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PMS vs. PMDD: How to Tell the Difference

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A problem identified is already half-solved. This is especially true for health conditions. If you don’t exactly know what you’re dealing with, you can’t know the next steps to take to get closer to wellness.

When it comes to PMS vs. PMDD, however, there is the added challenge that these two conditions are alike in many ways - the biggest difference being the approach to treatment. This is why it’s important to be aware of the subtle differences between the two. Whether you’re wondering why your apparent PMS is showing much graver symptoms; or just come across the term PMDD and are wondering what it’s about, you’re in the right place. In this article, we will cover the main differences (as well as the similarities) between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). 

Let’s begin!

A woman holding her abdomen in pain

What is PMS and PMDD? 

One to two weeks before menstruation is the timeframe when these two conditions manifest - hence both prefixes are “premenstrual.” As far as characterization goes, that’s where the similarities end. PMS is referred to as a “syndrome” while PMDD is referred to as a “dysphoric disorder” – so what exactly does it mean? 

Syndrome” is defined as a group of signs or symptoms that occur together and characterize a particular condition. Meanwhile, “dysphoria” is defined as a state of pronounced unhappiness, unease, or dissatisfaction. From a psychiatric context, dysphoria is linked with agitation, depression, and/or anxiety.

From just the names of these two premenstrual conditions, we can see that PMDD is a disorder that is more connected to severe mental health concerns. However, one should not confuse PMDD with PME (premenstrual exacerbation). Unlike PMS and PMDD which are self-contained conditions, PME is when underlying mood disorders (that are already present to begin with) worsen during the premenstrual period, thereby mimicking the symptoms of PMDD. 

PMS vs. PMDD: Prevalence 

Over 90% of women suffer from at least one of the symptoms of PMS. It’s also found that women in their 30s are more likely to have PMS or experience more of its symptoms. On the other hand, only 5 percent of women suffer from PMDD.

Before we take this number at face value, we must consider the possibility that deeper problems could be concealing the real number of women who suffer from this condition. For instance, because awareness around PMDD is so low, many women who suffer from it could be mistaking it for PMS. Or perhaps, a majority of PMDD cases go unreported by the patients due to a fear of stigmatization of not being taken seriously. 

While PMS is more common, this does not mean that it should go without treatment (which we will discuss later).

PMS vs. PMDD: Causes 

Both PMS and PMDD are connected to a common bodily event: menstruation. The exact underlying cause of both PMS and PMDD is still not clear nor is it why some people don’t experience either. Underlying conditions such as depression and anxiety are common in patients with PMS and PMDD, so it is possible that premenstrual hormonal changes can trigger behavioural disorders.

There is some evidence to support that those who suffer from PMDD have a subtly different genetic make-up and that the susceptibility to the condition is likely to be passed on. 

A mother and daughter share PMDD stories

Signs and Symptoms of PMS and PMDD:  

Both PMS and PMDD have symptoms that begin one to two weeks before a person’s period starts and these symptoms can extend into the first few days of the period itself. 

Premenstrual syndrome is characterized by any or all of the following symptoms:

  • Bloating or tummy aches
  • Headaches
  • Breast tenderness
  • Changes in appetite
  • Fatigue or low energy
  • Spotty skin or greasy hair
  • Mood swings or feelings of being upset, anxious, and irritable

In many respects, the premenstrual dysphoric disorder can be considered an extension or severe version of premenstrual syndrome. It has any or all of the following symptoms:

  • Any or all of the physical symptoms of PMS
  • Lasting irritability or anger
  • Mood swings and crying 
  • Feelings of sadness and despair
  • Feelings of tensions and anxiety
  • Feeling out of control
  • Thoughts about suicide
  • Panic attacks

PMS vs. PMDD: Diagnosis

As of now, there is no singular medical test to detect either PMS or PMDD. Qualified physicians would base their diagnosis on physical as well as behavioural symptoms observed during the patient’s luteal phase. Symptoms that appear outside of the hormonal time frame associated with PMS or PMDD is likely to be another condition. 

Along with this clinical approach, laboratory tests can be done on the patient’s blood sample. The blood test will not directly point to either PMS or PMDD but will rule out other conditions that have the same symptoms. For instance, a low blood count can point to anemia which might actually be the reason for extreme fatigue. Another example is when a patient has hypothyroidism or hyperthyroidism, conditions that tend to have the same symptoms as PMS or PMDD. Lab tests will be able to quantify the distinct hormones associated with hypothyroidism or hyperthyroidism, thereby ruling them out. 

PMS and PMDD Treatment

Because PMS and PMDD have a similar set of symptoms, a lot of the recommended treatments are similar. These are mainly for reducing stress and anxiety that can be experienced with both of the conditions. Some treatment options include:

  • Regular exercise and diet
  • Relaxation therapy like meditation, self-hypnosis, and biofeedback
  • Birth control pills (for select cases)
  • Vitamin B6 (typically for mild PMS)
  • SSRI class of antidepressant drugs (typically for severe PMS and PMDD)

We hope our guide on PMS vs. PMDD was helpful for you; please feel free to share this article with your loved ones who are suffering from symptoms that sound like either of these conditions. Together, we can combat stigmas surrounding menstruation and understand that the pains we’re facing are okay to talk about!


If you’re looking for a company that supports women’s health and understands their needs, The Brand Hannah is your go-to for all things menstruation-related!

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