--- title: How do different types of premenstrual symptoms change during the menstrual cycle? description: Different types of symptoms follow different patterns. Physical symptoms increase and decrease more sharply than mood and relationship symptoms, which are mil url: https://niyora.com/research/papers/using-natural-spline-models-to-explore-the-trajectories-of-empirically-derived-2024/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - How do different types of premenstrual symptoms change during the menstrual cycle? Study, 2024 # How do different types of premenstrual symptoms change during the menstrual cycle? Different types of symptoms follow different patterns. Physical symptoms increase and decrease more sharply than mood and relationship symptoms, which are milder throughout the cycle. Early or limited evidence 85 female college students in the US with regular periods, not using hormonal birth control ## What they did 85 college students with regular periods who were not using hormonal birth control kept daily diaries of their symptoms for 4 months. ## What they found The study identified distinct symptom groups including affective (mood), cognitive (thinking), interpersonal (relationships), pain, and somatic (physical) symptoms. Somatic symptoms increased and decreased more sharply and quickly than other symptoms. Interpersonal and affective symptoms stayed milder throughout the cycle. ## What it means for you Different types of symptoms don't all follow the same pattern during the cycle. The main limitation is that this was a small study of college students not using hormonal birth control, so results may not apply to all women with PMS or birth control users. 85 participants 4 months study duration ## About the study Original title Using natural spline models to explore the trajectories of empirically-derived domains of premenstrual symptoms (Preprint) Authors Lara Michelle Baez, Aaron Shain Heller Year 2024 Study design Study Participants 85 What was tested Daily symptom tracking Open access Yes Read the paper [doi.org/10.2196/preprints.56971](https://doi.org/10.2196/preprints.56971) Original abstract BACKGROUND Premenstrual symptoms are distressing and impairing for individuals and costly to society. These symptoms are heterogeneous within and across people, and they are dimensional, occurring on a spectrum. Furthermore, premenstrual symptoms are inherently dynamic—changing over the menstrual cycle and peaking perimenstrually. Understanding how symptom trajectories change over time may help us understand why symptoms occur. OBJECTIVE The first goal of this study was to enhance our understanding of the covariation among symptoms over the course of the menstrual cycle. We also sought to characterize the trajectories of these symptoms in a novel way, and use these characteristics to hypothesize about why symptoms might take different courses. METHODS A sample of female undergraduates (N=85) who reported no use of hormonal birth control and regularly occurring menstrual periods were recruited for a four month-long electronic daily diary study of premenstrual symptoms. We explored the covariation of symptoms over the cycle by conducting a multilevel exploratory factor analysis of the daily diary items. Next, we characterized the trajectories of each symptom domain using multilevel natural spline models and their first/second derivatives. RESULTS We identified six distinct but correlated symptom domains at the within-person level which were affective, cognitive, interpersonal, pain, and somatic. In the natural spline models, we found that somatic symptoms increased/decreased more sharply and quickly than other symptom domains, pointing to a unique trajectory. Interpersonal and affective symptoms, on the other hand, were milder throughout. CONCLUSIONS Natural splines offer a novel and unique way to investigate trajectories of menstrual cycle symptoms over time. Our findings highlight the importance of including menstrual cycle variables in daily diary studies, and underscore the need for more research on how to effectively model the impact of the menstrual cycle on mood and behavior in non-clinical samples. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Relationships and partners](https://niyora.com/research/topics/life-area-relationships/) 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 Survey study, 2026 Does stress affect premenstrual symptoms in female athletes, and can coping strategies help? Study, 2026 What coping strategies help women manage PMS symptoms? Survey study, 2026 Is academic stress linked to PMS severity in university students? Study, 2026 What are premenstrual syndrome and premenstrual dysphoric disorder? Systematic review, 2026 What life experiences and personal factors influence how severe PMS is? Survey study, 2026 Is self-compassion linked to PMS symptoms? 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