Many people notice changes in their body and mood in the few days before their periods start, or during the first few days of their periods. Some of these changes are normal and can usually be managed without medical care, but others may cause more disruption to daily life and may need treatment. Two common types are Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD). Knowing the difference is important, because PMDD is more serious and often needs special care.
What Are PMS and PMDD?
PMS (Premenstrual Syndrome)
PMS is a group of symptoms that happen about 1–2 weeks before your period. These symptoms are caused by hormone changes during the second half of the menstrual cycle that can affect your body and emotions. PMS generally isn’t a lot of fun, but it can be normal to experience it.
PMS symptoms can include:
- Bloating
- Breast tenderness
- Feeling tired (fatigue)
- Irritability or mood swings
- Headaches
To be called PMS, the symptoms must:
- Happen before your period
- Go away after your period starts
- Come back in more than one cycle
- Make daily life harder (like school, work, or relationships)
PMDD (Premenstrual Dysphoric Disorder)
PMDD is a severe form of PMS that also affects a person’s mood and emotions. It is generally considered to be a type of depression. People with PMDD often feel very sad, angry, or anxious before their period. These feelings can make it hard to work, study, or get along with others.
PMDD symptoms can include:
- Severe sadness or depression
- Anxiety or tension
- Anger or irritability
- Trouble focusing
- Sleep problems
Key Differences
PMS symptoms are usually mild to moderate. Most people can manage with healthy habits or sometimes over-the-counter treatments. PMDD symptoms are severe and mostly emotional. They can stop you from living your normal life and usually require treatment from a healthcare provider.
Why Tracking Symptoms Helps
Tracking your symptoms every day for at least two cycles is the best way to know if you have PMS or PMDD. You can use your Ovia app, a paper calendar, or other tracking tools. This kind of tracking helps to show patterns so you and your doctor know how often you’re experiencing different symptoms and how much they’re impacting your life. These patterns can help your doctor make a clear diagnosis. Tracking can also help you predict tough days and see if treatments are working.
Treatment Options
Lifestyle Changes
- Exercise regularly
- Eat a balanced diet
- Manage stress with relaxation techniques
Medications
For most cases of PMDD, the two most helpful treatments are SSRI antidepressants (selective serotonin reuptake inhibitors) for mood symptoms, or hormonal birth control to regulate cycles and reduce symptoms. Some types of hormonal birth control seem to work better than others, so it’s best to talk to your healthcare provider about the best choice for you. In severe PMDD that doesn’t improve with antidepressants or birth control, other treatments can be tried, but antidepressants and birth control are usually recommended first.
Therapy
Cognitive Behavioral Therapy (CBT) can help with improving mood symptoms and building coping skills.
Other Treatments
Pain medicine you can buy over-the-counter, like ibuprofen, can often help with PMS pain such as sore breasts or cramps. (These medicines are not safe for everyone, so double-check with your healthcare team.) Some people also think that acupuncture or supplements might help. However, studies have not proven that they are effective.
When to See a Doctor
It’s important to talk to a healthcare provider if your symptoms don’t get better with self-care steps and if they make it hard to work, go to school, take care of your responsibilities, or maintain your relationships. It’s always important to get help right away if you have thoughts of harming yourself, thoughts of hurting anyone else, or if you feel very distressed.
Conclusion
PMS and PMDD are common, but PMDD in particular can be very serious. Tracking your symptoms and talking openly with your healthcare provider can make a big difference. With the right care, you can feel better and improve your quality of life.
Sources
- “Premenstrual Syndrome (PMS).” ACOG, Nov. 2023, www.acog.org/womens-health/faqs/premenstrual-syndrome.
- Greer, Loren. “ACOG Guideline: Management of Premenstrual Syndrome and Premenstrual Dysphoric Disorder .” The ObG Project, 1 July 2024, www.obgproject.com/2023/12/27/acog-guideline-management-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder/.
- “Treatment of Premenstrual Syndrome and Premenstrual Dysphoric Disorder.” UpToDate, Aug. 2025, www.uptodate.com/contents/treatment-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder. “What Is PMDD?” International Association for Premenstrual Disorders, www.iapmd.org/pmdd.
