PMS vs. PMDD: Understanding the Difference and How to Address Them
When it comes to premenstrual health, many people are familiar with the term PMS (Premenstrual Syndrome), but fewer recognise PMDD (Premenstrual Dysphoric Disorder) as a separate condition. Although they both occur in the weeks before menstruation, they differ significantly in severity and root cause. Understanding these differences is key to addressing them effectively.
What Is PMS?
Premenstrual Syndrome refers to a collection of physical and emotional symptoms that arise one to two weeks before menstruation and generally subside once your period begins. These symptoms include:
Emotional: Mood swings, irritability, increased emotional sensitivity, anxiousness, and reduced resilience.
Physical: Breast tenderness, headaches, migraines, bloating, and constipation.
Cognitive: Poor concentration and changes in libido.
Cravings: Sweet or salty foods.
While PMS can be uncomfortable, it’s not typically debilitating. However, its impact on daily life varies from person to person.
What Is PMDD?
Premenstrual Dysphoric Disorder is a severe mood disorder that includes physical, emotional, and cognitive symptoms in the week or two before menstruation, often improving once the period begins. Common PMDD symptoms include:
Emotional: Severe irritability, depression, feelings of hopelessness, guilt, or worthlessness.
Cognitive: Decreased interest in usual activities, feeling overwhelmed, and changes in appetite.
Physical: Fatigue, hypersomnia, or insomnia.
Unlike PMS, PMDD is not just about discomfort—it significantly impacts quality of life and mental well-being.
How Do We Address PMS?
The key to managing PMS lies in understanding your menstrual cycle. In the luteal phase (the two weeks leading up to your period), the hormones progesterone and estrogen play crucial roles.
Progesterone: Should be slightly higher during the luteal phase.
Estrogen: Should be slightly lower during this phase.
When the balance between these hormones is disrupted—often due to stress or estrogen dominance—PMS symptoms are more likely to occur.
Steps to Address PMS:
Lower Stress Levels:
Chronic stress can throw off your hormone ratio, so stress management is key. Practices like mindfulness, meditation, and gentle exercise can help.Herbal Support:
Herbs like chaste tree (Vitex) and peony can help balance hormone levels.
Magnesium supplementation may also reduce symptoms like headaches and mood swings.
Dietary Interventions:
Focus on nutrient-dense foods, especially those rich in magnesium (leafy greens, nuts, seeds) and B vitamins.
Reduce inflammatory foods like refined sugars and alcohol.
How Do We Address PMDD?
PMDD is often not caused by a hormonal imbalance but rather by a heightened brain sensitivity to allopregnanolone, a metabolite of progesterone that interacts with GABA receptors in the brain.
When Allopregnanolone Functions Normally:
It acts as a natural anxiolytic (anxiety-reducer) and antidepressant, promoting calmness and emotional stability.
In PMDD:
Sensitivity to allopregnanolone can have the opposite effect, leading to symptoms like severe anxiety, depression, and irritability.
Steps to Address PMDD:
Increase Serotonin and Dopamine:
Adaptogenic herbs like Rhodiola and Withania (Ashwagandha) can support stress resilience.
Nervine tonics such as Passionflower and Chamomile calm the nervous system.
Thymoleptic herbs like St. John’s Wort and saffron may help improve mood.
Dietary Adjustments:
Consider supplementing with calcium, which has been shown to reduce PMDD symptoms.
Increase complex carbohydrates for serotonin production and sustained energy.
Personalised Support:
Every PMDD presentation is unique, so working with a hormone-focused naturopath ensures your care plan is tailored to your needs.
Why Seek Naturopathic Support?
Whether you’re dealing with PMS or PMDD, a naturopathic approach focuses on addressing the root causes of your symptoms while supporting your overall health. Through targeted lifestyle changes, herbal support, and dietary interventions, it’s possible to reduce the impact of these conditions on your life.