PMS vs. PMDD: How to Tell the Difference — and Why It Matters
Gentle, evidence-informed support for tender, cyclic humans navigating their luteal phase
If you’ve ever felt like the days before your period are a complete emotional derailment - or like your hormones hijack your brain and body once a month - you’re not alone. But how do you know if it’s “just PMS” or something more?
Let’s discuss the real difference between PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder), why your symptoms matter, and how we can work together - gently, practically, and from a feminist-forward lens - to make that pre-period phase feel more manageable.
🌘 What Is PMDD, and How Is It Different from PMS?
PMS is incredibly common - but that doesn’t mean it’s normal to feel awful every month. Around 75–80% of people who menstruate report some degree of PMS symptoms each cycle, which can include:
Mood swings or irritability
Fatigue or brain fog
Breast tenderness
Headaches
Bloating or cravings
These symptoms typically begin in the luteal phase (the 1–2 weeks before your period) and resolve within a few days of bleeding. They might be annoying or uncomfortable, but they don’t typically disrupt daily life in a major way.
How to Track Symptoms for an Accurate Picture
PMDD, on the other hand, is severe, cyclical, and often disabling. It’s a recognized mental health condition - not a character flaw, not “being too sensitive,” and definitely not something to power through alone.
Symptoms of PMDD can include:
Intense irritability or rage
Panic, anxiety, or depressive thoughts
Feeling out of control or dissociated
Physical symptoms like joint pain, migraines, or severe fatigue
Conflict in relationships, withdrawal from social life or work
These symptoms are also luteal-phase specific, meaning they tend to show up after ovulation and disappear within a few days of bleeding. But the difference lies in the severity and impact on daily functioning.
Pursuing a more formal diagnosis along with support from your full healthcare team requires tracking symptoms over at least 2–3 cycles - which is something I can guide you through with cycle awareness tools and compassionate clinical support.
🌼 What Causes PMS & PMDD?
The exact cause of PMDD isn’t fully understood, but research suggests it’s not about having too much hormone - it’s about sensitivity to normal hormone shifts, especially progesterone and estrogen fluctuations after ovulation. There's also a strong link between stress response systems, trauma, and PMDD.
Nervous system dysregulation, nutrient deficiencies, and inflammation may all play a role in symptom expression for both PMS and PMDD.
Naturopathic Approaches to PMDD Care
Evidence-informed approaches that I often integrate in care plans include:
Cycle tracking – to get a clear picture of symptom patterns and ovulation timing
Nutrition – with a focus on stabilizing blood sugar, supporting neurotransmitters, and actually eating enough (yes, it matters)
Supplements with research backing for PMS/PMDD support:
Calcium – shown to reduce mood and physical symptoms
Vitamin B6 – helps with mood regulation, especially in PMS
Magnesium – supports sleep, mood, and cramp reduction
Chaste tree (Vitex) – particularly helpful for PMS symptoms
Completing the stress response cycle – a nervous-system based approach from Burnout by Emily and Amelia Nagoski that I integrate often
Cognitive + emotional tools – including self-compassion, boundary work, and even trauma-aware referrals when needed
You Deserve Clarity and Support
Whether you’re navigating monthly irritation and mood dips, or full-on premenstrual spirals that make you feel unrecognizable, you deserve care that sees the full picture.
I work with folks just like you - sensitive, big-hearted, and a little burnt out by wellness trends - to build gentle, practical plans that feel like a relief, not another to-do.
🌿 Let’s talk about your cycle. Book a free consult here and let’s co-create a care plan that centers your lived experience, not just your hormone levels.