Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are both conditions that affect some individuals in the days leading up to menstruation. While they share some common symptoms, they differ in severity, duration, and impact on daily functioning. We spoke to our expert Dr B Menaka, Senior Gynaecologist, Kamineni Hospitals, LB Nagar, Hyderabad, who explained the distinctions between PMS and PMDD for accurate diagnosis and appropriate management.
What Is Premenstrual Syndrome (PMS)
PMS is a common condition that affects many menstruating individuals, typically in the week or two before their menstrual period. It is characterised by a variety of physical, emotional, and behavioural symptoms.
“While the exact cause of PMS is not fully understood, hormonal fluctuations, particularly changes in oestrogen and progesterone levels, are believed to play a role”, informed Dr Menaka.
According to StatPearls, the global pooled prevalence of PMS-affected women of reproductive age is 47.8%. Of them, 20% of the women have symptoms severe enough to interfere with their daily lives, while others have mild to moderate symptoms.
Also Read: Mood Swings, Bloating, Cramps: What's Behind Those Terrible PMS Symptoms?
Symptoms of PMS
PMS includes both physical and emotional/behavioural symptoms. On the physical front, individuals may experience breast tenderness, bloating, headaches, fatigue, and changes in appetite, including notable food cravings.
Dr Menaka added, “Concurrently, emotional and behavioural symptoms manifest as irritability, mood swings, anxiety, depression, and difficulty concentrating. This amalgamation of symptoms defines the multifaceted nature of PMS, highlighting its impact on both the body and mental well-being during the premenstrual phase.”
Duration and Severity
“PMS symptoms usually start to appear in the luteal phase of the menstrual cycle, peaking a few days before menstruation and often improving once the period begins”, said Dr Menaka. The symptoms are generally mild to moderate in intensity and do not significantly interfere with daily activities.
Management of PMS
Management strategies for PMS often involve lifestyle modifications, such as regular exercise, a balanced diet, stress reduction techniques, and sometimes the use of over-the-counter pain relievers or hormonal therapies.
Premenstrual Dysphoric Disorder (PMDD)
PMDD is a more severe form of premenstrual syndrome, and it is considered a psychiatric condition. It shares many symptoms with PMS but is distinguished by the intensity and impact these symptoms have on daily life.
Dr Menaka highlighted, “PMDD can significantly affect a person's emotional well-being and functioning, and its diagnosis requires careful consideration of specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).”
According to Harvard Health Publishing, you are more sensitive to your reproductive hormones in the two weeks leading up to your menstruation if you have PMDD. Changes in the neurologic circuits and brain chemicals that regulate your mood and overall sense of well-being are brought on by this sensitivity.
Also Read: Menstruation Diet: Expert Lists Foods To Eat And Avoid
Symptoms of PMDD
Dr Menaka listed the symptoms of PMDD as follows:
PMDD is characterised by severe mood symptoms, such as depression, irritability, hopelessness, and mood swings. These distinguish PMDD from milder emotional fluctuations seen in PMS.
It involves not only marked mood symptoms but also other impactful manifestations, including fatigue, changes in sleep patterns, difficulty concentrating, and physical symptoms like bloating and breast tenderness. These distinguish PMDD from the less severe symptoms typically associated with PMS.
Duration and Severity
PMDD symptoms are not only more severe than those of PMS but also last for a shorter duration. Dr Menaka added, “PMDD symptoms typically occur in the week before menstruation and improve within a few days after the onset of the menstrual period. The severity of symptoms can be debilitating, significantly impacting personal and professional aspects of life.”
Management of PMDD
The management of PMDD often involves a combination of pharmacological and non-pharmacological approaches. Antidepressant medications, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), are effective in alleviating PMDD symptoms. Additionally, lifestyle modifications, Cognitive Behavioural Therapy (CBT), and stress reduction techniques may also be beneficial.
Key Differences Between PMS And PMDD
Dr Menaka listed the key differences between PMS and PMDD as follows:
.jpg)
Severity and Impact
The primary distinction between PMS and PMDD is the severity of symptoms and their impact on daily functioning. PMDD involves more intense emotional and physical symptoms that significantly disrupt a person's life.
Duration
While both PMS and PMDD symptoms occur in the luteal phase before menstruation, PMDD symptoms are typically shorter in duration and more acute.
Psychiatric Component
PMDD is classified as a psychiatric disorder, reflecting the profound impact it can have on mental health. PMS, while challenging, is not considered a psychiatric condition.
[Disclaimer: This article contains information provided by a registered healthcare professional and is for informational purposes only. Hence, we advise you to not substitute this information with medical treatment and to consult your doctor to avoid complications.]
