PMS vs. PMDD: Symptom Similarities and Differences

Many women notice changes in their mood and body in the days before their period. For some, these changes are mild and only slightly uncomfortable. For others, they can be severe enough to interfere with work, school, relationships, and daily activities.

This is where understanding PMS vs PMDD becomes important. While both conditions happen before menstruation and share many symptoms, PMDD is a more severe and disabling form of PMS. Knowing the difference can help you get the right support and treatment.

PMS and PMDD in Malaysia

In Malaysia, research has shown a high rate of both PMS and painful periods (dysmenorrhea) among women. One study found that 50.2% percent of adolescent girls experienced PMS. These numbers highlight that menstrual-related symptoms are very common among young women.

The same study also showed that PMDD is less common but still affects between 1.8 percent and 5.8 percent of women of reproductive age. While the percentage is smaller, the impact of PMDD is far greater because it can disrupt daily life and emotional well-being.

Symptoms: How PMS vs PMDD Compare

PMS vs PMDD share several physical and emotional symptoms, including:

• Bloating
• Tender breasts
• Headaches
• Muscle or joint aches
• Fatigue
• Trouble sleeping
• Food cravings
• Mood changes

The main difference is in how severe these symptoms are and how much they affect your life.

For example:

• PMS can cause depression, low mood, but PMDD can bring extreme sadness, hopelessness, and even thoughts of suicide. This requires immediate medical attention.
• PMS may cause some worry or at worst anxiety, but PMDD can bring intense tension and feelings of being constantly on edge.
• PMS mood swings are milder, while PMDD mood swings can be severe and lead to anger, irritability, or sudden crying spells that feel out of your control.
• PMS might cause some discomfort at work or home, but PMDD can cause a loss of interest in hobbies, relationships, and work.

Causes

The exact cause of PMS or PMDD is not fully understood, but hormonal changes during the menstrual cycle are strongly linked. Levels of estrogen and progesterone rise and fall during the month, and some women are more sensitive to these changes.

Other possible factors include:

• Changes in brain chemicals like serotonin, which affect mood and energy
• Genetic factors
• Existing mood disorders such as depression or anxiety

Diagnosis

There is no blood test or imaging scan to diagnose PMS or PMDD. A doctor will usually ask you to track your symptoms for at least two menstrual cycles. They will look for a pattern of symptoms that:

• Start 1–2 weeks before your period
• Disappear once bleeding begins
• Repeat regularly

This tracking helps distinguish PMS or PMDD from other conditions such as depression, anxiety disorders, or thyroid disease.

Treatments

For PMS, many women find relief through:

• Regular physical activity
• Balanced diet with whole foods
• Good sleep habits
• Stress management techniques like yoga or deep breathing
• Over-the-counter pain relievers such as ibuprofen or naproxen

For PMDD, lifestyle changes can help but are often not enough. Medical treatments include:

• SSRIs (Selective Serotonin Reuptake Inhibitors): These antidepressants help balance serotonin levels in the brain and can ease mood symptoms. They may be taken every day or only during the luteal phase (the two weeks before your period).
• Hormonal birth control pills: Pills containing drospirenone and ethinyl estradiol, such as Yasmin, can stop ovulation and reduce hormonal fluctuations. This often lessens both physical and emotional symptoms.

Nutrition Support

Dietary changes and certain nutrients may help ease PMS vs PMDD symptoms.

1. Calcium

A clinical trial found that women who took 1,200 mg of calcium daily had fewer mood symptoms such as sadness, nervousness, and anxiety during PMS. The study suggested calcium plays a role in nerve and muscle function, which may explain the improvement.

2. Magnesium 

Research has shown that magnesium supplementation can help reduce bloating, fluid retention, and breast tenderness. Magnesium is also involved in muscle relaxation and stress control.

3. Vitamin B6 

Studies have found that vitamin B6, taken at doses of 50–100 mg daily, can improve mood and reduce irritability before menstruation. It may work by helping the body make serotonin and dopamine, both important for mood stability.

4. Limiting caffeine and alcohol 

Cutting back on these can reduce anxiety and sleep disturbances.

5. Eating complex carbohydrates 

Whole grains, vegetables, and legumes can help keep blood sugar steady and reduce irritability.

Misdiagnosis and Other Conditions

Because PMS vs PMDD share symptoms with depression, anxiety, and thyroid problems, they can be misdiagnosed. The key difference is timing: PMS vs PMDD symptoms appear only in the luteal phase and go away once menstruation starts. Mood disorders, on the other hand, tend to cause symptoms throughout the month.

How to Stop Feeling Sad Before Period

If sadness before your period is mild, improving your sleep, eating balanced meals, and exercising regularly can help. If the sadness is strong, affects your work or relationships, or comes with intense anxiety or anger, it may be PMDD. In that case, talking to a doctor is important. PMDD is treatable with lifestyle changes, medication, or a combination of both.

Final Thoughts

Knowing the difference between PMS vs PMDD is key to finding the right treatment. PMS is common and can often be managed with simple lifestyle changes. PMDD is less common but more severe, and it often requires medical treatment in addition to lifestyle changes.

If you have been wondering how to stop feeling sad before period, start by tracking your symptoms, making small health changes, and talking to a healthcare provider. Relief is possible, and the earlier you get help, the better your quality of life can be.