PMS Symptoms & PMDD Symptoms


Wondering whether you have PMS (Premenstrual Syndrome) or PMDD (Premenstrual Dysphoric Disorder)? What the symptoms are? What is the difference between PMS and PMDD (Premenstrual Dysphoric Disorder)?


Let’s talk about ‘PMS Symptoms & PMDD Symptoms’.


Hello, I am so thrilled to be here.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release (NER) Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


What is PMS?


PMS or premenstrual syndrome is when a woman will experience recurring symptoms during the luteal phase of the menstrual cycle (the phase after ovulation) / about 1-2 weeks prior to the next period. Which are generally relieved once the period commences or a few days afterwards. Approximately 85% of women have reported one or more premenstrual symptoms.


A severe form of PMS is known as PMDD (Premenstrual Dysphoric Disorder), this is next level and presents with more severe symptoms that impact day-to-day function. There is often irritability, depression and mood swings that are more severe.


PMS Symptoms


Sometimes symptoms may differ from cycle to cycle.


Emotional / psychological symptoms:


  • Loss of control

  • Feelings of inability to cope

  • Depression

  • Anxiety

  • Angry out-bursts

  • Mood swings

  • Irritability

  • Nervous tension

  • Confusion

  • Lack of concentration

  • Tearfulness

  • Forgetfulness

  • Social withdrawal


Physical symptoms:


  • Sore / tender boobs

  • Lumpy boobs

  • Headaches

  • Abdominal bloating, discomfort & distension

  • Fluid retention

  • Food cravings e.g. sweet foods, fatty foods, alcohol

  • Increased appetite

  • Libido altered

  • Joint or Muscle aches / pain

  • Tiredness

  • Premenstrual acne

  • Pelvic pain or discomfort

  • Insomnia

  • Sinusitis

  • Recurrent colds

  • Changes in bowel habits

  • Palpitations

  • Fainting

  • Dizziness

  • Recurrent vaginal thrush

  • Genital herpes outbreak

  • Changes in bowel habits



Different types of PMS


  • PMS-H (Hyperhydration): Fluid retention is the main symptom

  • PMS-D (Depression): Main symptom being depression

  • PMS-A (Anxiety): Associated with irritability and nervousness

  • PMS-C (Cravings): hypoglycaemic symptoms & cravings for sugar premenstrually

  • PMS-P (Pain)


It is possible to be a mix of these different subtypes of PMS.



What is the cause of PMS?


It is still misunderstood, and the main cause is not identified in this point in time. But there are some potential influences that may be contributing to PMS.


Contributing factors


  • Stress

  • Carbohydrate intolerance

  • Nutritional deficiencies: vitamin B6, magnesium, vitamin A, vitamin E

  • Deficient adrenal hormone secretion – due to an abnormality in HPA (Hypothalamic-pituitary-adrenal axis).

  • Serotonin deficiency

  • Sodium & water retention issues due to abnormal aldosterone function

  • Hormone issues: Oestrogen excess, progesterone deficiency in luteal phase, prostaglandin excess or deficiency, high prolactin (hyperprolactinemia)

  • Poor elimination & digestion: (liver function, digestive function), liver is important in clearance of hormones, same with your bowels (if you don’t do a poo at least once per day or suffer with constipation – your hormones will have no where to go and will be reabsorbed.

  • Prostaglandins not behaving as they should.

  • Gut bacteria dysbiosis (imbalance):

    • Arises in hormone imbalance, particularly poorly managed oestrogen levels & clearance. We have the Estrobolome which is a family of bacteria responsible for maintaining oestrogen levels in the body.

    • SIBO (Small intestinal bowel overgrowth)

  1. This can activate mast cells involved in our immune system & arise in high histamine which can lead to PMS symptoms. Histamine is a stimulating neurotransmitter > headaches, agitation & anxiety

  2. It arises in intestinal permeability (leaky gut) which causes immune dysfunction, inflammation, release of bacterial toxins entering the pelvis > hormone imbalance > PMS symptoms.

  • An abnormal neurotransmitter response to the ovaries messaging



How is PMS diagnosed?


There is no blood test to diagnose whether or not you have premenstrual syndrome. It is literally identified based on whether you have symptoms 1-2 weeks prior to your period.


Diagnosis criteria of PMS:


  • At least one emotional or one physical symptoms in the 5 days before your period

  • Symptoms stop from days 4-13

  • Symptoms impair functioning

  • Symptoms confirmed in 2 cycles

  • Symptoms not due to another condition or disorder



What is the difference between PMS and PMDD?


PMDD (Premenstrual Dysphoric Disorder) is a more severe form of PMS. The symptoms cause significant distress or interfere with day to day activities (social gatherings, work, school etc) or relationships with those around you.


Diagnostic criteria of PMDD:

  • In the majority of menstrual cycles, at least 5 symptoms are present the week before your period

  • Symptoms improve within a few days after your period starts

  • Symptoms become minimal or absent the week after your period


These are the symptoms of PMDD:


  1. ONE or MORE of the following must be present:

  2. Marked tension, anxiety and / or feeling of being keyed up or on edge

  3. Marked feelings of hopelessness, depressed mood, or self-deprecating thoughts (undervaluing yourself or being critical)

  4. Marked anger or irritability or increased conflicts with others

  5. Rapid or exaggerated changes in mood (increased sensitivity to rejection, feeling suddenly tearful or sad, mood swings)


  1. ONE or MORE of the following must be present to reach a total of 5 symptoms when you combine with symptoms from the above criteria

  2. Sensation of bloating or weight gain

  3. Joint or muscle pain

  4. Tender or swollen boobs

  5. Sense of being out of control or overwhelm

  6. Significant change in appetite: food cravings or over eating

  7. Lack of energy, easily fatigued

  8. Difficulty concentrating

  9. Decreased interest in activities



Can a Naturopath help with PMS (Premenstrual Syndrome) & PMDD (Premenstrual Dysphoric Disorder)?


Yes, absolutely. I would suggest seeing a Naturopath that specialises in Periods & Hormones like myself; to help support you. Perhaps you suspect you have PMS or have been told that this is the case for you.


Treatment wise, we would be using Natural medicine: including herbal medicine & nutritional medicine based on pathology findings, symptoms & signs, diet & lifestyle. I also use NER (Naturopathic Emotional Release) to look at underlying emotional contributors.




  • Nutritional Deficiencies

  • Hormonal imbalance: Girly Hormones (oestrogen, progesterone, testosterone etc.), Thyroid, Pancreas, Adrenals

  • Assessing gut health: might include microbiome testing for large bowel, SIBO testing for small bowel


If you would like support with your premenstrual symptoms, I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

If you have any questions or comments, pop them in the comments box below 🙂