---
title: Premenstrual exacerbation (PME): 168 studies, explained | Niyora
description: 168 studies on premenstrual exacerbation (pme) and PMS or PMDD, each summarised in plain English: what was tested, who took part, what they found and what it
url: https://niyora.com/research/topics/condition-pme/
---

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- Premenstrual exacerbation (PME)

# Premenstrual exacerbation (PME): what the research says

168 studies on premenstrual exacerbation (pme) in PMS and PMDD, each explained in plain English. 9 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 40

Study 29

Cohort study 27

Randomised trial 25

Case report 14

Review 13

Randomised trial, 2024

Does estradiol prevent thinking problems before the period in women with suicidal thoughts?

Yes. Estradiol prevented drops in working memory and verbal fluency that otherwise happened before the period.

Review, 2024

What do brain wave patterns show about PMS and PMDD?

Preliminary evidence suggests women with these conditions may have different brain wave patterns, but we need more research to be sure.

Review, 2024

What is premenstrual exacerbation and how does it affect different psychiatric illnesses?

Premenstrual exacerbation is when psychiatric symptoms worsen during the premenstrual phase. Hormonal changes during the menstrual cycle create a vulnerable period for many psychiatric conditions, but premenstrual exacerbation remains poorly defined.

Systematic review, 2022

Do mental health disorders get worse during the menstrual cycle?

Yes, several mental health disorders like depression, panic attacks, eating disorders and borderline personality disorder clearly worsen around menstruation. The evidence is less clear for anxiety or bipolar disorder.

Review, 2018

What are the most effective treatments for premenstrual syndrome and PMDD?

Serotonin reuptake inhibitors and contraceptives with shortened or no hormone-free interval are the most effective treatments. Some women who do not respond may benefit from GnRH agonist treatment.

Review, 2012

How should premenstrual disorders be diagnosed and organized?

An international group of medical experts created a unified system for defining and classifying premenstrual disorders, which separates typical PMS from more complex conditions.

Randomised trial, 2000

How should PMDD be diagnosed and treated?

PMDD is a distinct condition from regular PMS, characterized by mood symptoms like irritability and anger. SSRIs taken daily or only during the menstrual cycle are first-line treatment and work very well with minimal side effects.

Randomised trial, 2000

How effective are antidepressants for treating PMDD?

Serotonin reuptake inhibitors (a type of antidepressant) are very effective for PMDD, with excellent results and minimal side effects. Treating only during the premenstrual phase works nearly as well as daily treatment.

Randomised trial, 2000

How should PMS and PMDD be managed?

SSRIs are the most effective treatment for PMDD and can be taken daily or just during the premenstrual week, with excellent results and minimal side effects.

Study, 2026

Do anxiety and depression get worse before your period if you already have a mental health condition?

Yes. If you have depression, bipolar disorder, or other mental health conditions, symptoms often worsen before your period due to hormone changes. This can affect how well treatments work.

Review, 2026

How do social factors like stigma and unequal care responsibilities affect premenstrual symptoms?

This review shows that PMS and PMDD arise from both biology and social context. Menstrual stigma, unequal care work, violence, financial dependence, and healthcare bias all shape how symptoms develop and whether women get help.

Survey study, 2026

What is the true rate of PMDD, and does it worsen mental health conditions?

The true rate of PMDD when properly diagnosed is 3.2%. Depression, bipolar disorder, and schizophrenia can all worsen during certain times of the menstrual cycle, and SSRIs and hormonal therapies are proven treatments.

Study, 2025

Do ADHD symptoms get worse in the week before your period?

Yes. Women with ADHD had more symptoms, worse sleep, and higher stress in the late luteal phase (the week or so before their period), and they took more medication during this time.

Case-control study, 2025

Should menstrual cycle mood changes be treated as distinct categories or as a spectrum?

Menstrual cycle mood changes likely exist on a continuous spectrum rather than as separate PMDD versus normal categories, suggesting research should measure them on a scale rather than as distinct groups.

Cohort study, 2025

Do women with depression experience worse mood before their period?

Yes. Women with depression showed gradual mood decline starting 14 days before menstruation, with the lowest mood 3 days before to 2 days after. About 54% had worse mood during this window than during the rest of the cycle.

Cohort study, 2024

Does the tendency to ruminate make PMS mood swings worse?

No. This larger study found that trait rumination did not predict whether women experienced more mood changes across their cycle, contradicting some earlier smaller studies. Rumination may not be a useful treatment target for PMS mood disorders.

Cohort study, 2024

Does the menstrual cycle affect daily changes in suicidal thoughts?

Yes, for women with suicidal ideation. They had worse suicidal thoughts and planning during certain menstrual cycle phases, particularly around menstruation, driven mainly by depression and hopelessness.

Cohort study, 2024

Is childhood trauma related to premenstrual disorders?

Yes. The study found a link between childhood trauma and premenstrual symptoms, especially in women with moderate-severe PMS or PMDD. Women with premenstrual worsening of other mental health problems also reported more childhood trauma than healthy women.

Cohort study, 2023

Does the menstrual cycle affect how often women have suicidal thoughts?

