Experiencing severe premenstrual symptoms is not something to dismiss as normal. For many women, these symptoms significantly impact their lives, yet they are often misunderstood or minimized by healthcare professionals. In this blog, we’ll revisit the key differences between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), explore the role of cycle tracking in managing symptoms, and discuss emerging research and nutritional approaches that may offer relief.
What Is PMS and PMDD?
PMS encompasses a wide range of physical, emotional, and behavioural symptoms that occur during the luteal phase of the menstrual cycle—the time between ovulation and menstruation. Symptoms can include irritability, anxiety, low mood, headaches, sleep disturbances, and breast tenderness. These typically subside with the onset of menstruation and affect up to 90% of women monthly.
PMDD, however, is a much more severe condition that affects an estimated one in 20 women. Recognized as a mental health disorder in the DSM-5, PMDD is characterized by debilitating mood swings, depression, irritability, and anxiety that can interfere with daily functioning and, in some cases, lead to suicidal thoughts. While PMS symptoms are manageable for many, PMDD requires targeted support and intervention.
Causes and Contributing Factors
While the exact causes of PMS and PMDD are not fully understood, hormonal changes during the luteal phase play a central role. Women with PMDD may exhibit heightened sensitivity to these hormonal fluctuations, particularly to progesterone and its metabolites. Other factors, such as a history of trauma, genetic predisposition, and serotonin dysregulation, may also contribute to the development of PMDD.
Recent research highlights the role of neuroinflammation and gut health in exacerbating PMDD symptoms. For example, studies suggest that individuals with PMDD may have heightened inflammatory responses or altered gut-brain axis communication, which could influence mood and emotional regulation.
The Importance of Cycle Tracking for PMDD
Cycle tracking is a powerful tool for identifying patterns and triggers related to PMS and PMDD symptoms. By keeping a detailed record of symptoms throughout the menstrual cycle, you can:
Pinpoint symptom timing: Understanding when symptoms occur can help distinguish between PMS and PMDD.
Identify triggers: Certain lifestyle factors, such as stress, diet, or sleep patterns, may exacerbate symptoms.
Enhance treatment effectiveness: Sharing detailed symptom logs with healthcare providers can lead to more accurate diagnoses and tailored treatment plans.
Apps like Clue, Flo, or even a simple journal can help track mood, physical symptoms, and lifestyle habits.
Conventional and Nutritional Approaches to Managing PMS and PMDD
Conventional Treatments
For PMS: Over-the-counter pain relievers, and lifestyle changes such as exercise and stress management are commonly recommended.
For PMDD: Antidepressants (e.g., SSRIs), hormonal treatments, and psychotherapy (e.g., cognitive-behavioural therapy) are recommended and often necessary to manage the severity of symptoms.
Nutritional Support: Incorporating specific nutrients into your diet can help alleviate symptoms of both PMS and PMDD:
Nutrient-Rich Diet: Focus on whole grains, brightly coloured fruits and vegetables (8-10 portions daily), and lean protein to stabilize blood sugar and support hormonal balance.
Omega-3 Fatty Acids: Found in fatty fish, flaxseeds, and walnuts, omega-3s may reduce inflammation and improve mood.
Calcium: Sources like dairy, leafy greens, and fortified foods have been shown to reduce PMS and PMDD symptoms.
Magnesium: Dark chocolate, nuts, seeds, and legumes can help ease mood swings, anxiety, and bloating.
Complex Carbohydrates: Whole grains, quinoa, and sweet potatoes can stabilize blood sugar and improve serotonin production.
Herbal Support: Herbs like vitex (chaste tree berry), saffron, and Rhodiola rosea may offer symptom relief, but consult a Nutritional Therapist before use to ensure safety and efficacy.
Moving Forward
Differentiating between PMS and PMDD is crucial for effective symptom management. While conventional treatments are invaluable (I actively encourage all of my clients to get psychological and clinical support if they have PMDD). A holistic approach that includes cycle tracking and Nutritional Therapy is also invaluable.
I am a (former) PMDD sufferer, and I have done everything (nutrition, nervous system regulation, counselling, seeing the doctor) to manage my PMDD symptoms. I am passionate about this area, so if you want to explore personalised nutritional support and advocacy, please book a free call with me.
Catherine xx

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