Understanding the Difference Between PMS and PMDD

Hi all,

I decided it was time to write about what I feel is a really important topic and something that I wish I was aware of and knew more about from the beginning of time... (ie when I first began menstruating).

Although not every female experiences unpleasant periods, there are many that do and I'm here to tell you that you aren't alone. It isn't 'normal' to experience depressive episodes, panic attacks, debilitating anxiety, drastic mood fluctuations, unbearable pain and cramping before and during your period. In fact, it is quite abnormal. If this is what you have been going through, then be assured there are underlying reasons and driving factors (not always hormone related as many may presume).

I spent nearly a decade in pain and suffering. Every month, two weeks before my bleed I would live with sheer dread knowing what I was about to go through. First it was the mood instability, followed by sporadic bouts of what felt like depression, sudden and deep sadness, anger, irritability... the list goes on. Then when the bleed began, the emotional roller coaster would suddenly come to a drastic halt. Back to being regulated - 'normal' mood stability. However, this was when the physical pain would begin, the abdominal cramps that would send me into the foetal position for at least 24 hours. I would fret having to go into work or university knowing I was in agony and feeling like I couldn't express the truth of what I was going through. It became easier to call a 'sicky' and remain in bed the entire day, month after month, year after year. As you can imagine, this interfered with my quality of life in so many ways and I arrived at a point in my mid-late 20's where I genuinely believed I was going insane.

With very little awareness and understanding of the menstrual cycle, I had no clue where to turn for help. It wasn't until I became a student of Naturopathy that my mind opened to the insights and possibilities of what I had potentially been going through for all those years. I began researching; looking for guidance and answers on what was really going on inside my body...why was I experiencing such severe 'PMS'... or so I thought.

Through this new found awareness, I began to learn of a condition known medically as Pre-Menstrual Dysphoric Disorder (PMDD). The more I read and researched, the more I began to understand the patterns, and reflected on how this disorder described many if not all of the symptoms I had experienced for so long. I was so desperate for solutions, a quick fix, that I marched straight into the GP's office hoping for a diagnosis so it would validate my thoughs and I could start some type of treatment.

Well, there were no surprises for what happened next. I was diagnosed with PMDD and offered a long list of oral contraceptive pills, anti-depressant medication and even medications for personality disorders. Feeling confused, helpless and scared, I took the script from the GP and went home to deeply consider whether this was the right treatment option for me.

In my next blog I'll talk about the treatment I pursued and why, but before we get into that I'd like to cover the DIFFERENCE between PMS and PMDD.

PMS and PMDD are two distinct conditions that affect women in the luteal phase of their menstrual cycle, typically after ovulation and before menstruation begins. While they share some common symptoms, their severity and impact on daily life differ significantly. The underlying driving factors may also be vastly different, and that's why it's so important to address not only the symptoms, but the ROOT CAUSE.

Premenstrual Syndrome (PMS)

PMS is a common condition that affects up to 75% of menstruating women. It encompasses a wide range of physical and emotional symptoms that occur in the days leading up to menstruation. Symptoms of PMS can vary widely but often include:

• Physical Symptoms: bloating, breast tenderness, headaches, and fatigue.

• Emotional Symptoms: slight moodiness and irritability.

These symptoms usually start around the second half of the menstrual cycle and dissipate with the onset of menstruation. While PMS can be uncomfortable and disruptive, it generally does not interfere significantly with a woman's daily life or mental health.

Premenstrual Dysphoric Disorder (PMDD)

PMDD is a more severe form of PMS, affecting approximately 3-8% of menstruating women. The primary distinction between PMS and PMDD lies in the intensity of the symptoms and their impact on a woman's ability to function. PMDD is characterised by severe emotional and physical symptoms that can significantly impair daily activities, work, social activities and relationships. Common symptoms of PMDD include:

• Severe Mood Swings: intense feelings of sadness, hopelessness, or irritability.

• Anxiety and Tension: extreme anxiety or feeling on edge.

• Depression: severe depression or feelings of worthlessness, extreme indecisiveness and suicidal thoughts.

• Physical Symptoms: similar to PMS but often more intense, such as severe bloating, breast tenderness, headaches, and joint or muscle pain, lethargy and extreme fatigue.
  

Diagnosis and Management

The diagnosis of PMS and PMDD requires tracking symptoms over at least two menstrual cycles. PMDD is specifically diagnosed based on the presence of at least five significant symptoms, including one severe mood-related symptom, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

By understanding the differences between PMS and PMDD, women can seek appropriate treatment and support, ensuring they manage their symptoms effectively and improve their quality of life.

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If you resonated with any of the above, I encourage you to reach out for a free Discovery Consult to chat more about your concerns and how I can help you with your symptoms.

You can select this booking through the 'book now' button on the home page.

Yours in health & healing,

Liguori F, Saraiello E, Calella P. Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity. Medicina (Kaunas). 2023 Nov 20;59(11):2044. doi: 10.3390/medicina59112044. PMID: 38004093; PMCID: PMC10673441