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Is Your PMS Actually PMDD?


The journey through premenstrual symptoms can sometimes feel like navigating a labyrinth. It's a territory where the line between typical discomfort and clinical concern can blur, leaving many wondering: when might your PMS be PMDD? Let's take a closer look at some of the symptoms and the differences - and what you can do about it.


Understanding PMS: The Prelude to Menstruation


Premenstrual syndrome (PMS) is a familiar terrain for many women. It's the prelude to menstruation, often characterized by physical and emotional changes. It's a very common condition, affecting up to 75% of women during their reproductive years. PMS typically begins during the luteal phase of the menstrual cycle, which starts after ovulation and ends when menstruation begins. Symptoms may include:

  • bloating

  • breast tenderness

  • mood swings

  • fatigue

While disruptive, these symptoms are typically manageable and tend to go away as the menstrual flow begins.


Hormones, in particular fluctuations in estrogen and progesterone levels play a significant role, but neurotransmitter fluctuations, lifestyle factors, and individual susceptibility may also contribute to how severely you experience PMS symptoms.


Spotting PMDD: A Deeper Dive into Premenstrual Dysphoric Disorder


But for some, the premenstrual experience transcends typical discomfort. Premenstrual dysphoric disorder, or PMDD for short, isn't an exaggerated form of PMS; it's a distinct disorder with its own set of rules. 


PMDD is recognized and included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 is a comprehensive classification system published by the American Psychiatric Association (APA) used by mental health professionals to diagnose and classify mental disorders.


PMDD is listed as a specific diagnosis under the category of "Depressive Disorders" in the DSM-5 and is characterized by severe and debilitating symptoms of:

  • depression

  • irritability

  • mood swings

  • other emotional and physical symptoms that occur in the luteal phase of the menstrual cycle and significantly interfere with daily functioning and quality of life.


The inclusion of PMDD in the DSM-5 reflects its recognition as a distinct and clinically significant mental health condition that requires proper diagnosis and treatment. It allows healthcare professionals to accurately identify and address the specific symptoms and challenges associated with PMDD in clinical practice. This recognition is helping more people with PMDD get diagnosed and get the help they need.


Decoding the Differences: Recognizing the Signs


So, what sets PMDD apart from garden-variety PMS? While both conditions involve emotional changes, PMDD presents intense emotions that can be overwhelming. Think severe mood swings, feelings of hopelessness, intense irritability, and difficulty concentrating. These emotional upheavals typically unfold in the luteal phase of the menstrual cycle and relents shortly after menstruation begins.


The Physical Tango: Beyond Emotional Turmoil


Yet, PMDD isn't just about emotional turmoil; it's a full-body experience. Physical discomfort akin to PMS, such as bloating, breast tenderness, and fatigue, may also rear their heads. However, in PMDD, these physical manifestations tend to be more pronounced, further encroaching upon daily functioning and well-being.

PMS and PMDD symptom comparison chart

Seeking Sanctuary: Diagnosis and Treatment


If you suspect PMDD may be at play, begin by diligently tracking your menstrual cycle and symptoms over several menstrual cycles, which will help your health team to determine patterns and severity.


Treatment avenues may span lifestyle adjustments, pharmacotherapy, or a blend of both, depending on your needs.


Charting a Course Towards Wellness


In a world where women's health is muted or overlooked, it's important to amplify the conditions like PMDD. By building awareness and shedding light on the signs and symptoms, we empower individuals to reclaim agency over their health journeys. Remember to take care of number one (that's you!) and speak to your health care professional about any concerns you might have. Advocate for menstrual health! Living with PMDD is debilitating but there is help. You and your concerns are important and should never be dismissed.

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