What distinguishes Premenstrual Dysphoric Disorder (PMDD) from Premenstrual Syndrome (PMS)?

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Last updated: April 27, 2025View editorial policy

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From the Research

Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Syndrome (PMS) are distinguished primarily by the severity and impact of symptoms, with PMDD being a more severe condition characterized by significant mood disturbances that substantially impact daily functioning, as noted in a recent review 1. The key differences between PMDD and PMS include:

  • Severity of symptoms: PMDD symptoms are more severe and debilitating, while PMS symptoms are milder
  • Impact on daily functioning: PMDD symptoms significantly interfere with work, relationships, and daily activities, while PMS symptoms may cause some discomfort but do not significantly impact daily life
  • Specific symptoms: PMDD symptoms include severe depression, anxiety, irritability, mood swings, and feelings of being overwhelmed, while PMS symptoms may include physical and emotional symptoms such as bloating, breast tenderness, and mood changes According to the most recent and highest quality study 1, SSRIs are probably the most effective treatment for PMDD, and are probably more effective when taken continuously compared to luteal phase administration. Some key points to consider when treating PMDD and PMS include:
  • The importance of accurate diagnosis and differentiation between PMDD and PMS
  • The use of SSRIs as a first-line treatment for PMDD
  • The potential benefits and risks of hormonal treatments, such as combined oral contraceptives containing drospirenone
  • The importance of lifestyle modifications and self-care strategies in managing PMS symptoms Overall, the distinction between PMDD and PMS is crucial, as PMDD requires more intensive intervention due to its debilitating nature, while PMS can often be managed with simpler approaches 1.

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