Yes. Women with recent suicidal thoughts reported significantly more severe ideation during the perimenstrual phase (around their period) compared to other cycle phases. The cycle explained 25% of the change in suicidal thoughts.

Randomised trial, 2022

Do hormone pills prevent suicidal thoughts from getting worse around menstruation?

Yes. Giving women estradiol and progesterone during the time when their natural levels drop (around menstruation) significantly reduced suicidal thoughts, depression, and feelings of rejection and burden compared to placebo.

Survey study, 2022

How common are premenstrual symptoms, and do they change with age?

Very common. Food cravings affect 85%, mood swings 64%, and fatigue 57%. Several symptoms got worse with age, but mood symptoms stayed the same across all age groups.

Study, 2020

Does the menstrual cycle affect anger and aggression in women with borderline personality disorder?

Yes, the menstrual cycle affects how anger is expressed as aggression. Reactive aggression (responding aggressively to others) peaked during the midluteal phase, while planned aggression was highest during earlier phases when mood was more stable.

Systematic review, 2020

Do psychotic symptoms get worse during the menstrual period?

Yes. Women with psychotic disorders are 1.48 times more likely to need psychiatric admission during the perimenstrual phase. Some studies also found symptom worsening during this time.

Case-control study, 2019

Does multiple sclerosis get worse before your period?

Yes. Both cognitive function and physical ability appear to worsen in the premenstrual phase compared to ovulation in people with MS, more so than in healthy people.

Systematic review, 2019

Do lithium and valproate levels change during the menstrual cycle?

In women with bipolar disorder, lithium levels decreased during the luteal phase (before the period) despite stable doses, linked to worsening mood symptoms. In healthy women, lithium levels were not affected by the menstrual cycle.

Review, 2019

Do menstrual cycle hormones affect symptoms in women with borderline personality disorder?

This review found that menstrual cycle hormones do appear to affect symptoms in borderline personality disorder, with most symptoms worsening around menstruation and improving around ovulation. However, more research is needed to understand how and develop treatments.

Cohort study, 2013

Do depression, irritability, and anxiety get worse before the period in women with PMDD?

Yes. Women with PMDD showed worsening depression, irritability, and anxiety in the days before their period, while women without PMDD did not.

Randomised trial, 2013

Do women with depression whose symptoms worsen before their period respond differently to antidepressants?

About two-thirds of depressed women report premenstrual worsening, and these women tend to have more chronic depression and medical problems. However, premenstrual worsening does not predict which antidepressants will work.

Study, 2012

Does anxiety sensitivity affect panic symptoms differently at different menstrual cycle phases?

Women with higher anxiety sensitivity had more panicked thoughts during the premenstrual phase compared to the follicular phase, and compared to women with lower anxiety sensitivity. Physical panic symptoms did not differ clearly.

Case-control study, 2012

Do women with PMDD have working memory problems linked to concentration and irritability?

Yes. Women with PMDD perform worse on working memory tasks during the luteal phase, and this decline is linked to difficulty concentrating, irritability, and reduced daily functioning.

Survey study, 2011

How common is PMDD in women with depression compared to healthy women?

PMDD is much more common in women with depression. 43.1% of women with depression met PMDD criteria compared to only 5.9% of healthy women, suggesting these conditions may be related.

Study, 2011

Do women with PMDD have more hostility and aggression than women without it?

Women with PMDD had significantly higher levels of hostility, impulsive behavior, and behavior inhibition than women without PMDD during both phases. Higher hostility and impulsive behavior were linked to more severe irritability and daily difficulty.

Cohort study, 2011

Does premenstrual symptom worsening change how bipolar disorder develops over time?

Yes. Women with bipolar disorder who reported premenstrual symptom worsening had more mood episodes and relapsed sooner, though other patterns in their illness may partly explain this.

Cohort study, 2011

Do women with bipolar disorder who have premenstrual mood changes do worse than those without?

Yes. Among women with bipolar disorder, those with premenstrual mood changes had significantly more severe symptoms, relapsed faster, and had a worse course than those without premenstrual changes.

Cohort study, 2010

Does depression that worsens before the period differ from other depression?

No major differences in depression type or treatment response, but women with premenstrual worsening had more seasonal mood patterns and different personality traits (more self-control).

Study, 2010

Does pregnancy or menstruation affect OCD symptoms?

Yes. About 1 in 3 women with OCD saw symptoms start during pregnancy or after birth. Women whose OCD began during this time are more likely to have worsening with their period.

Survey study, 2010

Do women with premenstrual asthma have more premenstrual symptoms overall?

Yes. Women whose asthma worsens before their period had greater increases in most premenstrual symptoms, especially belly and breast tension, compared to women without this pattern.

Randomised trial, 2008

Does taking more antidepressant just before the period help depression that worsens then?

Yes. Women who increased sertraline dose during the premenstrual phase showed no worsening of depression at that time, while women on placebo still had significantly worse depression before their period.

Guideline, 2006

What is the best treatment for PMDD and severe PMS?

SSRIs are first-line therapy for PMDD and severe PMS. They can be taken continuously throughout the month, only during the luteal phase, or with higher doses in the late luteal phase depending on each person.

