Premenstrual Syndrome (PMS) vs Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are two menstrual cycle conditions that occur during the premenstrual phase of the menstrual cycle (Futterman & Rapkin, 2006). PMS is characterized as having psychological, physical, and behavioral symptoms associated with it. Depending on the severity of the symptoms, that is mild, moderate or severe symptom patterns determine the degree of interference within a person’s life such as personal, social and occupational aspects (Futterman & Jones, 2000). Mild PMS symptoms occur for 1-3 days; moderate PMS symptoms occur for 7-10 days and severe PMS occur for two weeks. The incidence of PMS is estimated at 20-43-% of women (Futterman et al.2000; Futterman et al, 2006).

The incidence of PMDD in the USA is 5-8% of women (Futterman et al, 2006). It is characterized by psychological symptoms i.e., depression, anxiety, and irritability, during the premenstrual phase of the menstrual cycle, causing a marked interference in overall functioning. PMDD is a severe form of PMS. It is diagnosed based on the exclusion of any psychiatric disorder such as Depression, Anxiety, Bipolar, Personality Disorder, Postpartum, Eating Disorder or Substance Disorder.

Diagnostic and Statistical Manual of Mental disorders fifth edition, DSM-5-TR, American Psychiatric Association,2022) diagnostic criteria for PMDD requires two months of perspective calendars or diaries that track daily symptom ratings that are psychological, somatic, and behavioral. This allows for the typology and severity of symptoms to be determined. The symptoms must be:

  • Limited to the last week of the premenstrual cycle in the previous year
  • Intensified by at least 30% during premenstrual phase during 6 days prior to menses
  • Be relieved within the first few days of menses and not recurrent during menstrual part of the cycle
  • Limited to Affective type symptoms, one or more are present during premenstrual phase i.e., Depression, Anxiety, and Irritability, being overwhelmed, difficulty concentrating, hypersomnia or insomnia. These symptoms cause significant distress or interference is functioning (DSM-5-TR, 2022)

The best way to work with these conditions through a holistic type of approach:

  • Track the type and severity of your symptoms using a daily calendars
  • Psychological methods that focus on mood and cognitive stability
  • Consult with practitioners that assist with nutrition, exercise, hormonal stability