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What's the difference between PMDD and PMS?

PMDD and PMS are fancy medical terms used to describe the varying amount of pain and discomfort that women experience with menstruation. Everyone woman experiences some level of discomfort with the arrival of aunty flo, after all, that’s how we know she has arrived! Whether it’s mild nausea or cramps or feeling worn out, we all have little signals the body gives us. For the most part, these signals are normal, but for some women, they can tether to the extremes of PMS and PMMD. This is what the terms stand for:

PMDD - Premenstrual Dysphoric Disorder

PMS - Premenstrual Syndrome

If it were a spectrum, it would look something like this. Here, mild period discomfort being the least concerning and most common, and PMMD being the most distressing.PMMD is a more severe form of PMS.

Mild period discomfort → PMS → PMDD

It is important to note that both PMS ad PMMD occur in the few days leading up to menstruation and tend to resolve a few days into menstruation ( hence the term pre-menstrual). Both are triggered by the changes in hormones as you approach menstruation. Some people are not too sensitive to the hormonal fluctuations while others esp those with PMMD are severely sensitive to the hormonal fluctuations. It has also been noted that the hormone serotonin has a role to play, where the body does not respond to it properly. Stress has also been indicated to be notably higher in women with PMDD.

Check out our blog post here to learn more about the intricacies of PMMD specifically.

3 differences between PMS and PMMD

  1. PMMD is more psychologically inclined

While PMS often manifests with majorly physical & emotional symptoms such as fatigue, painful cramps, acne, diarrhea, and general moodiness. PMMD is more of a severe mood disorder that affects not only a woman’s moods, emotions, and behavior but also her ability to cope with daily life.

While some of these mood changes do occur with PMS, in PMMD they are debilitating and are the most significant symptoms. PMMD often feels like major depression. The only difference between PMMD and major depression is that PMMD only occurs in the late luteal phase ( following ovulation) and resolves soon after menstruation begins. Needless to say, pregnant women, menopausal women, and pre-pubescent girls cannot suffer from PMMD or PMS. Oh and neither can the man next door - LOL!

  1. PMS is way more common

A mild form of PMS is noted by up to 30% of menstruating women, while PMDD only affects 5-8% of women. PMDD is a chronic condition that gravely affects a woman’s quality of life.

In order for a doctor to diagnose PMMD a woman will often be experiencing most of the common PMS symptoms as well five or more of the following:

1. Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection).

2. Marked irritability or anger or increased interpersonal conflicts.

3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.

4. Marked anxiety, tension, and/or feelings of being keyed up or on edge.

5. Decreased interest in usual activities (e.g., work, school, friends, hobbies).

6. Subjective difficulty in concentration.

7. Lethargy, easy fatigability, or marked lack of energy.

8. Marked change in appetite; overeating; or specific food cravings.

9. Hypersomnia or insomnia.

10. A sense of being overwhelmed or out of control - feeling wild

11. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.

With PMMD, she also needs to have experienced these symptoms for the majority of her cycles in a 1 year period.

  1. PMDD often requires intervention

While PMS can be significantly improved by simple lifestyle changes like better eating habits, regular exercise, and improved sleep, PMMD often requires major intervention. In Chinese medicine, it is treated with a very targeted approach of Chinese herbs, acupuncture, and lifestyle changes. The aim of these is to achieve a state of balance in the woman’s mind, body, and spirit which then inadvertently stabilizes her hormonal responses. In western medicine, the doctor will often prescribe antidepressants or even the birth control pill ( unfortunately this act as a band-aid to the real issues, simply masking the symptoms)

To sum it all up, whether it’s PMS and PMDD, it is important to remember that severe pain and discomfort with your period is not ‘normal’. You owe it to yourself to look into it and seek help to alleviate your symptoms. Feel free to reach out to me anytime for help with either of these issues.

As always, happy flowing ladies :)


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