PMS vs PMDD — What's the Difference?

Most women experience some premenstrual symptoms, but for some, these symptoms can be severe enough to significantly impact daily life. Let’s explore the difference between PMS and PMDD.

What is PMS?

Premenstrual syndrome (PMS) refers to a collection of physical and emotional symptoms that occur in the one to two weeks before your period. Up to 75% of women experience some form of PMS.

Common PMS Symptoms

Physical symptoms:

• Bloating
• Breast tenderness
• Headaches
• Fatigue
• Muscle aches
• Acne flare-ups

Emotional symptoms:

• Mood swings
• Irritability
• Anxiety
• Food cravings
• Difficulty concentrating

What is PMDD?

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that affects approximately 3-8% of women. It’s now recognized as a clinical diagnosis in the DSM-5.

PMDD Symptoms

PMDD includes PMS symptoms plus more severe psychological symptoms:

• Severe depression or hopelessness
• Intense anxiety or panic attacks
• Extreme mood swings
• Persistent anger or irritability
• Feeling out of control
• Difficulty with relationships
• Thoughts of self-harm (in severe cases)

Key Differences

Aspect	PMS	PMDD
Severity	Mild to moderate	Severe
Impact on life	Manageable	Significantly disruptive
Primary symptoms	Physical and mild emotional	Primarily psychological
Prevalence	~75% of women	3-8% of women

What Causes These Conditions?

Both PMS and PMDD are linked to:

1. Hormonal fluctuations — Changes in estrogen and progesterone during the luteal phase
2. Serotonin sensitivity — Some women’s brains respond differently to hormonal changes
3. Genetic factors — Family history increases risk
4. Stress and lifestyle — Can worsen symptoms

Treatment Options

For PMS

• Lifestyle changes (exercise, diet, sleep)
• Over-the-counter pain relievers
• Supplements (calcium, vitamin B6, magnesium)
• Stress management techniques

For PMDD

• SSRIs (can be taken cyclically or continuously)
• Hormonal treatments (birth control pills, GnRH agonists)
• Cognitive behavioral therapy (CBT)
• Lifestyle modifications

When to Seek Help

Consult a healthcare provider if:

• Symptoms significantly interfere with work, school, or relationships
• You experience symptoms of depression or anxiety
• Over-the-counter treatments aren’t helping
• You have thoughts of self-harm

Tracking Your Symptoms

Keeping a symptom diary for at least two cycles can help you and your healthcare provider:

• Confirm the diagnosis
• Identify your specific symptom patterns
• Measure treatment effectiveness

Ona makes this tracking effortless by helping you log symptoms daily and visualize patterns over time.