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What is Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)?
Premenstrual Syndrome (PMS) is when body and mood changes happen before or during a period.
The symptoms occur during the first 4 days before a period.
The symptoms usually resolve 2-3 days after a period starts.
PMS occurs in approximately 20-40% of people with periods.
Premenstrual Dysphoric Disorder (PMDD) involves body and mood changes that are very debilitating and cause disturbance in the ability to function daily.
It occurs one to two weeks before a period.
PMDD occurs in approximately 2-8% of people who have periods.
People at an increased risk of developing PMS or PMDD have:
A family history of PMS or PMDD.
A family or personal history of a mood disorder or postpartum depression.
Those who smoke cigarettes.
What causes Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)?
It is not known why some suffer from PMS or PMDD, but it is thought to be related to changes in hormones and a chemical the body makes and uses called serotonin.
Serotonin affects the mood and the way the body functions.
Experts think the brain in people who suffer from PMS or PMDD may be more sensitive to the changes in period hormones and serotonin.
They think there may be a decrease in serotonin that then creates more of these symptoms.
The body’s response to these changes then creates the mood symptoms and body discomfort of PMS and PMDD.
What are the symptoms of Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)?
Symptoms of PMS:
Your child may have emotional changes like moodiness, irritability, anxiety, and sadness.
Your child may have more general symptoms like fatigue, trouble sleeping, and food cravings.
Your child may have physical symptoms that include constipation, diarrhea, headaches, backaches, bloating, breast tenderness, and acne.
Symptoms of PMDD:
The symptoms of PMDD affect daily activities so much that home life, work, and school are often affected during this time.
Your child may have emotional changes like moodiness, irritability, anxiety, increased tension, feeling on edge, sadness, hopelessness or feelings of decreased self-worth, anger, crying more often or easily, more sensitive, and loss of interest in normal activities.
Your child may have more general symptoms like fatigue, trouble sleeping, food cravings, changes in appetite, and trouble with concentration.
Your child may have physical symptoms that include bloating, breast tenderness, back pain, constipation or diarrhea, headaches, weight gain, joint aches, and an increase in acne.
How are Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) diagnosed?
Your child’s CPCMG provider will talk to you and your child about their symptoms.
They will examine your child.
They may ask you and your child to keep track of your child’s symptoms on an app, journal, or calendar.
There are no specific labs or bloodwork that diagnose either of these conditions.
The diagnosis is based on the symptoms your child has, when they happen around your child’s period, and how often they happen when your child has a period.
If your child’s CPCMG provider thinks that your child’s symptoms may be related to another condition, they may order some bloodwork for your child.
How are Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) prevented?
There is no way to prevent PMS and PMDD.
If your child has been diagnosed with a mood disorder and may be at higher risk of having PMS or PMDD, please contact your child’s CPCMG provider for additional help.
If your child is in therapy, check in with them about how they are doing and make sure they are using any coping skills their therapist has discussed with them.
Keep your child active and encourage them to exercise, eat healthy, and take part in daily life.
If your child is being treated with any medication for mood or help with PMS or PMDD symptoms, make sure they are taking it as prescribed.
How are Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) treated?
There is no specific treatment for PMS or PMDD.
Encourage your child to exercise and encourage them to take part in calming techniques like belly-breathing or meditation.
Practice stress management techniques and develop a plan with your child for stress reduction.
Encourage your child to eat healthy and avoid large amounts of sugar or caffeine that may worsen symptoms.
Encourage your child to write about their symptoms or share them with their CPCMG provider during a visit to clinic.
Some medications that may help are:
Over-the-counter medications:
Anti-inflammatory medications like ibuprofen or acetaminophen for pain.
Specific medications that are for periods like midol or pamprin may help.
Before using any over-the-counter medications, check with your child’s CPCMG provider.
Prescription medications:
Serotonin based medications that help with mood such as zoloft (sertraline), prozac (fluoxetine), or lexapro (escitalopram).
Hormonal pills like birth control.
When to contact your CPCMG healthcare team:
You think your child has PMS or PMDD.
You have concerns about your child’s period or their symptoms.
You have concerns about your child’s mood.
You have any other questions or concerns.
You would like to have your child seen.
📚 References
This content was adapted from Menstrual Period: Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) – Center for Young Women's Health, Nemours TeenHealth, Cleveland Clinic, National Institutes of Health, and Johns Hopkins Medicine.
Written by TT DO, reviewed by JW MD, Patient Education Committee.