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PMS vs PMDD: When Menstrual Mood Swings Are Normal And When To Get Help

It’s normal to experience menstrual mood swings for up to two weeks before you start your period. However, they shouldn’t be ruling your life and affecting your daily activities.

Thanks to several pop-culture references and a generally apathetic attitude towards premenstrual health, PMS (premenstrual syndrome) has been reduced to the butt of too many moody-women-on-their-period jokes. 

This has only made it more challenging for people to seek medical treatment for serious premenstrual symptoms, as it’s difficult to take yourself seriously (and get to a doctor) when you’re belittled for experiencing PMS or period mood swings in the first place. 

In this article, we'll outline what PMS (premenstrual syndrome) is, how PMDD (premenstrual dysphoric disorder) is different from it, and share more detailed information about period mood swings and what to do about them.

What is PMS?

PMS (premenstrual syndrome) is a condition many women experience in the weeks leading up to their period due to changes in hormones. Symptoms can vary from person to person and even month to month, but PMS is characterised by its predictability. While PMS is a normal part of womanhood, if it affects your daily life, you should seek help to manage the symptoms.

PMS Symptoms

Everyone’s PMS symptoms are different and can vary every month, but the most common symptoms of PMS include:

  • Mood swings
  • Feeling upset
  • Anxiety or irritability
  • Low energy and trouble sleeping
  • Poor concentration
  • Headaches
  • Bloating, constipation or diarrhoea
  • Breast tenderness
  • Acne
  • Increases or decreases in appetite
  • Changes to sex drive
  • Joint or muscle pain
  • Food cravings

All symptoms can vary in severity, but most will subside about four days after your menstrual period starts.

PMS treatment

Fortunately, there are some treatment options to ease PMS symptoms. As always, good lifestyle habits will give you the best outcomes, so avoid drinking alcohol or smoking, stay active, get plenty of rest and maintain a balanced diet.

Some over-the-counter medications can help relieve PMS symptoms. If you suffer from headaches, breast tenderness or cramps, pain medication like ibuprofen or aspirin can help. 

Treatment for PMS depends primarily on the symptoms that concern you the most. If your symptoms are more severe, you may need prescription medicines including:

  • Hormonal birth control to ease physical symptoms
  • Antidepressants or anti-anxiety medication to help with emotional symptoms and mood disorders
  • Diuretics to reduce bloating and breast tenderness

Remember, always speak to your doctor about your concerns and ensure you fully understand the risks and benefits of any medications you might take. If you still experience PMS symptoms that affect your quality of life after trying prescription medications, you may be referred to a specialist like a gynaecologist or psychologist.

You can also explore taking supplements under the guidance of your GP. Calcium has been shown to ease fatigue, depression, and PMS cravings. Vitamin B6 can help with moodiness and bloating. Magnesium may reduce headaches and cramps.

Causes of PMS

We don’t know exactly what causes PMDD or PMS, but it’s likely that fluctuating hormones during the menstrual cycle play a role. When it comes to how periods affect mood, your oestrogen levels drop, which can consequently affect how much serotonin your brain produces, resulting in low energy. It’s also possible that women with severe PMS or PMDD have pre-existing, undiagnosed depression, but depression itself doesn’t account for all PMS symptoms.

What is PMDD?

Premenstrual dysphoric disorder (PMDD) is similar to PMS, except it is characterised by far more intense behavioural and psychological symptoms and a significant negative impact on daily life, in some women even causing suicidal thoughts. 

It’s important to understand that PMS is normal, but it should never feel debilitating. If you find that your mood, menstrual-related depression or anxiety becomes unmanageable during your period, seek help. The same goes for if you find that you’re more anxious than usual, suffering from panic attacks or having depressive or suicidal thoughts during your period. 

Treatment for PMDD can be life-changing. If you need urgent help for PMDD, here are some things you can do:

  • Arrange an emergency appointment with your GP
  • Call the Suicide Crisis Line on 0800 567 567
  • Call 10177 for an ambulance or take yourself to the emergency room if you are about to self-harm
  • Ask a trusted friend or family member to call 10177 or take you to the emergency room

Please know that no person deserves to feel any sort of pain, anguish or sadness, whether it’s caused by your period or not.

What PMDD red flags should I look out for?

Symptoms of PMDD can be difficult to distinguish from PMS, but here are some signs you need to seek help:

  • You’re feeling tempted to self-harm, hurt those around you or take your own life (suicidal ideation)
  • You can’t get out of bed because life just seems unbearable and your periods are painful
  • You’ve stopped socialising and doing things that you’d normally enjoy (exercising, hobbies) and are noticing changes in your sleeping and eating patterns (over or under-eating and sleeping)
  • You’re unable to focus at work, take care of your family or look after yourself (losing the will to maintain personal hygiene is a big sign that something is wrong).

If you experience thoughts of suicide, contact the Samaritans toll-free on 116 123 or text SHOUT to 85258.

How to treat PMDD 

Once you have a PMDD diagnosis there are a few treatments at your disposal including lifestyle changes, PMDD medication, and surgery. It’s important to communicate openly with your doctor about any PMDD remedies you want to try because all treatments may have side effects.  

Lifestyle changes

Treating PMDD naturally is possible. Like PMS treatment, lifestyle changes are important for PMDD treatment, but they can be difficult to implement if you’re feeling low. Do your best to:

  • Get regular exercise
  • Eat a balanced diet
  • Get enough sleep
  • Manage stress
  • Reduce your caffeine, alcohol consumption and cigarette use


If depression and period mood swings are affecting you severely due to PMDD, your doctor may suggest taking SSRIs (selective serotonin reuptake inhibitors) during the luteal phase of your cycle. You will need to check in with your doctor after a couple of months to see how the treatment is working for you.

The birth control pill

Oral contraception can help PMDD by stopping the hormonal fluctuations associated with your period. This treatment for PMDD varies in its efficacy from person to person and it can make PMDD symptoms worse, so don’t be afraid to try other options if it doesn’t help you. If you are trying to get pregnant, the contraceptive pill as a PMDD treatment may not be for you because it prevents ovulation.


If your worst PMDD symptoms are anxiety and depression, cognitive behavioural therapy (CBT) can help to manage them.


Painkillers and anti-inflammatories can help with severe headaches, muscle cramps and joint pain associated with PMDD.

Final resorts

PMDD is known for its severe symptoms, so it’s possible the above PMDD treatments might not be effective for you. If that is the case there are some last-resort treatments you can speak with your doctor about:

  • GnRH analogue injections: these are hormonal injections that cause temporary menopause.
  • Surgery: the total removal of your uterus, fallopian tubes and ovaries will permanently stop your menstrual cycle and consequently get rid of PMDD.

Both of these final resorts come with risks so you should speak to your doctor and ensure you have a comprehensive understanding of the pros and cons. 

Mood swings while on your period

Due to the hormonal changes before menstruation, periods and mood swings often go hand in hand. Mood swings during your period are a reality for women across all stages of their development. From early puberty to pregnancy and menopause, swiftly changing from happy to sad or irritated to angry is something very common in women’s health. 

That doesn’t make menstrual period mood swings any easier to cope with, though. And sometimes, rapidly changing moods can become sources of disruption and anxiety. If your period mood swings get in the way of your performance at work or school, or if they interfere with your family and social life, there’s no shame in seeking help.


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