PMDD is not PMS: Finally understand the difference 

PMDD is NOT PMS – AND Why Saying “It’s Just Bad PMS” Can Be Dangerous

“It’s just bad PMS,” they said, trying to be helpful. I smiled politely, but inside I felt that familiar ache of being misunderstood. Like many others with PMDD symptoms, I’ve heard this well-meaning but oversimplified comparison countless times. While the intention might be to relate and comfort, this common misconception can actually prevent people from seeking the help they desperately need. PMS is not PMDD.

The Problem with “Just Bad PMS”

When I finally received my PMDD diagnosis, it was like finding a missing puzzle piece. All those years of being told I was just experiencing severe PMS had led to delayed treatment and unnecessary suffering. This widespread misunderstanding isn’t just frustrating – it’s dangerous. Research shows that 72% of people with diagnosed PMDD report having experienced suicidal thoughts.¹ This isn’t “just PMS” – it’s a serious health condition that requires proper understanding and treatment. If you are still unsure of what PMDD is, we dive into it here.

Understanding the Key Differences

Let’s break down the four crucial differences between PMS and PMDD:

1. The Underlying Cause

PMS: Can be caused by various hormonal imbalances and often responds well to simple lifestyle changes.²

PMDD: Results from an abnormal brain response to normal hormone fluctuations, particularly estrogen and progesterone³,⁴ and has been found to have a genetic link.⁵

2. Duration

PMS: Typically lasts 3-5 days during the second week of the luteal phase.

PMDD: Can last 2+ weeks, starting from ovulation, with three distinct subtypes of symptom presentation.⁶

3. Severity

PMS: Generally causes mild to moderate discomfort without significantly impacting daily life

PMDD: Often debilitating, significantly impacting quality of life, work performance, and relationships.⁷

4. Prevalence

PMS: Affects about 90% of menstruating individuals to some degree.⁸

PMDD: Impacts approximately 3-8% of menstruating individuals.⁹

Why Saying “It’s Just Bad PMS” Can Be Dangerous

Understanding these differences isn’t just about academic knowledge – it’s about saving lives. Consider these sobering statistics¹⁰:

– 49% of people with diagnosed PMDD have planned for suicide

– 34% have attempted suicide, compared to 3% in the general population

Your Next Steps

Ready to better understand PMDD and its impact?

Here’s what you can do:

Join FREE support community to access FREE resources and connect with others who understand your experience

Remember: If you’ve been struggling with severe premenstrual symptoms that significantly impact your life, you’re not experiencing “bad PMS” – and you’re not alone. Understanding the difference could be the first step toward getting the help you need.

Citations:

1. Eisenlohr-Moul T, Divine M, Schmalenberger K, Murphy L, Buchert B, Wagner-Schuman M, Kania A, Raja S, Miller AB, Barone J, Ross J. Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder. BMC Psychiatry. 2022 Mar 19;22(1):199. doi: 10.1186/s12888-022-03851-0. PMID: 35303811; PMCID: PMC8933886. ↩︎
2. Bhuvaneswari K, Rabindran P, Bharadwaj B. Prevalence of premenstrual syndrome and its impact on quality of life among selected college students in Puducherry. Natl Med J India. 2019 Jan-Feb;32(1):17-19.  ↩︎
3. Huo L, Straub RE, Roca C, et al. Risk for premenstrual dysphoric disorder is associated with genetic variation in ESR1, the estrogen receptor alpha gene. Biol Psychiatry. 2007;62(8):925-933. ↩︎
4. Comasco E, Hahn A, Ganger S, et al. Emotional fronto-cingulate cortex activation and brain derived neurotrophic factor polymorphism in premenstrual dysphoric disorder. Hum Brain Mapp. 2014;35(9):4450-4458. ↩︎
5. Hantsoo L, Payne JL. Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA. Neurosci Biobehav Rev. 2023 Jun;149:105168. doi: 10.1016/j.neubiorev.2023.105168. Epub 2023 Apr 12. PMID: 37059403; PMCID: PMC10176022. ↩︎
6. Eisenlohr-Moul TA, Kaiser G, Weise C, Schmalenberger KM, Kiesner J, Ditzen B, Kleinstäuber M. Are there temporal subtypes of premenstrual dysphoric disorder?: using group-based trajectory modeling to identify individual differences in symptom change. Psychol Med. 2020 Apr;50(6):964-972. doi: 10.1017/S0033291719000849. Epub 2019 Apr 23. PMID: 31010447; PMCID: PMC8168625. ↩︎
7. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology. 2003 Aug;28 Suppl 3:1-23. doi: 10.1016/s0306-4530(03)00098-2. PMID: 12892987. ↩︎
8. Winer SA, Rapkin AJ. Premenstrual disorders: prevalence, etiology and impact. J Reprod Med. 2006 Apr;51(4 Suppl):339-47. PMID: 16734317. ↩︎
9. Gehlert S, Song IH, Chang CH, Hartlage SA. The prevalence of premenstrual dysphoric disorder in a randomly selected group of urban and rural women. Psychol Med. 2009 Jan;39(1):129-36. doi: 10.1017/S003329170800322X. Epub 2008 Mar 26. PMID: 18366818; PMCID: PMC2752820. ↩︎
10. Eisenlohr-Moul T, Divine M, Schmalenberger K, Murphy L, Buchert B, Wagner-Schuman M, Kania A, Raja S, Miller AB, Barone J, Ross J. Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder. BMC Psychiatry. 2022 Mar 19;22(1):199. doi: 10.1186/s12888-022-03851-0. PMID: 35303811; PMCID: PMC8933886 ↩︎