Everything You Need to Know About PMS & PMDD

Amanda Newlin
December 5, 2023

Have you ever felt that struggle in the days or weeks leading up to your menstrual cycle that makes you feel like your whole world is upside down? That’s called PMS (premenstrual syndrome), and it’s super common – like, millions of women experience it every month common.

In rare cases, women can experience a more severe and debilitating version of PMS called PMDD (Premenstrual Dysphoric Disorder). We will delve into everything you need to know about PMS and PMDD, including its symptoms, causes, and possible relief options.

What is PMS?

PMS, or premenstrual syndrome, is a common term used to describe a combination of physical, emotional, and behavioral symptoms that many women experience in the days or weeks leading up to their menstrual period. The exact cause of PMS is not fully understood, but hormonal fluctuations can play a significant role. Changes in hormone levels, particularly estrogen and progesterone, can trigger these symptoms. While PMS is a natural part of the menstrual cycle for many women, its severity can vary.

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a severe and relatively rare form of premenstrual syndrome (PMS). It is characterized by extreme and debilitating physical, emotional, and psychological symptoms that occur in the luteal phase of the menstrual cycle, typically in the two weeks before menstruation. PMDD is more intense and disruptive than regular PMS. Experts aren’t sure what causes PMDD or why only about 5% of women develop it. But many believe it’s related to hormones and neurotransmitters (the brain’s chemical messengers).

What are the symptoms of PMS and PMDD?

The symptoms of PMS can vary from person to person but often include:

Physical symptoms: These can include changes in appetite, back pain, bloating, acne, breast tenderness, hot flashes, and headaches.
Emotional symptoms: PMS can lead to mood swings, irritability, anxiety, and even depression in some cases.
Psychological symptoms: Some individuals may experience changes in their sleep patterns, fatigue, and difficulty concentrating.

PMDD is more intense and disruptive than regular PMS and is characterized by extreme and debilitating symptoms that can significantly affect a person’s quality of life and daily functioning.

Common symptoms of PMDD can include:

Physical Symptoms: This can include severe back pain, bloating, acne, breast tenderness, hot flashes, and headaches.
Emotional Symptoms: PMDD can lead to severe mood swings, such as extreme irritability, anger, panic attacks, depression, anxiety, tension, and a sense of being overwhelmed.
Psychological Symptoms: Some people may experience changes in their sleep patterns, extreme fatigue, difficulty concentrating, and a feeling of being out of control.

How is PMS/PMDD treated?

Managing PMS and PMDD can be challenging, but some various strategies and treatments can help alleviate the symptoms. What works for some individuals may not work for everyone. It’s always best to speak to a healthcare provider. Here are some general tips:

Diet and Nutrition: Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Limit your intake of caffeine, alcohol, and sugary foods, which can exacerbate symptoms.
Regular Exercise: Engage in regular physical activity, such as walking, jogging, or yoga, to help reduce PMS symptoms. Exercise releases endorphins, which can improve your mood and alleviate discomfort.
Stress Management: Practice stress-reduction techniques like deep breathing, meditation, or progressive muscle relaxation to cope with emotional symptoms.
Adequate Sleep: Ensure you get enough sleep, as lack of sleep can worsen PMS symptoms.
Over-the-Counter Pain Relievers: Nonprescription pain relievers like ibuprofen or aspirin can help relieve physical symptoms like cramps, breast tenderness, and headaches.
Hormonal Contraception: Birth control pills or other hormonal contraceptive methods may help regulate your hormonal fluctuations and reduce PMS symptoms in some cases. Consult with your healthcare provider to discuss these options.
Tracking Symptoms: Keep a journal to track your symptoms and menstrual cycle. Tracking symptoms can help you identify patterns and anticipate when PMS symptoms may occur.
Support Network: Talk to trusted friends and family members about your experiences. Having emotional support can be helpful during this time.

If you suspect you are experiencing PMDD, first, ask yourself how your symptoms impact your life. Are you missing work, missing school or unable to socialize? If yes, tell your healthcare provider because it may be PMDD.

During your visit, they may conduct blood tests to check for any deficiencies or issues that may have similar symptoms to PMDD. They may also ask about your medical history, including any previous experiences with anxiety or depression. There is no treatment that works for everyone, but some options that your doctor may bring up are:

Medication: In cases of severe depression associated with PMDD, your healthcare provider may prescribe antidepressant medication. These can help manage depressive symptoms during your menstrual cycle.
Hormonal treatments: Some individuals with PMDD find relief from hormonal therapies, such as birth control pills, which can help regulate hormone fluctuations.
Psychotherapy: Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) can be effective in managing depression and PMDD. Therapy can provide coping strategies and emotional support.
Lifestyle and Self-Care: Prioritize self-care activities such as exercise, a balanced diet, and stress-reduction techniques. And get adequate sleep, as PMDD can be exacerbated by sleep deprivation.
Support System: Lean on your support network, including friends and family, for emotional support during challenging times.
Therapeutic Activities: Engage in activities that promote relaxation and well-being, such as yoga, meditation, or mindfulness practices.
Tracking Symptoms: Track your symptoms, moods, and treatment outcomes in a journal. This can help you and your healthcare provider adjust your treatment plan as needed.
Consultation with a Specialist: If your depression and PMDD are severe and not responding to initial treatments, consider consulting with a specialist in women’s mental health or a psychiatrist who has expertise in these conditions.
Emergency Plans: Develop a crisis plan with your healthcare provider to address severe depressive episodes and PMDD exacerbations. If you ever experience thoughts of self-harm or suicide, reach out for immediate help from a crisis hotline or a mental health professional.

Understanding the challenges and differences between PMS and PMDD is essential for women’s well-being.

If you or someone you know is experiencing these symptoms, remember that various strategies and treatments are available. It’s important to consult with a healthcare provider to create a personalized plan to help alleviate these conditions’ physical, emotional, and psychological symptoms. With the proper support and information, managing and improving your quality of life during these challenging times is possible.

References:

https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315

https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780

https://www.uclahealth.org/news/your-severe-pms-actually-premenstrual-dysphoric-disorder

https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd