PMS and PMDD

Hormonal changes, particularly in the days or weeks leading up to your period, can have a significant effect on how you feel both physically and emotionally. For many women, this experience might not be pleasant, but is mostly manageable, and may be recognised as premenstrual syndrome (PMS).

However, for others, these changes can be more severe, pointing to a condition called premenstrual dysphoric disorder (PMDD).

Here, we’ll explore the signs and causes of both PMS and PMDD, to help you understand any symptoms you might be experiencing at different times in your cycle.  We’ll also look at some effective ways that our support and expertise can help you manage the symptoms of PMS or PMDD, and feel more in control of your health and wellbeing.

What Is PMS?

Premenstrual syndrome (PMS) refers to the physical, emotional, and behavioural symptoms you might experience during the luteal phase of your menstrual cycle—the time after ovulation and before your period begins. These symptoms typically improve once your period starts and are quite common, affecting most women at some point in their lives.

Common Symptoms of PMS

Symptoms vary from person to person, and sometimes from month to month, but they can include:

• Physical symptoms: Bloating, breast tenderness, headaches, and tiredness.
• Emotional symptoms: Mood swings, irritability, anxiety, or low mood.
• Behavioural symptoms: Changes in appetite, difficulty concentrating, or problems sleeping.

Symptoms can range from mild to more severe, and might affect your work and relationships. It’s really important to try and recognise what’s happening for you, so you can talk everything through with your doctor, and access the right help.

What Causes PMS?

The exact causes of PMS aren’t fully understood, but it is linked to hormonal changes during your menstrual cycle. In the second half of your cycle, levels of oestrogen and progesterone rise and then fall sharply if you don’t conceive. These hormonal changes are believed to interact with brain chemicals such as serotonin (which regulates mood), appetite, and sleep.

Other lifestyle factors, such as stress, an unbalanced diet and lack of sleep may also exacerbate symptoms.

Managing PMS

While PMS can’t be cured as it’s linked to natural changes within your body, there are many things that you can explore, to help minimise its impact on your life:

• Maintain a healthy lifestyle: Staying active, eating balanced, regular meals, adopting good sleep hygiene, and drinking enough water can all be simple habits that can have a big impact.
• Manage stress effectively: Stress is an unavoidable part of most people’s lives, but looking into relaxation techniques like yoga, meditation, or breathing exercises can help to relax your mind and stabilise your mood.
• Consider supplements: Some people find that taking certain supplements daily, such as vitamin B6, calcium, and magnesium, can help with mood and overall well-being.
• Track your symptoms: Keeping a diary of your symptoms can help you understand patterns and triggers, as well as guide conversations with your doctor.

Before you adopt any of the above, it’s a good idea to discuss potential changes with your doctor. They will look at your current lifestyle and medical history with you, and make personalised recommendations to help manage PMS symptoms.

What Is PMDD?

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. While it shares some symptoms with PMS, the emotional and psychological impact of PMDD is far more intense, and commonly interferes with work, relationships, and daily life in a way that can feel unmanageable for many women. 

Symptoms of PMDD

PMDD symptoms usually appear one to two weeks before your period begins and improve within a few days of bleeding. While PMDD includes physical symptoms similar to PMS, its defining feature is the intensity of emotional and behavioural symptoms, such as:

• Extreme mood swings, irritability, or anger.
• Feelings of hopelessness, sadness, or depression (sometimes including suicidal thoughts).
• Severe anxiety or panic attacks.
• Difficulty concentrating or making decisions.
• Extreme fatigue or low energy.
• Insomnia or changes in sleep patterns.

These symptoms can feel overwhelming, but it’s important to know that expert help is available, and it can have a profound effect on your wellbeing.

What Causes PMDD?

The exact cause of PMDD is not known, but it is thought to be linked to an extreme sensitivity to hormonal changes during your menstrual cycle. Similar to PMS, serotonin may also play a role.

Certain factors may increase your risk of developing PMDD, such as:

• A history of anxiety, depression, or mood disorders.
• A family history of PMS, PMDD, or mental health conditions.
• Personal experiences of significant stress or trauma.

Managing and Treating PMDD

If you suspect you have PMDD, it’s really important to seek advice from your doctor. They may recommend tracking your symptoms for at least two cycles to confirm the diagnosis and rule out other conditions, such as anxiety or depression.

Areas that can help you to manage PMDD symptoms may include:

• Lifestyle changes: Like PMS, regular exercise, a balanced diet, and reducing caffeine or alcohol intake can help.
• Stress management: Mindfulness, relaxation techniques, or talking therapies can help to support your emotional wellbeing.
• Medications: Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, can be effective in managing extreme emotional symptoms.
• Hormonal treatments: In some cases, contraceptive pills or hormonal therapies may be recommended to stabilise hormone fluctuations.

If you have symptoms of PMDD, it’s recommended that you consult a doctor with expertise in women’s health. They will be able to help you to reach a diagnosis, understand your specific symptoms, and help you create a healthcare plan that specifically aims to improve your daily life. 

Seeking Help for PMS or PMDD

If you’re feeling unlike yourself during certain times of your menstrual cycle, it’s important that you don’t underestimate the effect that PMS and PMDD can have on your life. The key difference between the two is the severity in symptoms, and how much they interfere with your ability to function in a way that feels normal for you. If you’re experiencing symptoms that feel overwhelming or persistent, our women’s healthcare specialists are on hand to help you. 

Our team includes world-class consultant gynaecologists, GPs with a specialism in gynaecology, sonographers and endocrinologists. They will work collaboratively with you to ensure the highest level of care, offering individualised plans to suit your unique needs and support your overall wellbeing.

Visit Our London Clinic for PMS or PMDD

You can visit The Medical Chambers Kensington for an appointment with one of our experiencedwomen’s healthcare team. To find out more, please telephone 020 7244 4200 or make an appointment online.