PMDD vs. PMS: How to Spot the Difference

It’s a few days before your period is supposed to start – you’re feeling moody, and bloated, maybe your skin is breaking out or you just generally feel achy and sore. In the 5-10 days ahead of your period, PMS (aka Premenstrual Syndrome) hits most people who menstruate, due to hormone changes as part of our cycle and tends to disappear once your period starts.

About 90% of all menstruating people report experiencing some premenstrual symptoms, according to the Office on Women’s Health.

However, you may not be aware that 1 in 12 women or those assigned female at birth in the United States suffer from a severe form of PMS known as Premenstrual Dysphoric Disorder or PMDD.

Similar to PMS, PMDD symptoms pop up a week or so before your period starts. What sets PMDD apart from PMS is extreme emotional and behavioral changes that can include:

• Sadness or hopelessness

• Anxiety or tension

• Extreme moodiness

• Marked irritability or anger

These severe mood and behavior changes may also be accompanied by the typical PMS symptoms that many get. Similar to PMS symptoms, these should disappear within the first few days of menstruation, but what makes PMDD different is that these mood changes “can be severe enough to interfere with your life” according to the Cleveland Clinic.

Treating PMDD

According to Harvard Health, antidepressants that help to slow the reabsorption of serotonin are the most effective for PMDD, and because they can alleviate PMDD symptoms more quickly than major depression, not all PMDD patients will need to take an antidepressant every day. In many cases, the medication can be prescribed for “luteal-phase dosing” which means it’s taken in the window between ovulation and menstruation when PMS and PMDD symptoms tend to pop up.

An alternative treatment could be hormone therapy.

If you’ve noticed extreme emotional symptoms in the lead-up to your cycle, enough so that it’s interfered with your relationships, work, or life overall, consider chatting with your OB at your next appointment about whether you might be experiencing PMDD.

Some additional risk factors to consider in evaluating your moods and severity of PMS symptoms:

• History of anxiety, depression, or seasonal affective disorder

• History of trauma

• Family history of PMDD

• Thyroid disorders

• Lifestyle factors such as Smoking, alcohol or substance use, and lack of exercise