Premenstrual dysphoric disorder (PMDD) is similar to premenstrual syndrome (PMS), but symptoms are more severe. Symptoms include emotional, behavioral, and physical symptoms in the week or two leading to a person’s period.

PMDD symptoms include depression, anxiety, or severe irritability a week or twoTrusted Source before a period. Over 90%Trusted Source of females report some form of PMS before their period, and symptoms may include swollen and tender breasts and a loss of interest in sex.

This article breaks down the differences between the two conditions and outlines symptoms, treatment, and diagnosis.

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People with either condition may experience physical, behavioral, emotional, or affective (psychological) symptoms that change the way they think and feel. However, the frequency and severity of these symptoms vary between the two conditions.

PMDD symptoms

PMDD symptoms are more severe than those of PMS and have a more significant impact on a person’s day-to-day life. Doctors and other experts classify PMDD as a depressive order.

According to the Office on Women’s HealthTrusted Source, a doctor diagnoses PMDD when a person experiences five PMDD symptoms, including a mood-related symptom.

Affective, or psychological, symptoms include:

  • mood swings
  • sudden sadness
  • increased sensitivity to rejection
  • anger
  • irritability
  • sense of hopelessness
  • self-critical thoughts
  • tension
  • anxiety
  • depressed mood
  • suicidal thoughts

Physical and behavioral symptoms include:

  • difficulty concentrating
  • change in appetite, food cravings, and overeating
  • diminished interest in usual activities
  • easily tired and decreased energy
  • feeling overwhelmed or out of control
  • breast tenderness
  • bloating
  • weight gain
  • joint or muscle aches
  • sleeping too much or not sleeping enough

PMS symptoms

A person with PMS may or may not experience any affective or psychological symptoms. People with PMS may experience the following symptoms.

Mental and emotional symptoms includeTrusted Source:

  • fatigue or feeling tired
  • irritability
  • problems with sleeping too much or too little
  • changes in appetite
  • mood swings
  • issues with memory or concentration
  • anxiety
  • decreased sex drive
  • tension
  • feeling sad, frequent crying or depression

Physical symptoms may include:

Experts do not know the exact cause of PMDD and PMS. But researchTrusted Source suggests that fluctuations in hormones may be responsible. A person’s sensitivities to these fluctuations could determine whether they experience PMDD or PMS.

Hormone fluctuations may cause a serotonin deficiency. Known as the happy hormone, serotonin is a neurotransmitter that can affect both mood and physical symptoms associated with PMDD and PMS.

In a 2016 studyTrusted Source, researchers suggested that a person’s sensitivity to estrogen and progesterone may have links to PMDD and PMS. Other factors. such as stress and genetics, may also contribute to symptoms.

Treatments for PMDD and PMS are typically similar but depend on the severity of a person’s symptoms and whether they have any underlying health conditions.

PMDD treatments

Treatments for PMDD vary according to the symptoms, and some therapies work better for some people than others. If treatment does not succeed at first, a person should not give up and keep working on a treatment plan with their doctor.

A doctor may suggest one or more of the following to help alleviate PMDD symptoms:

  • increasing sleep
  • not smoking
  • eating healthily
  • acupuncture
  • oral contraceptives
  • selective serotonin reuptake inhibitors (SSRIs)
  • mood stabilizers
  • gonadotropin-releasing hormone (GnRH) agonists

PMS treatments

In some cases, a person may be able to alleviate PMS symptoms at home with over-the-counter (OTC) pain relief medications, regular exercise, and a healthy diet.

According to the Office on Women’s HealthTrusted Source, a doctor may recommend or prescribe:

Home care is an integral part of PMDD and PMS management.

Though PMDD symptoms are more severe than PMS, a combination of home care methods and other therapies could help a person effectively manage PMDD.

Many people with PMS notice a difference in symptoms when they change aspects of their diet or practice stress management techniques.

Home care methods that help alleviate PMS or PMDD symptoms includeTrusted Source:

  • not smoking
  • eating a healthy diet
  • getting regular exercise
  • managing stress
  • getting about 8 hours of sleep each night
  • OTC pain medications, such as ibuprofen

According to the Office on Women’s HealthTrusted Source, there is no single test for PMDD or PMS. A doctor will likely ask several health-related questions to determine what symptoms a person is experiencing, how often they occur, and how severe they are.

For a doctor to diagnose PMDD, a person must have five or moreTrusted Source PMDD symptoms, including at least one mood-related symptom.

A doctor may also take into account:

  • symptoms that interfere with home, school, or work-life
  • symptoms that are not related to or exacerbated by another medical condition

A person likely has PMS or PMDD if:

  • symptoms end a few days into the period
  • symptoms present 5 days before a period for at least three menstrual cycles in a row
  • symptoms prevent enjoyment or participation in everyday activities

The main difference between PMDD and PMS is the severity and type of symptoms a person experiences. For example, someone with PMDD may experience more affective symptoms more often than someone who doesn’t have it. These symptoms include depressed mood or mood swings days before their period starts.

A person should talk to their doctor if they are experiencing PMDD or PMS symptoms that interfere with their daily lives. A doctor should be able to help distinguish between the two conditions and suggest a treatment plan.

Keeping a journal of symptoms can help a doctor reach a diagnosis, especially if the symptoms are severe and regular enough to indicate PMDD.

A person should also talk with their doctor if their symptoms worsen or treatment is no longer effective, as they can make adjustments to the treatment plan.

If a person, family member, or friend expresses thoughts of suicide, they should contact emergency services or the National Suicide Prevention Lifeline immediately.

PMDD and PMS are similar conditions. PMDD is a more extreme form of PMS that may require additional therapy. Pain relief medication and hormonal birth control may help prevent or reduce some of the symptoms.

If a person’s life is adversely affected in the week or two leading up to their period, they should talk to their doctor about possible treatment options.

It may take a while for someone to find an effective treatment plan, so they must stay in touch with their doctor and provide updates on what works well and what does not.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.