Study, 2005

Do women with depression experience worsening of symptoms before their period?

Yes. 64% of women with depression reported worsening of symptoms in the 5 to 10 days before their period. This worsening appears linked to longer-lasting depression.

Survey study, 2004

How often does depression get worse before a woman's period?

Depressed women had 1.34 more symptoms that got worse before their period compared to other times. Older women were more likely to experience worsening symptoms.

Randomised trial, 2003

Does taking estradiol before your period help premenstrual asthma?

No, estradiol 2 mg did not help control asthma symptoms or breathing more than placebo. This was a small study in women whose asthma was already well-controlled.

Study, 2003

Do skin flares get worse before your period if you have atopic dermatitis?

Yes. About half of women with atopic dermatitis have monthly skin worsening, mostly before their period. All women with premenstrual skin flares also had premenstrual syndrome symptoms.

Review, 2002

What are the reproductive-related mood disorders and how are they connected?

Mood and anxiety disorders are more common in women around menstruation, after childbirth, and during perimenopause. They all appear linked to changes in ovarian hormones.

Randomised trial, 2001

Can long-acting bronchodilators prevent asthma from getting worse before the period?

Yes. In women whose asthma worsens before their period, salmeterol given for 10 days before menstruation completely prevented worsening in 54% of them and partially prevented it in 15%.

Cohort study, 1998

Do some asthmatic women experience worsening asthma symptoms during their menstrual cycle?

Yes, in this study about 28% of asthmatic women reported menstrual-related asthma worsening with increased inhaler use and decreased airflow during the premenstrual phase. These women tended to be older with more severe asthma.

Study, 1998

How do stress and stress chemicals relate to premenstrual symptoms?

Stress and stress-related chemicals in the body are linked to premenstrual mood and fluid retention symptoms, but the relationships differ depending on whether a woman has PMS or premenstrual magnification.

Cohort study, 1998

How many Icelandic women actually experience premenstrual syndrome when tracked with daily diaries?

Only 2.4% showed a clear premenstrual syndrome pattern. This was much lower than a previous study that relied on memory, showing that daily tracking gives different results than asking women to remember.

Randomised trial, 1997

Does a GnRH agonist help PMS symptoms?

Yes, leuprolide significantly reduced PMS symptoms in women whose symptoms were limited to the premenstrual phase. It did not help women whose depression occurred throughout their cycle.

Randomised trial, 1994

Does nefazodone help premenstrual syndrome?

Premenstrual symptoms improved significantly in both groups. Improvement appeared by week 4 at an average dose of 245 mg. However, this was an open-label study without a placebo control, so the true effect is uncertain.

Study, 1994

Does skin sensitivity to nickel change during your menstrual cycle?

No. Skin sensitivity to nickel did not increase before the period. However, repeated nickel testing itself made the skin more sensitive.

Cohort study, 1993

How accurate are PMS diagnoses and how well do treatments work?

Only 38 of 100 women referred for PMS actually had it; 24 had other causes of similar symptoms. When women were properly diagnosed, 84 percent responded well to treatment.

Randomised trial, 1992

Do different types of birth control pills work differently for PMS?

All three pills helped PMS symptoms compared to before treatment. The desogestrel pill caused less mood swings, while the triphasic pill caused fewer physical complaints.

Study, 1991

Do women with premenstrual syndrome have different symptom severity in different menstrual cycles?

Symptoms were mostly stable between cycles. However, women with different PMS patterns behaved differently: those with symptoms only before menstruation had worse symptoms during the first cycle, while those with symptoms at other times felt better in the first cycle.

Randomised trial, 1990

Does alprazolam help premenstrual dysphoria?

Yes. Alprazolam was significantly superior to placebo in treating late luteal phase dysphoric disorder based on physicians' ratings and patients' reports.

Survey study, 1989

Can daily symptom tracking help doctors diagnose different types of PMS?

Yes. Daily symptom tracking separated women into three groups: those with symptoms only before their period (30%), those with ongoing symptoms that worsen before the period (56%), and those with no menstrual pattern (14%). This helps doctors understand each woman's specific pattern.

Cohort study, 1989

How much do PMS symptoms actually change with the menstrual cycle?

Physical symptoms like breast pain change reliably with the cycle, but emotional symptoms don't follow this pattern in most women. Only about one-third had emotional symptoms that mostly disappeared after their period.

Non-randomised trial, 1972

Does hydrochlorothiazide help control premenstrual acne?

No. A double-blind study of 21 patients found that taking this water pill for 10 days before the period did not reduce premenstrual acne flare-ups.

Cohort study, 2026

Can paying attention to where you are in your menstrual cycle improve mental health care?

This review says yes: many people are sensitive to normal hormone changes, and building cycle timing into psychological assessment and treatment can make care more accurate and effective. It is a summary of existing evidence, not a new study with its own results.

Study, 2026

Does a new therapy program help women with premenstrual problems?

This paper describes a new therapy program for premenstrual problems but is too early to say whether it works, since it has only been tested with one woman.

Systematic review, 2026

Does the menstrual cycle affect obsessive-compulsive disorder symptoms?

Yes, all 12 studies found that OCD symptoms worsened during the premenstrual phase. However, most research relied on self-reports rather than objective measurements.

