PMDD vs. PMS: Knowing the Difference and Finding Relief

Like many women, you may have dealt with premenstrual syndrome (PMS) at some point.

Whether it’s the bloating that makes your favorite jeans feel too tight, the irritability that sneaks up out of nowhere, or the headaches that make even simple tasks feel exhausting, PMS can be rough. Thankfully, these symptoms typically last for a short time, causing minimal disruption to life.

For about 1 in 20 women, however, premenstrual symptoms go far beyond the usual frustrations of PMS. Premenstrual dysphoric disorder (PMDD) is a severe, life-disrupting condition with a far longer duration than PMS. If your premenstrual symptoms are significantly interfering with your life, relationships, or mental health, you may be dealing with PMDD vs. PMS.

What Is PMDD vs. PMS?

PMDD is essentially an extreme form of PMS. The emotional and physical symptoms are much more intense, last longer, and can include:

Emotional Symptoms:

• Anxiety
• Irritability
• Weepiness
• Depression
• Suicidal thoughts

Physical Symptoms:

• Sleep disturbances
• Bloating and fluid retention
• Heart palpitations
• Joint pain
• Headaches
• Brain fog
• Food cravings
• Breast tenderness
• Skin changes like acne

PMDD symptoms typically start 7 to 10 days before your menstrual bleed — during the luteal phase — and resolve once bleeding begins. For some, the symptoms start immediately after ovulation, making half of every month a struggle.

Hormonal Aspects of PMDD vs. PMS

Hormones naturally rise and fall during your monthly cycle, and elements of these fluctuations lie at the root of PMDD. Understanding the hormonal factors involved can help explain why you might experience PMDD vs. PMS:

• High Estrogen: Too much estrogen can become inflammatory, triggering many of the symptoms mentioned above.
• Low Estrogen: Falling levels of estrogen as your cycle progresses can produce mood-related symptoms due to estrogen’s effect on neurotransmitters like serotonin.
• Suboptimal Progesterone: Because progesterone helps counterbalance estrogen’s negative effects, low progesterone levels can cause more pronounced PMDD symptoms. PMDD and PMS tend to be less common in women with optimal progesterone levels.

Because hormone balance plays such a major role in PMDD, detailed hormone testing can be helpful in understanding what’s happening in your body and guiding treatment (more on that below).

Does PMDD Affect Fertility?

While PMDD itself doesn’t cause infertility, suboptimal progesterone production — often found in women with PMDD — can make conception more difficult. Additionally, the emotional toll of PMDD symptoms can impact relationships and sexual health, making the journey to pregnancy more complex. Chronic stress, which often accompanies PMDD, can also negatively impact reproductive health.

If you’re experiencing difficulty conceiving and think you might have PMDD, don’t hesitate to reach out to an experienced healthcare provider for help with both fertility and PMDD symptoms.

Risk Factors for PMDD

Several factors can increase your likelihood of experiencing PMDD vs. PMS, including:

• Genetic predisposition (family history of PMDD)
• Cigarette smoking
• Obesity
• Past traumatic experiences
• Pre-existing anxiety disorders

The genetic component of PMDD means some women’s bodies are simply more sensitive to hormonal fluctuations. A woman without the predisposition may not notice symptoms as her hormones rise and fall, but one with the predisposition may experience significant mood swings even during small fluctuations.

What to Do About PMDD

The good news is that there are many options for managing PMDD symptoms. Treatment approaches range from holistic lifestyle changes to medical interventions, depending on the severity of symptoms and individual needs.

Lifestyle Changes

By starting with healthy lifestyle modifications, you give your body the support it needs to operate at its best and potentially mitigate PMDD symptoms.

• Reduce inflammation by minimizing intake of cow’s dairy, sugar, wheat, and alcohol.
• Keep your body moving with consistent exercise.
• Manage stress with mindfulness and relaxation techniques.
• Avoid endocrine-disrupting chemicals (EDCs) in household and personal care products; apps like Think Dirty and EWG’s Healthy Living help with identifying safer products.
• Consider supplements such as magnesium, vitamin B6, and adaptogens (for stress support).
• Find ways to prioritize self-care, however that looks for you.

Hormone Testing

Testing hormones throughout your cycle can provide a clear picture of imbalances and even inform targeted treatments. In the Haven office, we offer the DUTCH Test to clients so they can track exactly what their hormones are doing along with correlating symptoms.

Medication Options

If you’re working closely with a healthcare provider and you both agree you need further support, anxiety and depression medications may be an option. With the information from hormone testing, you might even discuss taking medication only during times in your cycle when symptoms are at their worst.

PMDD vs. PMS: Find the Right Support for Your Symptoms

If you suspect you have PMDD vs. PMS, don’t brush it off. There are real, effective solutions available. Working closely with a knowledgeable provider can help you find the right balance of lifestyle adjustments, supplements, and medical support to ease symptoms and improve your quality of life.

PMDD is tough, but you don’t have to navigate it alone. Whether it’s through hormone testing, targeted supplementation, or simply taking time to care for yourself, relief is possible.