PMS and PMDD: what is normal before your period and when to get help
PMS (premenstrual syndrome) is the name for the symptoms in the weeks before your period – mood swings, irritability, tiredness, bloating, breast pain, headaches. According to the NHS, most women have PMS at some point and it is normal. PMDD (premenstrual dysphoric disorder) is a much more severe form that affects a small number of women and can include intense anxiety, anger, depression or suicidal thoughts. If lifestyle changes do not help or the symptoms get in the way of your daily life, the NHS recommends seeing a doctor.
- According to the NHS, PMS is the symptoms women can experience in the weeks before their period, and most women have it at some point in their lives.
- Symptoms vary between women and can change from month to month.
- The cause is not fully understood, but the NHS links it to changes in hormone levels during the cycle, to which some women are more sensitive.
- PMDD is a more severe form of PMS in which the symptoms are much more intense and can include feelings of intense anxiety, anger, depression or suicidal thoughts.
- The NHS recommends keeping a symptom diary for at least 2 cycles and taking it to your doctor.
Which PMS symptoms are normal before your period?
According to the NHS, the most common symptoms of PMS are:
- mood swings;
- low mood or irritability;
- feeling upset, anxious or emotional;
- tiredness or trouble sleeping;
- bloating or cramps;
- breast tenderness;
- headaches;
- spotty skin and greasy hair;
- changes in appetite or cravings for certain foods.
The NHS stresses that symptoms are different for every woman and can change from month to month. Feeling "worse" one month does not necessarily mean something has got worse.
Why does PMS happen?
According to the NHS, the cause of PMS is not fully understood. It is thought to be linked to the changes in hormone levels during the menstrual cycle, and some women are simply more affected by these changes than others. This explains why one woman barely notices the premenstrual days while another feels them strongly every month.
What matters, according to the NHS, is that PMS can affect anyone who has periods, and that help is available if it is disrupting your daily life. You do not have to "put up with it" every month just because the symptoms are common.
What can I do about PMS myself?
The NHS recommends trying lifestyle changes first:
- regular exercise;
- a healthy, balanced diet – smaller, more frequent meals, every 2 to 3 hours, may help;
- enough sleep;
- reducing stress through yoga or meditation;
- painkillers such as ibuprofen or paracetamol for pain;
- a symptom diary for at least 2 menstrual cycles to take to your doctor.
According to the NHS, it is best to avoid smoking and too much alcohol. For supplements such as vitamin B6, calcium, vitamin D and magnesium, as well as acupuncture and reflexology, the NHS notes that there is not much evidence that they work – and advises checking with a doctor or pharmacist if you take other medicines.
What is PMDD and how is it different from PMS?
Premenstrual dysphoric disorder (PMDD), according to the NHS, is a more severe form of PMS that affects a small number of women. The symptoms are similar to those of PMS, but they are much more intense and can have a much greater negative impact on daily life.
The NHS states that with PMDD there can be headaches, joint and muscle pain, overeating and sleep problems, as well as feelings of intense anxiety, anger, depression or suicidal thoughts. The cause is unclear, but it has been linked to high sensitivity to hormonal changes or to certain inherited genes.
The practical difference: with PMS you feel bad but you cope; with PMDD the emotional symptoms are so strong that your daily life, work and relationships suffer seriously every month. A symptom diary helps you show your doctor exactly this pattern.
When should you see a doctor?
According to the NHS, you should book an appointment with a doctor if you have PMS symptoms and:
- lifestyle changes have not helped;
- the symptoms are affecting your daily life.
Urgent: the NHS is clear that if you have symptoms of PMDD and feel suicidal, you should call an emergency number or go to an emergency department. Do not drive yourself – ask someone to take you or call an ambulance, and take the medicines you are taking with you.
What treatment can the doctor offer?
According to the NHS, alongside lifestyle changes, the doctor may recommend a hormonal medicine such as the combined contraceptive pill, cognitive behavioural therapy (CBT) or antidepressants.
If the symptoms continue after that, you may be referred to a specialist – a gynaecologist, psychiatrist or counsellor. This is not a sign that you "exaggerated", but the standard next step according to the NHS.
Frequently asked questions
How long should I keep a symptom diary before going to the doctor?
The NHS recommends recording your symptoms for at least 2 menstrual cycles and taking the diary to your appointment – that way the doctor can see whether the complaints follow your cycle.
Do vitamins and supplements help with PMS?
According to the NHS, for supplements such as vitamin B6, calcium, vitamin D and magnesium there is not much evidence that they work. If you take other medicines, ask a doctor or pharmacist first.
Is PMDD a mental illness or a gynaecological problem?
The NHS describes it as a severe form of PMS with intense emotional symptoms and states that, if needed, you may be referred to a gynaecologist, psychiatrist or counsellor – in other words, it is often approached from both sides.
Sources
- NHS – PMS (premenstrual syndrome) – last reviewed by the NHS: 18 June 2024
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].