If you get periods, you may have experienced premenstrual syndrome (PMS). This is a set of symptoms, including mood swings, headaches, and even spots that some people experience before their period.
The phenomenon is common enough to have made its way into common parlance ― but we recently spoke to Dr. Samantha Wild, Women’s Health Clinic Lead and GP at Bupa Health Clinics, about premenstrual dysphoric disorder, PMS’s more severe sister.
Shortened to PMDD, the condition affects “Between two and eight women in every 100,” Dr. Wild says.
Its “symptoms are similar to PMS but much more severe and often last longer than PMS,” she shared ― explaining that the condition can be really hard on patients’ mental health, making them feel much more “angry, anxious and irritable.”
What are the signs it’s PMDD rather than PMS?
“The timing and severity of your symptoms will indicate whether or not you have PMDD,” Dr. Wilde says.
Irritability, anger, or aggression may be symptoms of PMDD, alongside experiencing a very low mood or depression. Individuals with PMDD may also encounter heightened levels of anxiety and find themselves less interested in their work, hobbies, and social life.
They may experience forgetfulness and difficulty concentrating, as well as persistent tiredness. Feelings of being overwhelmed or out of control are common, as well as challenges with sleeping patterns, either by sleeping too much or struggling to sleep at all.
PMDD can be so intense that it makes those with the condition feel suicidal, rather than just rundown or a little irritable.
“PMDD can make it really difficult to go about your day-to-day life, from working to socialising and in your relationships. PMDD is linked to suicidal thoughts as the mental health symptoms of it can often be severe,” Dr. Wilde shared.
In fact, “According to the International Association for Premenstrual Disorders, 34% of women with PMDD have attempted suicide.”
Other signs of the condition include physical signs like breast tenderness, bloating, headaches, backache, and either constipation or diarrhoea.
“It’s not just about the symptoms themselves either, but the impact they have on women’s lives,” Dr. Wild adds.
“They may feel unable to go to work or school as they’re so unwell, have tension in relationships, feel unable to concentrate and focus on normal activities or even complete daily tasks.”
How can I tell PMDD from depression?
Aside from the physical symptoms specific to PMS and PMDD, timing can also reveal all, Dr. Wilde shared.
“If you have PMDD, your symptoms will appear in the two weeks before your menstrual period, get better when you start your period, or soon after, and disappear between your periods” ― this differentiates it from other mental health conditions, like anxiety and depression.
What if I think I have PMDD?
“Symptoms of PMDD may have a severe effect on your quality of life. If you think you have PMDD, keep a diary of your symptoms for at least two months before you see a GP,” Dr. Wild says.
“This will help you and your GP to see if your symptoms are related to your periods.”
The doctor adds that PMDD “can’t be diagnosed with any specific tests.”
“So, your GP will usually make a diagnosis based on how you describe your symptoms and when they occur. But before diagnosing PMDD, they may need to rule out other underlying health conditions that could be causing similar symptoms. They may offer you a blood test to rule out thyroid problems, anaemia, and the perimenopause.”
Incorporating regular physical activity into your routine, such as exercise or yoga, may help improve symptoms, as can keeping a note of your symptoms and what helps them, Dr. Wild says.
Maintaining a healthy balanced diet, which includes smaller, more frequent meals and includes starchy carbohydrates like wholemeal bread, pasta, rice, and potatoes, while avoiding sugary snacks and reducing salt intake, can also be beneficial.
Limiting or avoiding caffeine and alcohol consumption may help alleviate some symptoms. It’s important to actively reduce stress through relaxation techniques and mindfulness exercises, too.
Whenever possible, tackle stressful tasks during periods when PMS symptoms are less severe. Adequate sleep is essential for managing symptoms effectively.
“If these lifestyle measures don’t work then your doctor will suggest other options, these can include taking anti-depressants, trying talking therapies or counselling or starting oral contraception or hormone medications,” Dr. Wild adds.
“A GP may also suggest painkillers or anti-inflammatory drugs to help manage physical symptoms of PMDD such as headaches or joint pain. In extreme cases the GP might recommend you have your ovaries removed to stop you getting PMDD symptoms and periods,” she adds.
Don’t wait to contact your GP if you’re concerned.