Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) share many of the same symptoms but the main difference is the intensity. Here we’ll explain more about both PMS and PMDD and give advice on how you can get the support you need to make the time before your period less stressful.
- PMS is the collection of symptoms you might experience before your period - like low mood or physical discomfort
- PMDD is a very extreme case of these symptoms and is likely caused by an heightened sensitivity to hormonal changes happening before your period
- Whilst PMS is common it’s not inevitable and there are natural ways you can reduce the risk of symptoms
- PMDD may need more medical intervention, and you should speak to a doctor if you are concerned you may be suffering from it
What is PMS?
PMS (Premenstrual Syndrome) is the name for a collection of symptoms you might experience in the run up to your period. These can include:
- Low mood
- Increased sensitivity and irritability
- Decreased confidence
- Swollen and sore breasts
- Skin issues
- Trouble sleeping
- Changes to sex drive
Everyone is unique and will have their own pre- menstrual experience - but we’re guessing you might recognise a few symptoms from this list!
What causes these symptoms?
Despite the fact that PMS is so common, we still don’t really have a clear answer as to why it happens and why it affects people differently - but it’s definitely to do with our hormones.
Throughout our menstrual cycle, our hormones are fluctuating and in the second half of your cycle (between ovulation and your period) there’s quite a lot going on. This time is known as your luteal phase and is when PMS symptoms can occur for many people.
Progesterone starts to rise after ovulation and then plummets just before your period. Likewise oestrogen increases a little during the luteal phase and then declines along with progesterone before menstruation. These changes can also cause happy hormones like serotonin and dopamine to also get pretty low, which could be the reason behind our increased sensitivity at this time (aka the reason you’re crying at all those rescue dogs on TikTok).
How can I reduce PMS?
Whilst PMS is very common, there is a myth that it is an inevitable part of life and there’s nothing we can do about it, which isn’t exactly true! Our lifestyle choices can make a huge difference to the fluctuation of our hormones and severity of our premenstrual symptoms. Some ways you can reduce your risk of PMS include:
Exercise - Working out releases endorphins which can help counteract the negative feelings that you might experience in the run up to your period. Workouts can also help to reduce bloating and painful cramps
Eating a balanced diet - If you are eating lots of junk food or sugary snacks, this can cause your hormones to fluctuate more aggressively. Try to eat lots of nourishing food like fruit and vegetables throughout your cycle, as they will help to balance your hormones.
Avoiding alcohol - Alcohol is a depressant, so if you have a wild night out in your luteal phase you might find that you struggle with low mood or anxiety even more intensely, so try to keep alcohol consumption to a minimum.
Meditation - Breathwork or mediation can help to calm your nervous system and make you feel a lot calmer. It’s a simple self care technique that can help your PMS feel less intense.
What is PMDD?
Premenstrual dysphoric disorder (PMDD) is like a very extreme case of PMS. Whilst PMS symptoms can be unpleasant to deal with, PMDD is another level. For people struggling with PMDD, the physical and emotional symptoms in the lead up to their period can be completely debilitating.
A simple example would be looking at your mood in the week or two before your period. You might notice that you feel a little less confident and more sensitive at this time, and PMS might even make you tearful on occasion. However, if you experience an extreme bout of depression, struggle to leave the house, or have suicidal thoughts, this could be a sign of PMDD. It’s important to track whether you feel like this throughout your cycle or very specifically in the lead up to your period.
Whilst the emotional symptoms are most commonly recognised within PMDD, extreme physical symptoms can also be attached to the condition. You might find that your breasts are extremely tender or that your cramps are so bad they stop you doing things like going to work or school. Of course, this could also be a sign of a condition like endometriosis or adenomyosis, but PMDD might also be something to explore.
What causes PMDD?
We still need a lot more research into the causes of PMDD, but it’s classified as an endocrine disorder. This means it’s related to our hormone levels. Researchers believe that people struggling with PMDD have an increased sensitivity to the hormonal changes that happen throughout our menstrual cycle - particularly the drop in serotonin levels that can happen before our period.
This could be a genetic predisposition or there might be other reasons at play. There is also some research that indicates PMDD could be linked to stress or trauma - but this is still ongoing.
How to speak to a doctor if I think I have PMDD?
It can be very hard to get a clear diagnosis of PMDD. This is partly because a lot of the symptoms are subjective, but it’s also because there is a general lack of understanding about the condition amongst healthcare professionals. If you suspect you might have PMDD and want to talk to your doctor about it, here are some tips to get the most out of your appointment.
- Keep a detailed journal of your symptoms over a 3 month period. This will help the doctor recognise patterns but will also give you more clarity when you’re describing your experience.
- Take PMDD guidelines with you and make notes on them if that helps. Here are some well respected ones your doctor should be familiar with.
- National Institute for Health and Care Excellence (NICE)
- National Association for Premenstrual Syndrome (NAPS)
- Royal College of Obstetricians & Gynaecologists (RCOG)
- If you aren’t feeling understood, ask your GP to refer you to a gynaecologist or mental health expert who will have a deeper knowledge of PMD
Is there a cure for PMDD?
There is currently no clear cure for PMDD, but a combination of treatments and lifestyle changes can help to reduce its impact. Here are some options your healthcare provider might suggest.
- They may advise you to take anti-depressants throughout your cycle or specifically in the lead up to your period.
- Hormonal contraceptives can reduce PMDD symptoms by ‘pausing’ your menstrual cycle. However, some people find that these forms of birth control can actually make their mental health worse, so it’s important to speak to your GP and see if it’s the right option for you
- The lifestyle advice that we gave for PMS - like increasing exercise, eating a balanced diet and avoiding alcohol - can also be helpful if you are struggling with PMDD
- In some extreme cases your GP may recommend a hormonal medicine (called GnRH analogues) which can be taken through injections or nasal spray. This technically brings on temporary menopause, so it’s not something that should be approached lightly.
- If pain is a big trigger for your PMDD, finding the right pain relief for you can help you feel more in control of your symptoms. Many people with extreme period pain find that the Myoovi kit can help relieve their painful cramps.