PMS vs. PMDD vs. PME: Why Knowing the Difference Matters

As women, there are multiple different reasons why we feel different in the week or two leading up to our periods than in other times of the month. While most of the time these symptoms can be normal there are also times that they can be pathologic and start to impact our quality of life. Being able to understand why those symptoms are coming up is the key to actually being able to treat it adequately.

There are 3 major types of premenstrual symptoms. These can all present very similar making it very hard to tell the difference if you are the one experiencing it. It is important to understand which category you might all into. Each of these different conditions, while they can look the same, have different physical factors that are causing the symptoms and therefore need to be assessed and treated differently. Here are some of the ways to start to differentiate between these conditions.

PMS - Premenstrual Syndrome

PMS or premenstrual syndrome refers to the time of month for women between ovulation (about halfway through a monthly hormonal cycle) and getting their period. These two weeks are known as our luteal phase. During this time women can experience a collection of varying symptoms both physically and emotionally. Some of these symptoms can include:

bloating
diarrhea or constipation
cramping
headache or backache
breast swelling and tenderness
weight gain
water retention
mood swings
irritability
food cravings or changes in appetite
changes in sexual drive
feeling tired
trouble sleeping
low mood or depression
increased sensitivity to stress
and much more

The combination of symptoms that someone experiences during this phase of their cycle is unique to them. Therefore no two woman will experience PMS in the same way. The intensity of these symptoms can also vary depending on the person. PMS symptoms can have a profound impact on a person’s life. When the emotional symptoms associated with one’s PMS become particularly intense and debilitating they can meet the classification of PMDD (premenstrual dysphoric disorder).

PMDD - Premenstrual Dysphoric Disorder

This is a diagnosis that refers to a group of pre-menstrual symptoms that become so intense that they have extreme mood implications, and severe impacts on quality of life. It can be seen as an extreme and severe form of PMS.

It can get so bad that for that period of the month it can feel like a depressive episode.
This is different than normal pre menstrual symptoms and is a diagnosable mental health conditions with physical impacts as outlined in the DSM 5 which outlines the diagnostic criteria for all mental health conditions.
It is thought to be a negative reaction to normal hormonal changes in the second half of the menstrual cycle

PME - Premenstrual Exacerbation

This occurs when there is an existing condition such as anxiety or depression that gets exacerbated during the luteal phase of the menstrual cycle.

This can present exactly as PMDD and be extremely debilitating.
In this case the symptoms would not disappear throughout the rest of the month even though they would vary in intensity

Sometimes it can be hard to tell if the symptoms you are experiencing are PMS or PMDD or PME. PMDD and PME can have all of the same symptoms of PMS but is much more intense. This is the main differentiating factor between them. The emotional symptoms associated with PMDD can be so intense that during this luteal phase the person experiencing them can even meet the criteria for severe depressive disorder. The hallmark that differentiates PMDD from MDD is that symptoms disappear as soon as their period starts and they feel almost like a different person in that first half of their menstrual cycle PME can look exactly like PMDD. The main difference is that the symptoms don’t disappear entirely once you get your period. In PME these PMS symptoms exist on a much more manageable scale through the entire cycle.

It is ALWAYS worth getting a thorough assessment if you are unsure where you pre menstrual changes are coming from. Someone like a naturopathic doctor can help to identify the condition as well as the causes of it allowing for targeted support and treatment to help YOU feel your best. Book in for a free consultation to figure out if this support might be right for you.