Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Always consult a qualified healthcare professional for diagnosis and treatment.
What Is PMS (Premenstrual Syndrome)?
Menopause is often discussed as a woman’s health issue, but its impact extends far beyond the individual experiencing the physical changes. For women, menopause can bring a complex mix of symptoms, including hot flushes, fatigue, brain fog, mood changes, anxiety, depression, joint pain, and sleep disturbance. These symptoms can affect confidence, relationships, work performance, and mental health, and for some women, they can be severe and long-lasting. Menopause is not a single moment in time but a transition that can span several years, during which women may feel misunderstood, dismissed, or unsupported, particularly in professional or clinical settings.
Men also play an important role in understanding menopause, whether as partners, family members, colleagues, employers, or carers. Increased awareness helps reduce stigma, improves communication, and fosters empathy rather than frustration or misinterpretation of symptoms as personality changes or stress alone. Menopause is a shared social and workplace issue, not a private inconvenience. When both men and women are informed, it creates space for compassion, reasonable adjustments, and supportive relationships, ensuring that menopause is recognised as a legitimate health transition deserving of respect, understanding, and appropriate support.
Male menopause, often referred to as andropause or age-related testosterone decline, is a recognised health issue that can affect men typically from their 40s onwards. Unlike female menopause, it does not involve a sudden hormonal stop, but a gradual reduction in testosterone levels, which can lead to symptoms such as fatigue, low mood, irritability, reduced concentration, sleep problems, weight gain, reduced libido, and feelings of loss of confidence or motivation. These changes are frequently misunderstood or dismissed as stress, ageing, or lifestyle issues, leaving many men reluctant to seek help. Greater awareness of male menopause is essential to reduce stigma, encourage open conversations, and ensure men receive appropriate medical advice, mental health support, and lifestyle guidance—recognising that hormonal health is important for everyone, regardless of gender.
Premenstrual symptoms are extremely common, but not all premenstrual conditions are the same. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are often confused, yet they differ significantly in severity, impact, and clinical recognition. Understanding the difference is essential, particularly for women whose symptoms affect their mental health, relationships, work, and overall quality of life.
PMS refers to a group of physical, emotional, and behavioural symptoms that occur in the luteal phase of the menstrual cycle (typically 1–2 weeks before a period) and ease once menstruation begins.
Common PMS Symptoms
Physical symptoms
- Bloating
- Breast tenderness
- Headaches or migraines
- Fatigue
- Changes in appetite or cravings
- Joint or muscle pain
Emotional & behavioural symptoms
- Irritability
- Mood swings
- Tearfulness
- Mild anxiety
- Low mood
- Difficulty concentrating
Key Characteristics of PMS
- Symptoms are mild to moderate
- Daily functioning is usually still possible
- Symptoms improve once the period starts
- Very common (affects up to 75% of menstruating women at some point)
What Is PMDD (Premenstrual Dysphoric Disorder)?
PMDD is a severe, hormone-related mood disorder recognised as a distinct medical condition. While it follows the menstrual cycle like PMS, its impact, particularly on mental health, is far more profound.
PMDD is not “bad PMS”. It is a serious neuro-hormonal condition.
Common PMDD Symptoms
Psychological symptoms (core features)
- Severe depression or hopelessness
- Intense irritability or rage
- Anxiety or panic attacks
- Emotional numbness or detachment
- Sudden crying spells
- Feeling out of control
Cognitive symptoms
- Brain fog
- Difficulty concentrating
- Intrusive thoughts
- Heightened sensitivity to rejection
Behavioural & physical symptoms
- Sleep disturbances
- Extreme fatigue
- Appetite changes
- Worsening of existing mental health conditions
- Suicidal thoughts (in severe cases)
Key Characteristics of PMDD
- Symptoms are severe and disabling
- Significant impact on work, education, and relationships
- Symptoms resolve shortly after menstruation begins
- Occurs in around 3–8% of women
- Often misdiagnosed as depression, anxiety, or bipolar disorder
PMS vs PMDD: Key Differences at a Glance
| Feature | PMS | PMDD |
| Severity | Mild to moderate | Severe and debilitating |
| Mental health impact | Mild mood changes | Severe depression, anxiety, rage |
| Effect on daily life | Manageable | Often unmanageable |
| Risk of self-harm | No | Can be present |
| Medical recognition | Symptom-based | Diagnosable disorder |
| Treatment intensity | Lifestyle changes often sufficient | Often requires medication |
Diagnosis: How PMS and PMDD Are Identified
PMS Diagnosis
- Based on symptom history
- No formal diagnostic test
- Symptoms tracked over several cycles
PMDD Diagnosis
PMDD requires:
- Prospective symptom tracking for at least 2 menstrual cycles
- Symptoms present in the week before menstruation
- Symptoms resolve shortly after the period starts
- At least one severe mood symptom (e.g. depression, anxiety, rage)
Doctors may use symptom diaries or tracking apps to confirm the cyclical pattern.
