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Many people experience mood swings, bloating, and irritability before their periods. However, for some people, these symptoms are far more severe and disruptive.

While both premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are related to the menstrual cycle, they are not the same thing — there are key differences in terms of severity, impact on daily life, and treatment approaches.

Learn about the differences between the two and when to speak to a doctor about your symptoms.

PMS Meaning vs. PMDD Meaning

Premenstrual syndrome (PMS) is a common condition that occurs in the week or two before your period. Symptoms usually resolve once your period begins. Most cases of PMS are mild and allow you to continue your daily routine without too much interruption or discomfort. Symptoms are manageable enough, even if you are somewhat uncomfortable.

Premenstrual dysphoric disorder (PMDD) is a more severe and disabling form of PMS that begins about six days before your period. While PMS affects 70% to 90% of menstruating people, PMDD affects between 3% to 8% of menstruating people. However, PMDD has more severe emotional symptoms and makes a significant impact on mental and emotional well-being. PMDD symptoms are more intense and can interfere with work, relationships, and overall quality of life.

What Are PMS Symptoms?

PMS symptoms can be managed without the aid of a doctor, but it is always good to speak with your doctor if you have any concerns.

Common PMS symptoms include:

• Anxiety.
• Bloating.
• Breast tenderness.
• Constipation.
• Cramps.
• Diarrhea.
• Depression.
• Fatigue.
• Food cravings or overeating.
• Headaches.
• Irritability.
• Joint or muscle aches.
• Mood swings.
• Nausea.
• Restlessness.
• Sleep disturbances.
• Weight gain.

What Are PMDD Symptoms?

PMDD symptoms are disruptive enough to require the aid of a doctor as they interfere with your everyday life. Speak to one right away if you think you may have PMDD.

People with PMDD have similar physical symptoms to PMS but also have at least one mood-related symptom. They usually have at least five symptoms before being diagnosed with PMDD.

PMDD symptoms include:

• Debilitating depression and decreased interest in usual hobbies and activities.
• Difficulty concentrating.
• Extreme fatigue.
• Feeling hopeless or having suicidal thoughts.
• Feeling overwhelmed or out of control.
• Insomnia or excessive sleep.
• Intense irritability or anger that can lead to conflict.
• Lethargy or lack of energy.
• Panic attacks or severe anxiety.
• Severe mood swings, increased sensitivity, or crying spells.

How Is PMDD Diagnosed?

Most PMDD diagnoses involve five or more symptoms that negatively impact daily life. These symptoms are severe enough to interfere with work, social activities, or personal relationships.

At least one of the following emotional symptoms is present:

• Depressed mood or feelings of hopelessness.
• Marked irritability or anger.
• Severe anxiety or tension.
• Severe mood swings.

Additionally, other symptoms — such as difficulty concentrating, sleep disturbances, extreme fatigue, feeling overwhelmed, decreased interest in activities, physical symptoms (e.g., bloating, breast tenderness, joint pain), and appetite changes — can be present.

The timing is also important. For a PMDD diagnosis, symptoms appear before your period and are gone by the time it begins or shortly thereafter. Charting your symptoms can help determine your patterns.

How Does PMDD Impact Everyday Life?

Unlike PMS, which may cause mild discomfort, PMDD can disrupt multiple areas of your life. Here are a few places where the severe symptoms can disrupt daily routines and even hurt you socially, academically, or professionally:

• Work and academics — People with PMDD may struggle to concentrate, experience brain fog, and feel extreme fatigue, leading to poor work or academic performance.
• Relationships and social life — Increased irritability and mood swings can cause tension in relationships with partners, family, and friends. Communication becomes difficult when emotions are overwhelming and out of control, with heightened sensitivity.
• Mental health — PMDD is strongly linked to depression and anxiety. People may feel overwhelmed, hopeless, or disconnected.

What Are the Causes of PMS and PMDD?

While there is no exact cause for PMDD, both PMS and PMDD are connected to hormonal changes during the menstrual cycle.

Some risk factors for PMDD include:

• Existing anxiety or depression.
• Genetics or family history.
• Obesity.
• Past trauma.
• Smoking.
• Substance use, like alcohol.

How Do I Treat PMS?

For those with mild PMS, you can often manage symptoms yourself with lifestyle changes or over-the-counter medications.

Here are some treatment options for PMS:

• A healthy diet rich in whole foods.
• Limiting caffeine, alcohol, and processed foods.
• Over-the-counter pain relievers.
• Regular exercise.
• Stress reduction techniques (e.g., meditation, breathing exercises, yoga).

How Do I Treat PMDD?

Speak with your doctor about a treatment plan for PMDD. Treatment options include medications, therapies, lifestyle changes, and more. Your doctor will likely recommend a mix to find what’s right for you.

Here are some common treatment options for PMDD:

• Cognitive behavioral therapy to help manage emotional distress and negative thought patterns.
• Lifestyle changes, such as a healthy diet, a consistent sleep schedule, regular exercise, and stress-relieving techniques.
• Medications like antidepressants or birth control pills.

When to Seek Help for PMDD

Knowing the difference between PMS and PMDD can help you know when you can manage symptoms on your own and when to seek the help of a professional.

While PMS and PMDD share similarities, PMDD is a much more severe condition that can significantly disrupt daily life. If you’re experiencing extreme mood swings, suicidal thoughts, or intense depression, speak to a doctor right away. Treatment is possible, and you can find relief.