PMS - Could It Actually Be Premenstrual Dysphoric Disorder (PMDD)?

Around ‘that time of the month’, do you feel like your mood is out of control and you’re spiraling? You are not alone. Many women experience symptoms related to their period. When these symptoms affect your daily life, you may have PMS or PMDD.

What is PMS or Premenstrual Syndrome?

PMS is when a woman experiences physical and behavioral symptoms in the second half of the menstrual cycle, and sometimes into their period. These symptoms can impact family or work life. The more severe form of PMS is PMDD or premenstrual dysphoric disorder.

What Symptoms Are Associated with This?

• Physical symptoms like abdominal bloating, breast tenderness, fatigue, headaches, hot flashes. Sleeping more than usual or difficulties sleeping.
• Emotional or behavioral symptoms including mood swings, feeling sad, hopeless, anxiety, feeling on edge, irritability. Feeling out of control. Decreased interest in usual activities. Difficulty concentrating. Change in appetite and/or cravings.

Symptoms with PMS and PMDD are typically severe and leave women having trouble dealing with work and home life. There are other disorders that can mimic PMS and PMDD, so it’s important to discuss your symptoms with your doctor.

How Common is this Premenstrual Disorder?

It is common for women to experience one or two of these premenstrual symptoms, however several symptoms that are severe and affect daily life are less common. About 3-8% of women have clinically significant PMS (more than just 1 or 2 mild symptoms) and about 2% have PMDD.

Why Do I Have This?

There is limited data on the cause of PMS and PMDD. Hormonal levels are similar in women with PMS and PMDD and those who do not have it. In patients that have PMS/PMDD, they may be more sensitive to normal changes in hormones.

How is PMS/PMDD Diagnosed?

There is not a single test, lab or physical finding that can diagnose PMS or PMDD. The diagnosis is based on documented symptoms from the patient, occurring during a specific time of the menstrual cycle.

If I’m Diagnosed, is Treatment Available?

Absolutely! There are lifestyle changes that can help and medical therapy available when needed. Lifestyle changes include exercising, which can reduce stress, anxiety and depression. Relaxation techniques can be helpful, and include meditation and therapy.

Medications available for treatment include combined oral contraceptive pills or selective serotonin reuptake inhibitors (SSRI). There are specific birth control pills that can be more helpful with PMS/PMDD, your doctor can discuss this more with you. SSRIs are medications that are used for patients with anxiety and depression, but are also helpful for PMS/PMDD.

If you are experiencing these symptoms related to your menstrual cycle and feel like you may have PMS or PMDD, please contact your provider to discuss it in more detail.

If you do not have a women's health provider, please learn more about our CHI Health Women's Health Team.