--- title: Is the stress hormone system different in women with PMDD? | Niyora description: Women with PMDD had significantly lower cortisol levels throughout the menstrual cycle compared to controls (p=0.0004 in follicular phase, p=0.0007 in luteal url: https://niyora.com/research/papers/cortisol-and-acth-response-to-dex-crh-testing-and-24-hour-urine-free-cortisol-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Is the stress hormone system different in women with PMDD? Case-control study, 2025 # Is the stress hormone system different in women with PMDD? Women with PMDD had significantly lower cortisol levels throughout the menstrual cycle compared to controls (p=0.0004 in follicular phase, p=0.0007 in luteal phase), suggesting PMDD may have a different mechanism than other depression types. Moderate study design 26 women with PMDD and 25 controls, both menstrual cycle phases ## What they did Researchers tested the stress hormone system in 26 women with PMDD and 25 controls without PMDD. Testing was done during both the follicular and luteal phases using a combined dexamethasone suppression and CRH stimulation test, plus 24-hour urine cortisol measurements. ## What they found No significant differences were found in plasma cortisol or ACTH levels between groups in response to the test. However, the PMDD group had significantly lower 24-hour urine cortisol levels compared to controls during both the follicular phase (p=0.0004) and luteal phase (p=0.0007). ## What it means for you Women with PMDD have lower cortisol than expected, which differs from major depression. This suggests PMDD may be more similar to stress disorders like PTSD. The main limitation is that this was a relatively small study. 26 women with PMDD 25 controls without PMDD 0.0004, 0.0007 p-values for lower cortisol in PMDD ## About the study Original title Cortisol and ACTH response to Dex/CRH testing and 24-hour urine free cortisol levels in women with and without premenstrual dysphoric disorder Authors Zou CX, Guerrieri GM, Martinez PE et al. Journal Psychoneuroendocrinology Year 2025 Study design Case-control study Participants 26 What was tested Dexamethasone and CRH stimulation test, 24-hour urine cortisol measurement Open access Yes Read the paper [doi.org/10.1016/j.psyneuen.2024.107250](https://doi.org/10.1016/j.psyneuen.2024.107250) ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Stress](https://niyora.com/research/topics/symptom-stress/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Major depressive disorder](https://niyora.com/research/topics/comorbidity-major-depression/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Cohort study, 2022 What are PMS and PMDD and how should they be diagnosed and treated? Review, 2000 What conditions beyond depression can antidepressants treat? Review, 1999 Is premenstrual dysphoric disorder a distinct clinical disorder? Non-randomised trial, 2024 Does luteal phase sertraline treatment affect stress hormones and inflammation in PMDD? Randomised trial, 2025 Does taking an antidepressant only during the second half of your cycle reduce anger and aggression in PMDD? Review, 2024 What are the most effective treatments for PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