What's the difference between PMS and PMDD?
Premenstrual syndrome (PMS) refers to physical and emotional symptoms in the days before your period — bloating, breast tenderness, mood changes, irritability, and fatigue. Most women experience some degree of PMS.
Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that causes significant emotional distress. Symptoms can include severe depression, anxiety, anger, and feeling overwhelmed — to the point where they affect your relationships and daily functioning. PMDD affects about 3–8% of women.
Why does it happen?
PMS and PMDD are thought to be caused by sensitivity to normal hormonal fluctuations — particularly the drop in progesterone and oestrogen in the days before your period. It's not a hormone imbalance per se, but an abnormal response to normal hormonal changes.
This is why treatments that suppress ovulation — like the combined pill — can be effective, as they create a more stable hormonal environment.
Treatment options
For mild to moderate PMS, lifestyle measures can help: regular exercise, stress management, reducing caffeine and alcohol, and ensuring adequate sleep. Some women benefit from supplements like calcium, magnesium, or vitamin B6.
For PMDD or severe PMS, medical treatment may include the combined oral contraceptive pill (particularly formulations containing drospirenone), SSRIs (antidepressants, which can be very effective for PMDD), or cognitive behavioural therapy. Your GP can discuss which approach is right for you.
Related condition
Periods & menstrual health →References & sources
- 1.Periods — Jean Hailes for Women's Health
- 2.Heavy periods — healthdirect
- 3.Menstruation — healthdirect
- 4.Heavy periods — Better Health Channel
This content is general information and not a substitute for individual medical advice. Please consult a GP for your personal situation.
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