Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)



PMS is common, affecting approx. 40% of women. PMDD is much less common but more severe with only 2% women meeting diagnostic criteria. Both cause significant psychological and physical symptoms to the women that they effect.


So what are they?


Why do they happen?


And what can we do?


PMS is a when women feel irritable, sad, angry, anxious, or confused as well as having breast tenderness, bloating or headaches in the weeks before their period. These symptoms resolve in the days after their period arrives. PMDD is these same symptoms to a much more severe extent effecting ability to work, sleep, socialise, their relationships and sometimes even causing suicidal ideation.


The exact mechanism of action is not entirely understood but it is though to be related to levels of estrogen as rates of PMS and PMDD increase with age and as estrogen levels fluctuate and it is also thought that with ovulation there may also be a reduction in serotonin levels. Serotonin is a key chemical in mood stabilisation.

So, if you have noticed that your mood is low, you are feeling irritable or you are getting physical symptoms keep a diary and see if there is a relation to your menstrual cycle and talk to your doctor about it. It is important to differentiate PMS and PMDD from other underlying mental health conditions such as anxiety, depression and bipolar.


It is important to diagnose PMS and PMDD because there is a lot we can do to help you.


Treatments include:

- lifestyle interventions such as exercise, reducing salt in your diet, relaxation and psychological intervention

- natural therapies / supplements such as chasteberry, vitamin B6, calcium, magnesium and evening primrose oil. It is important to get the doses of these correct.

- antidepressants in particular selective serotonin reuptake inhibitors

- the combined oral contraceptive pill or topical oestrogen with microgenised progesterone.

- referral to a gynaecologist for some more intense options


So please, don’t suffer at home. If you suspect you might have PMS or PMDD please come and talk to the doctors at LGP about what options might be available for you!


See this link below to assess your symptoms.

https://www.aafp.org/afp/2011/1015/afp20111015p918-fig1.pdf