Study, 2026

Could early stress or past trauma make PMDD symptoms worse later in the cycle?

This research offers a possible explanation for why PMDD symptoms vary so much, and why related conditions can worsen before a period. It is only a theory, not tested on patients, so we don't yet know if it is true.

Cohort study, 2026

How do motivation and emotion control change across the menstrual cycle?

This abstract describes a research study design but ends abruptly and provides no results, so no answer can be given.

Case report, 2025

Can birth control medication help menstrual cycle-related psychosis?

Yes, in one case. A woman with severe monthly psychotic episodes linked to menstruation had sustained improvement over four months after adding a combined oral contraceptive.

Survey study, 2025

What causes premenstrual syndrome and premenstrual dysphoric disorder, and how common are they?

This review article explains the known biological, genetic and lifestyle factors behind premenstrual disorders rather than testing a treatment; it reports that any premenstrual disorder may affect up to 87% of women.

Study, 2025

Does taking more ADHD medication during the premenstrual week help women with ADHD?

Yes. All 9 women with ADHD who took a higher medication dose during the premenstrual week experienced better focus, mood, and energy during those weeks.

Interview study, 2025

What kind of therapy do people with premenstrual conditions want?

People want therapists trained in their condition to validate them and help them gain control and self-compassion. They also want broader social recognition of premenstrual conditions.

Survey study, 2025

How do hormonal changes affect ADHD symptoms in women?

Hormonal changes significantly impact women with ADHD. Symptoms may get worse during certain parts of the menstrual cycle and after childbirth, often with mood and sleep problems.

Study, 2025

What is premenstrual exacerbation and why does it matter?

Premenstrual exacerbation (PME) is a condition where symptoms of existing mental illnesses become much worse during the luteal phase of the menstrual cycle. It is not the same as PMS or PMDD and is often misdiagnosed.

Review, 2025

Can self-guided online therapy help premenstrual mood symptoms?

A review suggests that self-guided online cognitive behavior therapy shows promise for premenstrual mood symptoms and could be integrated into menstrual tracking apps. However, more research is needed.

Review, 2025

How does the menstrual cycle affect psychiatric symptoms like depression and anxiety?

Many women experience worsening psychiatric symptoms during the premenstrual and menstrual phases due to hormonal changes in estrogen and progesterone. Treatment should monitor symptoms across the menstrual cycle and may include lifestyle changes, therapy, antidepressants, or hormonal therapies.

Case report, 2024

Can dermatitis herpetiformis get worse before menstruation?

Yes. One woman with this blistering skin condition had worsening rashes 5 days before her period through the end of menstruation, and needed to increase her medication during this time.

Interview study, 2024

Do women with ADHD benefit from a group focused on the menstrual cycle?

Women with ADHD who attended a group program focused on the menstrual cycle said it was helpful and made them more aware of their symptoms. We do not know if ADHD symptoms actually improved.

Cohort study, 2024

Do women with PCOS get worse mood symptoms before their period?

It is not clear yet. There are early hints that women with PCOS may have premenstrual mood flare-ups, but the research so far is too preliminary and inconsistent to say for sure.

Survey study, 2024

Is mental health different in premenstrual exacerbation versus core premenstrual disorder?

Women with premenstrual exacerbation, where an existing mental health condition worsens before menstruation, had higher anxiety and depression and lower quality of life than women with core premenstrual disorder. This was a very small study.

Survey study, 2024

Does asthma get worse around your period in teenagers?

Yes, 75.5% of teenage girls with asthma reported their symptoms worsened around their period. This was a small study with no comparison group, so we cannot be completely certain.

Cohort study, 2024

Does borderline personality disorder get worse at certain times in the menstrual cycle?

Yes. Most emotional symptoms in women with borderline personality disorder worsen in the midluteal phase and around menstruation. The majority showed at least 30% worsening of symptoms.

Case report, 2023

What psychiatric conditions do women referred to a specialist clinic for premenstrual disorders have?

Most women with premenstrual disorders have another psychiatric condition. Of 146 women referred to a UK specialist clinic, 89.0% had a psychiatric diagnosis, 64.4% met criteria for PMDD, and 45.6% had worsening of another psychiatric disorder.

Study, 2022

What are the different types of premenstrual disorders and how are they treated?

Premenstrual disorders include main premenstrual syndrome, premenstrual exacerbation of other diseases, and premenstrual dysphoric disorder (PMDD). PMDD requires mental health care. Combined oral contraception with drospirenone can reduce symptoms for many women.

Systematic review, 2022

Are PMDD and bipolar disorder connected?

Yes. PMDD is more common in women with bipolar disorder than in the general population, and bipolar disorder is more common in women with PMDD. Between 10% and 15% of women with PMDD also have bipolar disorder, while 27% to 76% of women with bipolar disorder also have PMDD.

Case report, 2022

Can stopping the menstrual cycle help women whose arthritis gets worse before their period?

One woman whose arthritis flared severely before her period improved significantly when her menstrual cycle was controlled with hormones.

Survey study, 2021

Can kambakutaisoto help emotional symptoms of PMS?

