Menstrual Disorders Pmdd Pms

The Difference Between PMDD and PMS Image

The PMS Picture

Premenstrual syndrome is fairly well known as the period of time about a week prior to her menstrual period when a woman’s behavior becomes . . . well . . . a little bit more ‘sensitive.’ While the “How many women with PMS does it take to change a light bulb?” joke has saturated the Internet, most women are willing to concede that they are a bit edgy during that time.

While mood swings are quite common in premenstrual women, the physical discomforts are also a big part of the picture. In fact, some of the physical symptoms are debilitating enough to interfere with normal living. Cramping, bloating, binge eating, anxiety and many other indicators are considered normal. Some women, who suffer from depression, report that their depression is at its worst prior to menses.

Typically, these discomforts are attributed to the hormone imbalance that occurs when a woman’s body goes through her natural cycle. The degree of discomfort ranges from mild to severe, and that is the cause of confusion: how do the more severe symptoms of PMS differ from those of PMDD?

The PMDD Picture: Is It Clear?

 Some of the literature on premenstrual dysphoric disorder defines it simply as a more severe version of PMS. While this may be a comprehensive descriptor, it isn’t very effective in helping a woman determine whether her mood swings are worthy of the PMDD label.

Check the list of symptoms below. You may experience several of them from one month to the next, although not necessarily the same ones each time. If they interfere with your daily life in some significant way they cause you to miss work, fight with members of your family, cancel your scheduled visit to the gym, withdraw from social activities then you should start to suspect PMDD. In fact, your doctor may diagnose PMDD if you experience five or more of these symptoms with your period:

  • Your feelings of depression and hopelessness are worse.
  • You feel tense, anxious or edgy.
  • You’re confused and have trouble concentrating or focusing on your. reading, work or activities.
  • You feel touchy or sensitive, and your moods change abruptly.
  • You have unusual feelings of anger or rage.
  • You have little interest in your usual activities and outings.
  • You have trouble sleeping.
  • Your energy is low and doing almost anything takes great effort.
  • You sleep more than usual and don’t feel rested afterwards.
  • You feel that your life may be out of control or that your responsibilities overwhelm you.
  • You’re more likely to resort to binge eating.
  • You’ve lost your appetite.

While this list of symptoms is descriptive of the mood swings that accompany PMS and are thought to be caused by a hormone imbalance, note that the presence of a significant number of these symptoms and their severity are a cause for concern.

Sounds Like Clinical Depression

The symptoms of PMDD are, in fact, remarkably similar to those of several mood disorders, particularly bipolar disorder. The difference is that these particular effects are felt during the premenstrual period about seven to ten days then they go away until the next menstrual cycle.

How Severe Is Severe?

Claudia says, “I’m a naturally energetic person. I love to have things organized and ready. I’m the type who packs a lunch and does the ironing the night before so I can have time to go out for a run in the morning.

“I knew I was in trouble when my PMS got much worse. One night, I was soaking in the tub and noticed that the toilet paper roll was empty. As I got out of the bath, I was so overwhelmed with the job of replacing the toilet paper roll that I had to sit down and work up the energy to do it . . .”

This is only one of Claudia’s symptoms, but it was the factor that helped her decide to tell her doctor about her other symptoms.

The symptoms of mood disorders such as manic depression don’t disappear. While a bipolar disorder is marked by alternating lows and highs, the highs are not periods of relief, but periods in which compulsive or “manic” activity dominates. The patient does not feel relief during a manic period.

One important clue that PMDD is related to the menstrual cycle is that it completely disappears during pregnancy!

The Bottom Line

Ask your physician or gynecologist for help. Even if your condition is not diagnosed as PMDD, you can get treatment that brings relief from your symptoms.


Medline Plus. (updated 2002). Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Retrieved August 14, 2002, from

OBGYN.Net. (Updated 2001). PMDD or PMS: Is there a difference? Retrieved September 9, 2002, from

Podell, R. (1993). Premenstrual syndrome (PMS). Retrieved August 15, 2002, from