hair

  • changes in appetite and sex drive

PMS is a term often used to explain or dismiss a woman's volatile mood, depression, anger, or behaviour in the run up to and on her period. A woman or AFAB individual with PMS will have fewer, and usually less severe, premenstrual symptoms than a woman with PMDD. PMS is more common than PMDD, and as many as 80% of women experience some form of PMS in the second half of their menstrual cycle. Women may experience mild, moderate, or severe symptoms of PMS. 

PMS symptoms are generally more easily managed than PMDD and do not require prescription medication including antidepressants. PMS is also not classified as a mental illness.

Symptoms of PMDD

If you have PMDD, you might find that you experience some of the symptoms listed below. It is different for different people, so you might also experience other kinds of feelings which aren't listed here.

Emotional experiences

  • mood swings

  • feeling upset or tearful

  • feeling angry or irritable

  • feelings of anxiety

  • feeling hopeless

  • feelings of tension or being on edge

  • difficulty concentrating

  • feeling overwhelmed

  • lack of energy

  • less interest in activities you normally enjoy

  • suicidal feelings

Physical and behavioural experiences

  • breast tenderness or swelling

  • pain in your muscles and joints

  • headaches

  • feeling bloated

  • changes in your appetite such as overeating or having specific food cravings

  • sleep problems

  • finding it hard to avoid or resolve conflicts with people around you

  • becoming very upset if you feel that others are rejecting you

You will typically only experience these symptoms for a week or two before your period starts. The symptoms follow your menstrual cycle, so you might find they start to get better when you get your period and will usually have disappeared by the time your period is finished.

Diagnosing PMDD

PMDD affects an estimated 2-10% of women of reproductive age. While PMDD is directly connected to the menstrual cycle, it is not a hormone imbalance. It is a suspected cellular disorder with symptoms often worsening over time and sometimes worsening around reproductive events such as menarche, pregnancy, birth, miscarriage, and peri-menopause. Those with PMDD are at increased risk for suicidal behaviour. Many, but not all women with PMDD have a history of sexual trauma or depression. 

There is no blood or saliva test to diagnose PMDD although these tests can rule out other underlying disorders. The only way to diagnose PMDD is by tracking symptoms for at least two menstrual cycles.

Treatment can involve some but not limited to, talk therapy, antidepressants, painkillers or anti-inflammatory drugs, combined oral contraceptives, GnRH injections, surgery and/ or lifestyle changes. 

How To Get Help 

If you think you may be suffering with PMDD, you can find out more information here or alternatively speak to your GP. 

The personal impact of PMDD can cause severe emotional, professional and personal harm and as women today have an estimated 450 periods during their lifetime, PMDD is a long term diagnosis. It is important that sufferers reach out and begin the journey of receiving the help they need. 

The International Association For Premenstrual Disorders (IAPMD) is a peer support, education, research and advocacy association dedicated to providing hope and support to those who suffer with PMDD.  

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