Historically, the existence of premenstrual syndrome (PMS) has been seen as little more than an unfortunate and unavoidable side effect of being a female. Once a month, for about a week or two before getting their periods, over 90% of women report having at least some PMS symptoms.

Because menstrual discomfort is so common, many women assume that their period and PMS experiences are normal, and as a result, they don’t think to discuss their PMS symptoms with their doctors. However, PMS affects everyone in different ways; some women experience only mild symptoms, while others may suffer very severe symptoms. Sometimes the severity of these symptoms can even cause women to miss work or school.

In the vast majority of cases, PMS truly is nothing to be overly concerned about – while it can be uncomfortable or even painful, it’s generally easy to manage the symptoms. However, some women with extreme symptoms may have a rare condition known as premenstrual dysphoric disorder (PMDD).

PMS and PMDD: Similar Symptoms

Part of the difficulty of differentiating between PMS and PMDD is that both conditions have very similar symptoms. This includes physical symptoms such as:

  • Bloating
  • Cramping
  • Headache
  • Fatigue
  • Weight gain due to water retention
  • Change in appetite
  • Change in libido
  • Muscle and joint pain
  • Breast tenderness
  • Acne breakouts
  • Constipation or diarrhea

Both conditions also feature a slew of emotional and behavioral symptoms, which can include:

  • Irritability
  • Depression
  • Crying
  • Anxiety
  • Inability to concentrate

What really distinguishes PMDD from PMS is the severity of these symptoms, particularly the emotional ones. One of the main hallmarks of PMDD is the presence of at least one extreme mood disturbance, the most common of which are these.

  • Panic attacks
  • Intense sadness, depression, or feelings of hopelessness
  • Severe mood swings
  • Feeling out of control
  • Intense anger and irritability that create conflict with other people

In some cases, these symptoms are so severe that they wreak havoc on many facets of a woman’s life.


Just like with PMS, there isn’t a physical exam or blood test that can determine if someone has PMDD.

In order to make a diagnosis, doctors have to rely on the process of elimination. When you report your symptoms to your gynecologist, she or he probably will take a full medical history, perform a thorough physical exam, have your thyroid tested, and administer a psychiatric evaluation. The results of these tests then will be used to rule out all other medical and mental conditions.


Once a formal diagnosis of PMDD has been made, your doctor can develop a treatment plan that targets your specific symptoms. Your PMDD regimen may include a combination of:

  • Birth control pills, to manage the hormonal shifts of menstruation and PMDD
  • Antidepressants, to balance your brain chemistry
  • Therapy, to take charge of your mental health

Learn More

To learn more about PMDD or to schedule a wellness exam, please contact PGOMG today.