Kambakutaisoto, a traditional medicine made from jujube, licorice, and wheat, appears to help emotional instability in PMS, especially in young women. No large clinical trials are presented, so more research is needed.

Randomised trial, 2021

Do women with depression or bipolar disorder experience worse symptoms before or during their menstrual cycle?

About 60% of women with mood disorders report premenstrual worsening of symptoms, which predicts worse disease overall. Current PMDD treatments work less well or not at all for this problem, and more research is needed to understand what helps.

Review, 2021

How does the menstrual cycle affect anxiety and PTSD symptoms?

The menstrual cycle and its hormones affect anxiety and PTSD symptoms. The clearest finding is premenstrual worsening of anxiety, and estradiol may help with trauma memory processing.

Cohort study, 2020

Do schizophrenia symptoms change across the menstrual cycle?

Yes, schizophrenia symptoms significantly vary across different phases of the menstrual cycle. Positive symptoms improved during the progesterone phase, while negative symptoms and general psychopathology improved during the estrogen phases.

Cohort study, 2019

Why should psychologists research and treat premenstrual disorders more?

Premenstrual disorders are real conditions linked to hormone sensitivity that psychologists are well-trained to study and treat. This article provides guidance for increasing psychology involvement in this field.

Study, 2019

Can a medicine help prevent severe allergic reactions and hives before the period?

Two women with life-threatening or severe hives before their periods were treated with low-dose dextroamphetamine sulfate. Both showed complete elimination of hives, and when one woman stopped the medicine, her hives returned immediately.

Survey study, 2018

What is PMDD and how common is it?

PMDD is a serious form of premenstrual distress affecting 1.8 to 5.8 percent of women who menstruate. It is officially recognized as a psychiatric condition, though the exact cause is still being researched.

Study, 2018

Does aggression change during the menstrual cycle in borderline personality disorder?

Yes, different types of aggression change at different times in the cycle. Reactive aggression was highest during the days around the period, while a different type of aggression (proactive) was highest during other parts of the cycle.

Randomised trial, 2018

Does an oral contraceptive with drospirenone reduce premenstrual worsening of Meniere's disease?

Yes. The oral contraceptive combined with rehabilitation significantly improved dizziness and balance over 6 months, with the contraceptive group showing much better symptom improvement than rehabilitation alone.

Cohort study, 2018

Do emotional and behavioral symptoms of borderline personality disorder get worse before menstruation?

Most emotional symptoms appeared to get worse in the middle-to-late luteal phase and around menstruation, then improved in the follicular phase. However, the study was very small and included only unmedicated women without painful periods.

Cohort study, 2018

Does suicide risk change across the menstrual cycle?

Suicide risk may increase at certain cycle points, especially in women with PMDD. However, no studies have actually tracked suicidal thoughts or attempts throughout the cycle to confirm this.

Case report, 2018

Does dienogest help premenstrual mood changes in someone with schizophrenia?

One woman with schizophrenia improved in her premenstrual mood symptoms and returned to work. This is one person's experience, so we can't be sure others would benefit.

Study, 2017

How can women prevent psychiatric symptoms from getting worse before their period?

Semi-intermittent dosing (adjusting medicine doses in the days before the period) may help women stay stable all month. However, research on this approach is limited.

Randomised trial, 2017

Does adding birth control to antidepressants help depression that worsens before your period?

Adding drospirenone/ethinyl estradiol to antidepressants did not significantly improve premenstrual depression better than placebo in this small study. Both groups improved similarly.

Case-control study, 2016

Does body weight affect whether asthma gets worse around a woman's period?

Yes, in this small study women whose asthma flared up around their period had a higher BMI than women with asthma without that pattern, or healthy women. A type of white blood cell called eosinophils did not explain the flare-ups.

Survey study, 2016

Do women with schizophrenia have irregular periods, and does this affect their psychiatric symptoms?

Among 139 women with schizophrenia, 41% had irregular periods. Irregular cycles were linked to antipsychotic medications and lower estrogen levels, but did not appear to worsen psychiatric or depressive symptoms.

Survey study, 2016

Can asthma get worse around your period?

Yes. This review explains that asthma can flare up in the days around the period, a pattern called perimenstrual asthma, and looks at why this happens and how it might be treated.

Survey study, 2014

Do women's asthma symptoms get worse around their period?

Up to 40 percent of asthmatic women may have worse asthma around their period. Doctors think female hormones affect the lungs, but they don't fully understand how and need more research.

Cohort study, 2014

Do lifestyle and nutrition affect menstrual symptoms?

Yes. Women with menstrual symptoms had different eating patterns and lifestyle factors than those without symptoms. Strong links were found between diet and the type of menstrual pattern.

Survey study, 2013

Do women with OCD experience worse symptoms before their period?

About half (49.7%) do experience premenstrual worsening of OCD symptoms. These women show higher rates of depression, anxiety, suicidal thinking, and specific obsessions about sex or religion.

Case report, 2013

Does olanzapine help premenstrual psychosis?

One girl with recurrent premenstrual psychosis was successfully treated with olanzapine. This is one case of a very rare condition, so we need much more research.

Randomised trial, 2013

What treatments work for PMDD?

