PMS vs. PMDD: What's the Difference and Which is Worse?

PMS vs. PMDD: What's the Difference and Which is Worse?

You may notice a variety of symptoms affecting you a week or so before you are about to bleed. These may include general mood swings, acne, tender breasts, fatigue or the feeling of bloatedness and can plague you around the same time each month right before your periods and become better as you start to bleed. If this sounds like you, then you most likely have premenstrual syndrome (PMS).

But sometimes, your symptoms can feel extreme and interfere with your daily activities, often influencing your thoughts and emotions to a grave extent. If this happens to be the case, you are likely suffering from something more severe than PMS, which goes by the name of premenstrual dysphoric disorder (PMDD).

Symptoms of PMS vs PMDD

PMS symptoms affect about 90% of menstruators who experience one or more of the symptoms associated with it. But, PMDD is much rare and affects only about 3-8% of people with periods and usually need a doctor’s guidance to help with the symptoms.

Common symptoms

Both PMS and PMDD have some common symptoms that can affect a menstruator:

Symptoms that differ

However, there are certain symptoms of PMS and PMDD that vary in their degree of severity and these can include:

  • Anxiety - You can feel anxiety in both PMS and PMDD, but the degree varies towards more severe in the case of the latter. With PMDD, you may feel extremely stressed or on the edge.
  • Depression - Temporary feelings of mild depression are common in PMS, but with PMDD, you may end up feeling hopeless and even have thoughts of suicide in certain extreme cases. Further, you may not want to engage in day-to-day activities or feel like socializing at all.
  • Mood swings - Oscillating quickly between happy and sad to bursting into tears is a common phenomenon when you are experiencing PMS symptoms. But with PMDD you may feel like you are not in control of your life and your emotions can swing from extreme irritability to uncontrollable anger over things that would normally not upset you.
  • Detached feelings - PMS can sometimes make you feel like distancing yourself from your normal routine for a bit, but with PMDD, you can experience a complete disinterest in your job, hobbies and even your family and friends.

What are the causes of PMS and PMDD?

Experts have not been able to pinpoint exactly why you may experience either PMS or PMDD symptoms, but hormonal fluctuations are likely the culprit. And your genetic or otherwise disposition may determine your sensitivity to these fluctuations. This can likely govern whether you will experience PMS or PMDD.

These hormonal imbalances can also affect your serotonin levels, which can make your already existing depression even worse, or cause you to feel a surge of sadness.

How do  PMS and PMDD differ in terms of severity?

The main difference between PMS and PMDD is the degree of severity with which you feel the symptoms. Depression, anxiety and mood swings are much worse in the case of PMDD than they are with PMS.

How can you get PMS or PMDD diagnosed?

No formal diagnosis of PMS or PMDD exists at the moment, but your doctor may ask you to track your symptoms for several weeks to determine which of the two you are suffering from. You can track your symptoms for at least two cycles and then get diagnosed with the one you most likely have.

What are your treatment options?

The treatment options for both depend on the degree of severity experienced by you and which one you are most likely facing:

  • Lifestyle modification - For PMS symptoms, usually some lifestyle modification is enough to help with the symptoms. You can engage in regular exercise, maintain a healthy diet, get adequate sleep and reduce your stress levels to notice and improvement. In PMDD, lifestyle changes do help to a certain extent, but you may need other forms of treatment as well.
  • OTC medication - For cramps and other aches, OTC painkillers can work well, although you may want to visit a doctor and get yourself prescribed medicines that you feel will be able to help you better.
  • Antidepressants - Due to the depression that becomes severe in the case of PMDD, your doctor may prescribe you antidepressants that work by raising serotonin levels in your brain, causing your depression levels to go down.
  • Birth control pills - These contraceptive pills work by stopping ovulation in your body, which can relieve you of PMS and PMDD symptoms. They can work with both the emotional and the physical symptoms and you can speak to your doctor to see which would be a good option for you.

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