Is it me or my PMS?
About 80% of women report at least 1 physical or emotional symptom during the 2 weeks prior to their period (luteal phase). Having symptoms that present in the 5 days before your period and resolve within 4 days of the onset of menses is considered premenstrual syndrome (or PMS).
However, we need to be careful when was call something PMS. This is because, hormonal changes that happen closer to our periods can exacerbate pre-existing conditions. For example, if you have IBS, it will probably be aggravated before your period, same goes for anxiety and depression, the list goes on and on.
What are symptoms of PMS?
PMS includes at least 1 of the following symptoms that starts after day 13 of menses and resolves by day 4 of menses, each month for at least 2 months:
Irritability, anxiety, confusion, depression, social withdrawal, headache, breast swelling and/or tenderness, abdominal bloating, joint or muscle pain, swelling of the extremities.
So, how do you know if it is PMS that is causing your symptoms??
The answer is: YOU HAVE TO TRACK
In order to identify whether or not something is purely hormonal is to track your symptoms for at least 2 months, or more ideally 3 cycles. This can be helpful for 2 reasons. Number 1 is that it ensures that we don’t miss the diagnosis of something else by saying, “its just that time of the month.” Number 2 is that we can direct treatment appropriately. If it is a worsening of symptoms because of your upcoming period the treatment may look different than if it is PMS specifically.
CAN’T YOU JUST DO A BLOOD TEST?
The answer is actually NO. Research shows that if we line up the blood work of women who have PMS with women who don’t we wouldn’t be able to tell the difference. This is because, just because the hormones look normal in that snapshot in time, it doesn’t tell us about hormonal fluctuation. However, some blood tests may be ordered by your practitioner to rule other things out that can cause similar symptoms or increase risk of PMS. These may include iron levels, thyroid, or vitamin D. In addition, other hormone testing may be used to rule out other hormonal causes of your symptoms.
What is the difference between PMS and PMDD?
PMDD stands for premenstrual dysphoric disorder which is a relatively recent classification for women who experience significant mood changes in the weeks leading up to their menstrual cycle. For women with PMDD they face significant changes in the 2 weeks leading up to their period. For these women, their symptoms are severe impacting their quality of life, work and relationships of then leading to their missing work or school and experiencing days of social withdrawal. The difference between PMDD and major depressive disorder (MDD) is that these women experience a distinct shift in the way they feel once their period comes. They often feel great the week of and week after their period almost like they are 2 separate people.
PMDD is diagnosed in the same way as PMS. Tracking is essential, but with PMDD the symptoms have to occur in at least 6 of the last 12 months.
Diagnosing PMS and PMDD (and distinguishing between the 2) can help women get on the right track for improving her symptoms. At Health Over All, we offer programs that will not only help you with your hormone-related symptoms, but also provide you the support you need from other women who are going through hormonal challenges of their own. You are not alone. And we can help. Book your free Alignment Call HERE to find out how you can work with us.
Dr. Lisa Maddalena, ND
- Hantsoo L, Epperson CN. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Curr Psychiatry Rep. 2015 Nov;17(11):87.
- Hofmeister S, Bodden S. Premenstrual Syndrome and Premenstrual Dysphoric Disorder. Am Fam Physician. 2016 Aug 1;94(3):236-40. PMID: 27479626.
- Craner JR, Sigmon ST, McGillicuddy ML. Does a disconnect occur between research and practice for premenstrual dysphoric disorder (PMDD) diagnostic procedures? Women Health. 2014;54(3):232-44. doi: 10.1080/03630242.2014.883658. PMID: 24512469.