⚠️ Important: PMDD is frequently under-recognised. Many women are told their symptoms are “just hormones” or mislabelled as having a primary psychiatric condition.
Treatment Options
PMS Treatment Options
- Regular exercise
- Balanced diet
- Reducing caffeine, sugar, and alcohol
- Stress management
- Sleep optimisation
- Over-the-counter pain relief
- Vitamin supplements (e.g. magnesium, B6, under medical advice)
PMDD Treatment Options
PMDD often requires medical intervention:
Medication
- SSRIs (antidepressants), taken daily or only during the luteal phase
- Hormonal treatments (e.g. combined contraceptive pill)
- In severe cases, hormone-suppressing therapies
Psychological support
- Cognitive Behavioural Therapy (CBT)
- Trauma-informed therapy (particularly where symptoms overlap with anxiety or OCD)
Lifestyle support
- Structured routines
- Reduced sensory overload
- Workplace or educational adjustments
PMDD, Disability, and Legal Recognition
For many women, PMDD can:
- Meet the definition of a disability
- Require reasonable adjustments at work or education
- Be relevant to benefits and occupational health assessments
Severe cyclical mental health symptoms should not be dismissed simply because they are hormone-related.
When to Seek Help
You should seek medical or professional support if:
- Symptoms interfere with work, study, or relationships
- You feel emotionally unsafe at certain points of your cycle
- Symptoms are predictable, cyclical, and severe
- You are experiencing intrusive or suicidal thoughts
Final Thoughts
PMS and PMDD exist on the same hormonal spectrum, but PMDD is not just a more intense PMS. It is a serious condition that deserves recognition, validation, and appropriate care. If your symptoms feel overwhelming, cyclical, and dismissed, trust your experience. You are not weak, dramatic, or overreacting; you may simply need the right diagnosis and support.
Further Reading:
- Menopause – NHS
- PMS (premenstrual syndrome) – NHS
- Premenstrual syndrome | Health topics A to Z | CKS | NICE
- What is PMDD: Difference from PMS, Symptoms, Treatment
- What is PMDD? | Types of mental health problems | Mind
- PMDD vs. PMS: Episodes, Intensity, Mental Health
- PMS vs. PMDD: What’s the difference?
- PMS vs. PMDD: Symptom Similarities and Differences
- PMS vs. PMDD: What’s the Difference and Which is Worse?
- Definitions PMS/PMDD | NAPS – National Association for Premenstrual Syndromes
Zena graduated with a Distinction in MSc International Business Management | First Class Graduate in BA (Hons) Marketing Management | Distinction in CIM Level 4 Digital Marketing Techniques
Zena is the co-founder and sub-editor of DisabledEntrepreneur.UK & DisbilityUK.co.uk Zena may look normal to an untrained eye even though she has an invisible disability, thanks to a great support network she is able to adapt into society and has additional help, whenever she needs it.
Zena aspires to be a role model for young people with Multiple Sclerosis. She too suffers from MS and encounters chronic pain symptoms in the legs and has noticed cognitive impairment and muscle weakness.
Recognized as a 'Cosmetic Champion Influencer', she celebrates the innovation, glamour, and empowering spirit that define Disabled Entrepreneur - Disability UK Affiliate Partner Beauty Ranges.
When it comes to marketing Zena works remotely which does not put an added strain on her health. She writes articles and posts on an array of subjects, namely health and wellbeing, business,. She also does social media management, content creation and digital marketing, whilst promoting DisabledEntrepreneur.uk and DisabilityUK.co.uk brands.
