The side-effects associated with PMS can be very mild (low-grade cramps and a tendency to cry more easily), or they can be quite severe (debilitating cramps and significant mood swings). Over a lifetime spectrum of menstrual cycles, you can expect some periods will be more intense than others – that is entirely normal.

But, then there are the situations that aren’t.

What’s the difference between PMDD and PMS

Sometimes, women consistently experience periods that are so painful or temporarily life changing that we move them from the pre-menstrual syndrome (PMS) bracket to the premenstrual dysphoric disorder (PMDD) category.

Here are some of the ways that PMDD differs from PMS:

Symptoms begin earlier in your cycle

With PMS, symptoms typically begin just a few days or even the day before your period begins. With PMDD, women begin experiencing shifts in mood, breast tenderness, bloating, etc., as long as seven or even 10 days before their period starts.

Since the average menstrual cycle lasts about 28 days, the pre-menstrual phase plus the actual week of a woman’s period begins to dominate her life, with PMDD, period-free days being the smallest phase in her monthly cycle.

Depression and anxiety

When you experience PMS, you may have a slight over-reaction to something your partner said, or feel poignantly emotional about a particular scenario; then you start your period, look back and kind of chuckle, “Oooooh, that was PMS!” With PMDD, there’s nothing to chuckle about.

Women who experience PMDD can have dramatic and uncontrollable mood swings that make them feel extremely depressed, irritable, hopeless and/or anxious. These emotions can rule them to the point that they damage relationships or disrupt their work life.

Marked irritability and anger

A little irritability is one thing. With PMDD, women can be so irritable and angry that they’re almost rage-filled – even about things that don’t seem all that important in the big picture. In addition to the negative emotions they carry, which we know isn’t good for overall well-being, this marked irritability and anger can also create rifts in valuable relationships as the result of overly-intense and/or hurtful outbursts and reactions.

Insomnia and fatigue

Another powerful piece of the puzzle is insomnia and fatigue, both of which are PMS symptoms that intensify for women with PMDD. Insomnia is associated with fluctuations in hormones, so it’s a common side-effect of PMS, PMDD and menopause, too. Whenever you lose sleep, you become fatigued and other side-effects such as irritability, cramps, nausea, headaches, etc., are exacerbated.

Is there treatment for PMDD?

If you feel your symptoms are closer to PMDD than PMS, schedule a consultation with your OB/GYN or bring it up at your next appointment (sooner is better than later).

While there’s no absolute treatment for PMDD (until menopause, anyway), there are plenty of things we can do to help you weather your month-to-month cycle in a more balanced way.

Some of the most common and effective treatments for PMDD are:

• Antidepressants. Researchers have found that the risk for experiencing PMDD is higher in women who have a previous history of depression, anxiety and other mood disorders. Antidepressants, specifically serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem, others) and sertraline (Zoloft), are effective at minimizing or eliminating some of the more frustrating symptoms of PMDD, like depression, irritability, food cravings and sleep disorders.
• Birth control pills. Contraception isn’t the only reason to take birth control pills. Because they work by controlling hormone levels, they also work to control things like the symptoms of PMS and PMDD. If you have PMDD, your doctor may recommend eliminating or reducing the pill-free interval (the week you typically bleed) to keep things more consistent.
• Nutritional supplements. Always talk to your doctor before adding nutritional supplements to your life. However, if you’re interested in going this route, ask about Calcium (some studies have shown that consuming 1200 mg/day – via diet and supplements – can reduce PMS and PMDD symptoms), magnesium, vitamin B-6 and L-tryptophan, all of which may benefit you.
• Herbal supplements. Chasteberry is an herbal supplement that has potential benefit for women with PMS and PMDD. Macca is another supplement associated with naturally balancing women’s hormones and moods. It’s a powder that can be added to smoothies or drinks. Herbal remedies like these aren’t approved by the FDA so you should ask your doctor for more information.
• Lifestyle changes. If your body has bigger hormone fluctuations than “normal,” or you are more sensitive to these fluctuations, changing your lifestyle can have consistent and significant effects. Incorporating regular exercise into your routine is the first step, as exercise is proven to minimize PMS symptoms. A healthy diet, minimizing caffeine and alcohol intake, reducing salt and refined sugar intake and focusing on whole foods can also make a difference.

Don’t let your Self be dictated by your hormones and PMDD. Contact us here at Women’s Health Associates and make time to pull up a chair. We are a women-staffed, women’s healthcare provider and we’re dedicated to providing personalized, quality care to every patient at every stage of life.

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