What's the difference between PMS, PMT & PMDD?

Updated: Nov 14

As women, we know the classic signs of PMS, how it feels and how it's often unexplainable. A French study identified over 400 symptoms women attribute to their menstrual cycle and PMS, ranging from mild pain, to hospitalisation.


However your period and time beforehand manifests, one thing is clear to me - there's still much confusion around terminology and that these symptoms are treatable and manageable. I repeat, you do not have to just "live with" your symptoms.

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So first, terminology:


PMS = pre menstrual stress


PMT = pre menstrual tension


These two are more or less the same. There are then 4 subcategories of PMS/T:


PMS - C = Cravings: for sweets and chocolates. 60% of women experience this

PMS - H = Hyper-hydration: water retention and bloating

PMS - D = Depression: low mood, tearful, lack of coordination, sense of hopelessness

PMS - A = Anxiety: feelings of panic, increased stress. Up to 80% of women experience this


All of the above can also include some of the more common symptoms: pain across the abdomen, lower back and backs of legs, cramping, mood swings, feeling more emotional than normal, breast tenderness, headaches or migraines (to name just a few).


Some women can have severe PMS/T, which involves feelings of much more severe depression and anxiety which can last for 2 weeks or more throughout the menstrual cycle.


This is called PMDD = Premenstrual Dysphoric Disorder


Why do some women suffer from PMDD and others don't?

Annoyingly there is no definitive cause as some women who experience it have a hormone imbalance and some don’t.


The good news is that there is a lot that can be done with nutrition, exercise, lifestyle, supplements and herbs to improve symptoms.


Most importantly you need to follow a hormone balancing diet so the liver is supported for clearing hormones, toxins and wastes, preventing them for recirculating in the blood stream and wrecking havoc with emotions and pain centres.


Working to balance your blood sugar by eating regular meals, eating lots of fruits and vegetables, healthy fats such as oily fish and avocado are all great ways to reduce your symptoms too. Avoiding caffeine, sugar, salt, alcohol and processed foods is also essential, but more on that later.


What does conventional medicine recommend?

Usually women will be offered the contraceptive pill to treat PMS/T/PMDD. However this can often make things much worse!

pms women's health

Not only can the synthetic hormones in the pill cause further hormonal imbalance, it can take many months and even years to clear the body of the excess hormones once you come off the pill.

I see women in my clinic on a regular basis who come to me for the after affects of being on the pill: acne, female hair thinning, weight gain, mood changes, loss of periods and concerns about fertility and reproductive health.


My advice is to always understand the root cause of your PMS. Is it diet, stress, sleep or lifestyle related? The more that you do now to balance your hormones naturally, the quicker and easier you will see resolution of symptoms. I have had some women see miraculous results in just one month by cleaning up there diet. Learn more about that here .


Top Tip!

Did you know that science has proven that inflammatory foods such as alcohol, caffeine, sugar and processed foods can actually make your symptoms MUCH WORSE!


If you are experiencing PMS, especially cramping and pain, it is best to avoid all of the above, especially around the time of the month when symptoms are at their worst.


These inflammatory foods can increase chemicals called prostaglandins in the body. These chemicals are made from traces of fat stored in cell membranes, and promote inflammation.


When these cells break down during menstruation, the prostaglandins are released. They constrict the blood vessels in the uterus and make its muscle layer contract, causing painful cramps.


Opt for a mediterranean diet to help reduce symptoms. Lots of fresh fruit and vegetables, olive oil, whole grains, oily fish and plenty of water.


My Hormone Balancing Program is a great way to get your PMS under control. If you want to learn more, why not book in for a free 20 minute consultation with me or one of my team.



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Kelly Mulhall

Registered Nutritional Therapist

Dip CNM, mBANT, mANP, mCNHC










Kelly is a Registered Nutritional Therapist who focuses on positive physical and mental wellbeing, achieved through diet, lifestyle, sleep and exercise. Having struggled for years with IBS and hormonal imbalance, and increasingly frustrated with the lack of support and helpful advice from her GP, Kelly began her own journey of healing the body from the inside out. After seeing huge improvements she quit her job to study nutrition and focus on harnessing the healing powers of food to help other people in similar situations.


I am not attempting to prevent, treat or cure any physical, mental or emotional issues. Do not disregard medical advice or delay seeking medical advice because of information you have read on this website. Do not start or stop taking any medications without speaking to your primary health care provider.


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