Serotonin reuptake inhibitor antidepressants and hormonal contraceptives are the most evidence-based treatments. Alternative treatments like calcium, chasteberry, St. John's wort, and behavioral therapy may help but have less research supporting them.

Non-randomised trial, 2012

Do schizophrenia symptoms get worse before menstruation?

Many women with schizophrenia do experience worse symptoms before their period, but no treatment studies have been done so doctors must decide case-by-case how to help.

Randomised trial, 2012

Does Candida yeast grow more before your period and cause symptoms?

In a very small pilot study of three women, Candida yeast grew more during the premenstrual phase before symptoms appeared. This is preliminary evidence and needs confirmation in larger studies.

Survey study, 2010

Is your immune system response linked to asthma that gets worse before your period?

Yes. Women with asthma worsening before their period had higher levels of one immune marker (IgE) than those without. Specific allergens did not seem to matter.

Case report, 2010

Do Meniere disease symptoms get worse before a woman's period?

Yes, some women with Meniere disease report that their symptoms get worse during the premenstrual period. Hormonal changes may trigger this.

Survey study, 2010

How many women with asthma notice their asthma gets worse before their period?

About 44% showed measurable asthma worsening before menstruation when tracked over two cycles, though only about 54% of those who experienced worsening actually noticed it.

Randomised trial, 2008

Can adding aripiprazole to an antidepressant help premenstrual violence?

A single 38-year-old woman with major depression and severe premenstrual violence improved when aripiprazole was added to her SSRI. However, this is only one case, so we cannot be confident it works for other women.

Non-randomised trial, 2008

Does montelukast help asthma that gets worse before the period?

Yes, in women whose asthma worsens premenstrually, montelukast improved airflow and reduced symptoms compared to placebo. In women whose asthma does not worsen with their cycle, montelukast made no difference.

Survey study, 2007

Are personality traits different between women with PMDD and women with major depression?

Personality traits are mostly similar between PMDD and depression during the second half of the cycle. Both groups were more likely to show a trait of caution and worry about harm than healthy women, but personality tests could not reliably distinguish PMDD from depression.

Review, 2007

Could premenstrual symptoms result from infections that worsen with immune changes?

This is a theoretical proposal that PMS may result from infections that flare when hormones suppress immunity. This is speculation, not a research finding.

Randomised trial, 2007

Do birth control pills help depression that worsens before the period in women on antidepressants?

Both women who got additional hormone in the second phase and those who got placebo improved significantly, so we cannot say whether the additional hormone made a difference.

Survey study, 2006

Does the menstrual cycle affect mood disorders?

Some women with mood disorders may experience worsening symptoms during the premenstrual period. Evidence is limited and study methods are inconsistent across available research.

Survey study, 2006

Does the menstrual cycle affect how severe OCD symptoms are?

Yes. For many women with OCD, symptoms get worse before their period, with nearly half reporting this pattern. The menstrual cycle should be considered when assessing OCD severity.

Survey study, 2005

Does the menstrual cycle affect obsessive-compulsive disorder symptoms?

Yes, for some women. OCD started at menarche in 22% of women and worsened premenstrually in 20%. It worsened after childbirth in 50% of women who became pregnant.

Study, 2004

Does what you eat affect your period symptoms?

Yes. Women with and without period symptoms had different diets, and certain nutrients were linked to having fewer premenstrual symptoms.

Survey study, 2004

How common is PMS and premenstrual worsening of psychiatric symptoms in women with mental health disorders?

Very common. Between 52% and 80% of women with anxiety, depression, or panic disorder reported PMS symptoms, and between 36% and 52% experienced worsening of their psychiatric symptoms before their period.

Randomised trial, 2003

Does estradiol help asthma that worsens before the period?

This is one case of a woman with severe asthma who improved on estradiol, but the finding may only apply to severe asthma and more research is needed.

Randomised trial, 2003

What causes asthma to worsen before the period?

Asthma worsens before the period in 30-40% of asthmatic women, but the exact cause is unknown. Hormone changes are likely involved, but this hasn't been proven.

Case-control study, 2003

Do bulimia symptoms change across menstrual cycle phases?

Yes, bulimia symptoms worsen in mid-luteal and premenstrual phases compared to other cycle phases. The study is very small with only 8 women, so results need confirmation.

Study, 2003

Do your family relationships affect your period symptoms?

Yes, according to interviews with women. Period symptoms were closely tied to family relationships and how family members responded to their feelings.

Survey study, 2002

What characteristics do women seeking PMS treatment share?

Most have other psychiatric conditions, and over one-third have a psychiatric disorder that worsens before their period.

Case report, 2002

Does taking estrogen help reduce symptoms that get worse before your period?

In a small study of 4 women with schizophrenia, estrogen improved symptoms in 2 of them (with one showing major improvement), but responses varied widely.

Randomised trial, 2002

Does taking extra nefazodone before your period help depression that worsens premenstrually?

Yes, all 3 women in the study showed significant improvement with extra nefazodone taken before their period, but not with placebo. However, the study was very small.

Survey study, 2002

Does the premenstrual period trigger multiple sclerosis flare-ups in women?

