PMS and PMDD

PMS (Premenstrual Syndrome) refers to a group of physical, emotional, and behavioral symptoms that occur in the luteal phase (the second half of the menstrual cycle). Common symptoms include mood swings, irritability, fatigue, bloating, and breast tenderness. PMS is very common, affecting up to 75% of menstruating individuals to varying degrees.

PMDD (Premenstrual Dysphoric Disorder)  is a severe form of PMS that significantly impacts daily life and emotional well-being. It affects about 3-8% of menstruating individuals and is characterized by symptoms such as intense mood swings, depression, irritability, and physical discomfort in the lead-up to menstruation.

PME (Premenstrual Exacerbation)  refers to the worsening of underlying mental health or medical conditions (e.g., anxiety, depression, migraines) during the premenstrual phase, rather than symptoms appearing only during this time.

How Common Are They?

• PMS: Up to 75% of menstruating individuals experience some degree of PMS.

• PMDD: Affects approximately 3-8% of menstruating individuals.

• PME: Prevalence is less clear but is often linked to conditions like mood or anxiety disorders.

Management Options

• Lifestyle changes: Regular exercise, balanced nutrition, stress management, and prioritizing good sleep hygiene can help ease symptoms.

• Medications include antidepressants and hormonal treatments.  Antidepressants (SSRIs/SNRIs) are effective for managing mood symptoms, often taken continuously or during the luteal phase (at lower doses).  Hormonal treatments: Certain combined oral contraceptives (COCs) can help stabilize hormone fluctuations—some pills (e.g., those containing drospirenone) are more effective for PMDD than others.  GnRH agonists are 'hormone blockers'.  Which stop the natural cycling ie up and down of hormones.  These are usually used with add-back hormones to avoid menopausal symptoms (and the health conditions that come with early menopause)

• Supplements: Calcium, magnesium, or vitamin B6 may help with some symptoms.

• Therapies: Cognitive Behavioral Therapy (CBT) can be beneficial, especially for emotional and psychological symptoms.

• Tracking symptoms: Keeping a symptom diary can help identify patterns and guide the best treatment options.

Some more useful information

PMS and PMDD often worsen during perimenopause due to fluctuating hormone levels. If you’ve experienced PMS in the past, staying alert to early, subtle changes during this transition can help you recognize and address symptoms early.