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Premenstrual Dysphoric Disorder (PMDD) Vs. Premenstrual Syndrome (PMS)

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Premenstrual dysphoric disorder (PMDD) is a more severe, debilitating form of premenstrual syndrome (PMS). PMDD includes many signs of PMS, but it is characterized by extreme mood and behavioral changes a woman might experience during her menstrual cycle.

How PMDD Differs from PMS

Women who have periods have likely suffered symptoms of PMS at the onset of their cycle. PMS is often indicated by:

  • Cramps or bloating in the abdomen
  • Back pain
  • Headaches
  • Fatigue
  • Moodiness or increased irritation
  • Changes in appetite and diet
  • Tender or sore breasts
  • Acne on the face or body

While PMS can be difficult, it lasts for only a few days, and most women can handle their everyday lives when experiencing these symptoms.

PMDD, however, can have a more profound effect. Women with PMDD may find it interrupts their normal routine. PMDD might make you miss school, work, or other daily activities. It can stop you from seeing friends or even leaving the house.

Symptoms of Premenstrual Dysphoric Disorder

PMDD usually begins about seven to ten days before your period starts, and lasts until a few days after you have stopped bleeding. It can cause a myriad of symptoms, including both the effects of PMS and the following behavioral changes:

  • Intense mood swings
  • Depression or sadness
  • Anxiety
  • Feelings of hopelessness
  • Extreme anger or irritation

Like any form of depression, PMDD can have a negative effect on a woman’s enjoyment of hobbies or everyday activities, relationships, and self-esteem.

Diagnosing PMDD

If you suspect you have PMDD, talk to your doctor about the problems you’re experiencing. Because many of the symptoms of PMDD mirror depression and anxiety, your doctor will need to determine whether what you feel is related to your menstrual cycle or a possible mental or emotional disorder.

If the following are true:

  1. You have at least five of the 11 symptoms listed for PMDD
  2. Symptoms start about a week or ten days before you get your period
  3. They go away soon after your period ends

Your doctor will likely confirm your diagnosis and get you started on treatment.

Treatment Options for PMDD

There are a number of treatment options for PMDD. They include:

  • Birth control
  • Anti-inflammatory medication
  • Vitamin supplements
  • Antidepressants

You may also benefit from making changes to your physical health, such as incorporating more healthy foods into your diet or exercising regularly.


The antidepressants most commonly prescribed are selective serotonin reuptake inhibitors (SSRIs) like Paxil, Prozac, or Zoloft. These can help with your mood, appetite, and fatigue. They might reduce feelings of sadness or hopelessness, which can help you maintain your regular schedule during the days leading up to your period.

Prescriptions for antidepressants are available for the entire month or just for the days between ovulation and the start of your period. Your doctor will help you decide which dosage is right for you.


Women with PMDD can also find therapy beneficial. You are able to talk about your symptoms with your PMDD therapist, who can teach you to recognize and cope with these issues.