PMS vs. PMDD — What Is the Difference?

PMS vs. PMDD — What Is the Difference?
Page content

PMS and PMDD Similarities

Premenstrual syndrome (PMS) affects women in the week or two before menstruation begins. So does premenstrual dysphoric disorder (PMDD). Women who are affected by PMS experience physical and psychological symptoms. The same goes for women who have PMDD. PMS symptoms usually subside when menstruation begins or soon after, only to return the following month, just like PMDD. So, PMS vs PMDD, exactly what is the difference? Are the two conditions basically the same thing? Can they be treated in the same way? How do they differ?

Distinct Differences

It is true that both conditions have a lot in common, but for women who suffer from premenstrual dysphoric disorder, the difference is profound. PMDD is a severe version of PMS. It is characterized by psychological symptoms that are so intense that they disrupt normal life, particularly impacting relationships with family members, friends and even co-workers. While PMS may be a series of symptoms that 75 to 80 percent of women deal with every month, often without the need for medical attention, PMDD is so serious that some form of treatment is necessary.

Premenstrual Dysphoric Disorder Symptoms

How do you know if you have PMDD rather than just PMS? The following are the symptoms of premenstrual dysphoric disorder:

  • Depression and hopelessness
  • Severe anxiety, tension, and irritability
  • Extreme sensitivity
  • Persistent anger
  • Loss of interest in everyday activities
  • Problems with concentration and focus
  • Fatigue
  • Appetite changes
  • Insomnia or excessive sleeping
  • Feeling out of control
  • Weight gain
  • Bloating
  • Breast tenderness
  • Headache
  • Joint pain

Not all symptoms need to be present to be diagnosed with this condition. The basic characteristic of PMDD is not being able to function properly because of psychological disturbances. It is possible that the reason for premenstrual mood and emotional disturbances is a sensitivity to estrogen and progesterone shifts. This sensitivity leads to disruptions with neurotransmission, particularly of serotonin. While this is the case with the psychological symptoms of PMS as well, the sensitivity is more marked with PMDD.

While a healthy diet, herbs, exercise and nutritional supplements may be able to treat this condition, you can also choose prescription medications for PMDD, including selective serotonin reuptake inhibitors (SSRIs), antidepressants and oral contraceptives. There are potential risks with these drugs, including addiction and an increased risk of stroke and heart disease. You can discuss treatment options with your doctor, taking into consideration how severe the symptoms are.

PMS Symptoms

The symptoms of PMS are very similar, although the psychological problems are not as debilitating and will respond well to nutritional therapy, herbs, exercise, and stress management. Headahces, bloating, cramping, mood swings, and skin eruptions are common.

PMS vs. PMDD, how do you know which one you have? If your symptoms are severe see a doctor for an official diagnosis and then you can discuss treatment options. Keep in mind, while the majority of women experience premenstrual syndrome, only 3 to 8 percent of women of child bearing age have PMDD. If you do suffer from it, understand that it is a medical condition and that it can be treated.


MGH Center for Women’s Mental Health


Balch, Phyllis A. " Prescription for Nutritional Healing." Fourth Edition (Penguin Books, 2006).

photo by: Law Murray (CC/flickr)