In about 42% of women with MS, flare-ups were more likely during the premenstrual phase, suggesting it may be a trigger for some women. The evidence is not definitive as this was a small observational study.

Cohort study, 2001

Do psychiatric symptoms get worse before the period in women with schizophrenia?

Yes, overall psychiatric symptoms were worse in the premenstrual phase. However, the psychotic symptoms like hallucinations barely changed, while mood and behavioral symptoms worsened significantly.

Study, 2001

How can doctors tell PMDD apart from other mood disorders that get worse before a period?

PMDD can be recognized by specific timing: symptoms must appear in a monthly cycle and impairment must increase in the days before a period. Symptoms that continue year-round or don't follow a monthly pattern indicate other conditions instead.

Randomised trial, 2001

Why does asthma get worse before a period and how is it treated?

Up to 40% of women with asthma experience flare-ups before their period, likely due to female hormones and changes in airway reactivity. Most respond to regular asthma treatment, though some may benefit from hormonal birth control.

Cohort study, 2001

Does having PMDD increase the risk of developing major depressive disorder?

In this small pilot study, 7 of 8 women with PMDD developed major depressive disorder within two years. However, this needs confirmation in much larger studies.

Review, 2001

Can mood disorders get worse before your period?

Yes. Mood disorders can worsen before the period. This is different from PMDD and PMS but it is not well understood.

Survey study, 2000

Does premenstrual worsening of panic disorder increase suicide risk in women?

Yes. Women with panic disorder who experienced premenstrual worsening had higher suicide risk scores and were more likely to be considered suicidal than women whose panic did not worsen premenstrually. This was independent of depression.

Non-randomised trial, 2000

Do psychiatric hospital admissions happen more often at certain menstrual cycle phases?

57% of admissions happened during the pre-menstrual or menstrual phase, but this link was only statistically significant for cycloid psychoses, a rare type of psychosis. For most other psychiatric conditions, the menstrual cycle did not affect admission timing.

Case report, 1999

Can suppressing menstrual hormones help severe premenstrual asthma?

In this one case, yes. A woman with severe premenstrual asthma improved significantly when hormones were suppressed to stop her menstrual cycle.

Survey study, 1999

What are the main symptom clusters in PMS and how do they vary during the menstrual cycle?

Four main clusters were identified: turmoil, fluid retention, somatic symptoms, and arousal symptoms. Some clusters remain consistent across the cycle, while others change more.

Case report, 1999

Can a GnRH analogue stop premenstrual attacks of hereditary coproporphyria?

Yes. In this one woman, the GnRH analogue stopped her menstrual cycle and her symptoms got much better. She has had only a minor attack once in 5 years but developed weaker bones.

Study, 1998

Do women with different patterns of premenstrual symptoms have different cortisol levels?

Women with more severe premenstrual symptoms showed clear differences in cortisol levels during the second half of their cycle. However, cortisol differences were not found during the first half, suggesting the stress hormone changes are connected specifically to when symptoms are worst.

Case report, 1998

Can birth control pills make premenstrual asthma worse?

Yes, in this case. One woman's asthma got much worse after starting birth control pills and improved when she stopped. We cannot know how often this happens from a single case.

Review, 1998

What does research say about diagnosing and treating PMS and PMDD?

This review explains that careful symptom tracking and ruling out other conditions are key to diagnosing PMS, and that some promising drug treatments exist for PMDD, though it is unclear if they work as well for milder premenstrual symptoms.

Survey study, 1997

How common is asthma worsening related to the menstrual cycle?

About 23 percent of female asthma patients in this study reported that their asthma got worse during their menstrual cycle, usually in the week before their period. This form of asthma was often more severe.

Survey study, 1997

Does pregnancy or the menstrual cycle affect OCD symptoms?

Some women's OCD worsened before their period (42 percent) and after childbirth (29 percent), suggesting hormones may play a role. However, most women's OCD did not change during pregnancy itself (69 percent had no change).

Non-randomised trial, 1997

Does estrogen help asthma symptoms that worsen before periods?

Yes. Taking estradiol significantly improved asthma symptoms and breathing difficulty in women with premenstrual asthma, though this very small study needs confirmation.

Cohort study, 1997

Does estrogen reduce asthma symptoms before a period?

Yes, in 14 women with asthma, extra estrogen significantly improved asthma symptoms and breathing difficulty. However, this is very preliminary evidence from a tiny study with no control group.

Case-control study, 1997

Are PMDD and eating disorders related?

Possibly. PMDD and eating disorders share high rates of mood and anxiety disorders and a personality trait called harm avoidance, but this small study cannot confirm they share a common cause.

Study, 1996

Can asthma get much worse right before your period?

Yes. One woman had life-threatening asthma attacks that only happened before her period. When a medication temporarily stopped her cycle, the attacks stopped.

Case report, 1995

Does stopping the menstrual cycle help skin conditions that get worse before periods?

Yes. In this one woman, both a hormone medicine and surgery to remove her ovaries showed dramatic improvement in her skin condition.

Survey study, 1995

Do women with PMS explain their symptoms differently depending on when in their menstrual cycle they are?

