PMS vs PMDD: What’s the Difference?
Ever feel a bit more sensitive, sluggish, or just not quite yourself before your period? You’re not imagining it, and you're definitely not alone. Many people who menstruate experience premenstrual symptoms. But for some, those symptoms go far beyond the occasional mood swing or a craving for chocolate, and that’s where PMS and PMDD come into the picture.
Although they sound similar, Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) impact the body and mind very differently. Recognising that difference is the first step toward understanding what your body is telling you, and taking back control of your cycle.
What is PMS?
PMS (Premenstrual Syndrome) is a collection of physical, emotional, and behavioural symptoms that tend to show up in the week or two before your period begins, during what we call the luteal phase. It affects up to 40% of the menstruating population.
What is PMDD?
PMDD, or Premenstrual Dysphoric Disorder, is a more intense and often debilitating condition. It affects up to 5–8% of menstruating individuals and is classified as a hormone-related mood disorder.
Key Symptoms
Symptoms of PMS
Physical: Bloating, breast tenderness, mild headaches, fatigue, and lower back pain.
Mental: Mood swings, heightened emotions, and mild irritability.
Energy: General lack of energy and fatigue.
Changes in appetite and sleeping patterns.
Symptoms of PMDD
Physical: Same as PMS except more severe with significant discomfort, pain, and exhaustion.
Mental: Intense episodes of irritability, depression, suicidal thoughts, or emotional numbness.
Energy: Debilitating fatigue, unable to focus, function, or carry out daily tasks.
Joint pain, migraines, brain fog, sleep disruptions, and digestive issues (nausea, low appetite).
The Hormone Connection: What’s Really Going On?
Both PMS and PMDD are linked to the hormonal shifts that occur after ovulation, particularly the rise and fall of oestrogen and progesterone during the luteal phase.
But here’s the key difference – individuals with PMDD are more sensitive to the normal hormonal fluctuations that occur during their cycle. Imaging studies show that brain activity changes, and people with PMDD experience a much sharper, more intense emotional response.
The Key Neurotransmitters Involved
This heightened sensitivity primarily affects neurotransmitters, especially serotonin (the mood-balancing and calming brain chemical).
During the luteal phase, as progesterone rises then drops off sharply before menstruation, it appears that:
Serotonin activity drops
Mood-regulating circuits become destabilised
For those with PMDD, this results in extreme mood symptoms e.g anger, despair, anxiety, that resolve rapidly as hormonal levels shift when the period starts.
Treatment
As a Naturopath there are many treatment options I can offer for you – and it’s one of my favourite areas to treat as the difference in symptoms pre- vs post treatment is amazing.
Depending on what symptoms you are experiencing, treatment will differ (as no two person is the same!). I will commonly use herbal medicine, supplements, diet and lifestyle advice, as well as functional testing.
If you are someone who experiences PMS or PMDD, I want you to know that you are not alone, and there are options for you!
Book in for a consultation so we can work on treating the root cause and get you back to feeling good.