PMS & PMDD
(Premenstrual Syndrome & Premenstrual Dysphoric Disorder)
Remember, it is okay to ask for help. Asking for help shows bravery and courage. Seek emergency care if you have plans or intent of harming yourself or others.
What is Premenstrual Syndrome (PMS)?
PMS is a collection of physical and emotional symptoms that start one to two weeks before your period begins. Symptoms usually go away once your period starts or shortly after.
- Mood swings, irritability, or anger
- Anxiety or feeling tense
- Sadness or crying spells
- Food cravings or appetite changes
- Trouble concentrating
- Social withdrawal
- Bloating or a feeling of gassiness
- Breast tenderness
- Headaches
- Fatigue and low energy
- Acne flare-ups
- Muscle aches or joint pain
What is Premenstrual Dysphoric Disorder (PMDD)?
PMDD is a much more severe and disabling form of PMS. While the symptoms may be similar, in PMDD they are intense enough to significantly interfere with your work, school, social life, and relationships. PMDD is a serious medical condition that requires diagnosis and treatment.
Symptoms of PMDD often include those of PMS but are far more severe. Key signs include at least one of the following:
- Marked depression, feelings of hopelessness, or self-deprecating thoughts
- Significant anxiety, tension, or feeling “on edge”
- Extreme mood swings (e.g., suddenly feeling sad or tearful)
- Persistent and marked anger, irritability, or increased conflict with others
The exact cause is not fully understood, but it is strongly linked to the hormonal fluctuations that happen during the second half of the menstrual cycle (the luteal phase). These hormonal shifts can affect brain chemicals called neurotransmitters, such as serotonin, which plays a crucial role in mood regulation.
There is no single blood test or exam to diagnose PMS or PMDD. Diagnosis is based on your symptoms: what they are, when they occur, and how much they impact your life.
Your provider will likely ask you to track your symptoms for at least two full menstrual cycles. This helps to confirm that your symptoms appear consistently before your period and resolve after it starts.
Treatment & Management Strategies
Managing PMS and PMDD often involves a combination of approaches.
For many women with mild to moderate PMS, these changes can provide significant relief:
- Regular Exercise: Aim for at least 30 minutes of aerobic activity (like walking, swimming, or cycling) most days of the week.
- Dietary Changes:
- Eat smaller, more frequent meals to reduce bloating.
- Limit salt, sugar, caffeine, and alcohol, especially in the two weeks before your period.
- Increase complex carbohydrates (whole grains, vegetables) and calcium-rich foods.
- Stress Management: Practice relaxation techniques like yoga, meditation, or deep breathing. Prioritizing good sleep is also essential.
If lifestyle changes aren’t enough, your provider may recommend:
- Over-the-Counter Pain Relievers: NSAIDs like ibuprofen (Advil®, Motrin®) can help with cramps, headaches, and muscle aches.
- Antidepressants (SSRIs): These are often the first-line treatment for severe PMS and PMDD. They can be taken daily or only during the two weeks leading up to your period.
- Hormonal Birth Control: Contraceptive pills, the patch, or the vaginal ring can regulate hormonal swings and often reduce or eliminate symptoms.
When to Call the Clinic
You don't have to just "live with" severe premenstrual symptoms. Please schedule an appointment with us if:
- Your symptoms are disrupting your daily life, work, or relationships.
- Lifestyle changes have not provided enough relief.
- You feel overwhelmed, hopeless, or are experiencing severe depression or anxiety.