Yes. Women with PMS blamed the menstrual cycle more often for their symptoms during the premenstrual phase than at other times, while women without PMS showed no difference. This suggests that cycle phase changes how women interpret their symptoms.

Survey study, 1995

Do menstrual cycle phases affect mood and impulsive behavior in women with borderline personality disorder?

No clear connection was found between menstrual cycle phase and mood or behavior when women tracked their symptoms daily. However, all women reported premenstrual worsening when asked afterward. None met criteria for severe premenstrual disorder.

Survey study, 1995

Are certain personality traits linked to PMS?

Women with PMS have higher scores on harm avoidance and novelty seeking compared to the general population. These traits are modestly linked to specific symptom patterns.

Case report, 1995

Do weak electromagnetic fields help multiple sclerosis symptoms that get worse before the period?

Yes, in two women. Their premenstrual worsening of multiple sclerosis symptoms resolved within two months of starting the treatment. This is based on only two women, so we cannot know how often it would work.

Study, 1994

Can we measure how well treatments work for individual women with severe PMS?

Yes. Some women's symptoms improved to a mild, cyclic pattern while others remained unpredictable, showing that treatment affects different women differently.

Randomised trial, 1994

Does nefazodone reduce symptoms of premenstrual syndrome?

Yes. Women taking nefazodone showed significant improvement in PMS symptoms within 4 weeks. However, this study did not use a placebo control group, so we cannot be certain the improvement was not due to expectancy.

Survey study, 1993

Does the menstrual cycle affect how well female athletes perform?

Athletic performance may vary across the menstrual cycle, with better performance right after the period ends and worse performance during the premenstrual time and first few days of menstruation. However, research results have been inconsistent.

Survey study, 1992

Do premenstrual symptoms improve when depression is treated with antidepressants?

Overall symptom severity decreased after antidepressant treatment, but improvement was only significant for mood-related symptoms. In 2 women, other PMS symptoms became more noticeable after treatment, possibly because depression lifting allowed them to recognize the pattern.

Survey study, 1991

Is PMS a psychiatric disorder or a gynecological disorder?

PMS is a gynecological disorder tied to ovulation and the corpus luteum, since symptoms stop when ovulation stops. Women with 'pure PMS' have less psychiatric history than other groups.

Survey study, 1991

Does atopic dermatitis get worse before your period?

Yes, about one in three women report their atopic dermatitis worsens before their period, especially if they have PMS. During pregnancy, half worsened but some improved.

Survey study, 1990

Can premenstrual anxiety and depression be confirmed with objective tests?

Yes, women with reported premenstrual anxiety and depression had higher objective test scores in the premenstrual phase. Results suggest two populations: one with pure PMS and another with underlying depression that worsens premenstrually.

Survey study, 1989

Do women with different types of PMS differ in age, education, or marital status?

No significant differences were found in age, education, marital status, or employment between women in three PMS groups. The only difference was that women with pure PMS had lower neuroticism scores and less psychiatric history.

Study, 1988

Are women with premenstrual dysphoric changes at higher risk for depression?

Yes. Women who report premenstrual dysphoric changes are more likely to have had previous episodes of major depression and are at higher risk for future episodes. They also face increased risk of suicidal, aggressive, or impulsive behavior during the premenstrual period.

Case report, 1988

Does progesterone help asthma that gets worse before your period?

Yes. Three patients with severe asthma that worsened each month and hadn't responded to other treatments had the monthly breathing problems stop after starting progesterone injections.

Study, 1987

Does chronic pain get worse before your period?

For some women, yes. About 37% of the women with chronic pain reported pain getting worse before menstruation, especially those with pain in multiple areas of the body or severe pain.

Study, 1987

What causes PMDD and what is the best treatment?

The exact cause is unknown and no single treatment has been shown to clearly beat placebo in controlled studies. The condition involves hormone cycling, but doctors do not fully understand the mechanism.

Survey study, 1987

Does binge eating in bulimia get worse before your period?

Yes, this small study found a modest but statistically significant increase in binge eating during the premenstrual phase in women with bulimia.

Cohort study, 1986

Is PMS mainly about symptoms worsening before your period, or is there more?

Women with PMS have higher depression, anxiety, and tension even in the early part of their cycle. Some symptoms do worsen premenstrually, but baseline mood appears to be the bigger issue.

Study, 1986

Do women with agoraphobia experience worse anxiety before their period?

Yes, just over half of the women with agoraphobia in this study experienced worse anxiety before their period.

Cohort study, 1985

Is PMS connected to mood disorders like depression, and how should it be studied?

This review argues PMS does seem related to major mood (affective) disorders, but says much past research has been flawed, and that tracking symptoms day-by-day as they happen gives more reliable answers than asking women to recall them later.

Survey study, 1984

Do asthma symptoms get worse before a woman's period?

Yes, about 40 percent of women with asthma reported worsening symptoms, confirmed by peak flow measurements. This is a cross-sectional study with unreported sample size, which limits how certain we can be.

Interview study, 1980

What causes premenstrual tension syndrome?

The authors propose that high prolactin levels, possibly combined with low estrogen or progesterone, may cause premenstrual symptoms. This is a theory, not a tested finding.

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