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Anxiety and tension: what the research says

819 studies on anxiety and tension in PMS and PMDD, each explained in plain English. 29 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 345Randomised trial 116Study 102Cohort study 53Review 50Case-control study 48
Randomised trial, 2026

Does Kundalini Reiki help reduce PMS symptoms and improve quality of life?

Yes, according to this rigorous double-blind study. Nursing students receiving Kundalini Reiki showed significantly greater improvements in PMS symptoms and quality of life compared to those who received placebo.

Randomised trial, 2026

Does calcium and vitamin D supplementation reduce PMS symptoms?

Yes. Women taking 1,000 mg calcium daily plus 50,000 IU vitamin D every two weeks for 12 weeks showed significantly greater improvements in anger, anxiety, food cravings, physical symptoms, and work efficiency compared to placebo.

Randomised trial, 2026

Does aerobic or resistance exercise reduce anxiety in women with PMS?

Both aerobic and resistance exercise reduced anxiety and improved emotional control in women with PMS. Resistance exercise was superior to aerobic exercise for reducing anxiety.

Systematic review, 2026

Does vitamin D supplementation help PMS symptoms?

Vitamin D reduced overall PMS severity and particularly helped with physical symptoms and depression, but the certainty of this evidence is very low. We cannot be confident in these findings yet and more high-quality research is needed.

Systematic review, 2026

Do mindfulness and relaxation techniques help with PMS symptoms?

Yes. These techniques reduced physical symptoms like pain and fatigue, and emotional symptoms like anxiety and depression. However, the evidence is still limited.

Cohort study, 2025

Do women with PMS or PMDD report lower quality of life than women without these conditions?

Yes. Women with PMS or PMDD reported significantly lower quality of life, particularly those with PMDD. These findings held even after accounting for mood and pain.

Cohort study, 2025

How common is PMS in Chinese teenage girls, and what factors are linked to it?

About 1 in 4 Chinese girls (24.6%) has PMS. Higher stress, anger, alcohol use, menstrual cycles of 24 days or less, and period pain are all linked to increased PMS likelihood.

Cohort study, 2024

Does psychological distress in adolescence predict menstrual symptoms in adulthood?

Yes. Women who had higher psychological distress at age 16 were significantly more likely to experience various menstrual symptoms at ages 16, 30, and 42. This is based on a large, long-term study.

Randomised trial, 2024

Does curcumin reduce depression, anxiety, and stress in women with PMS and dysmenorrhea?

Yes, curcumin significantly reduced depression, anxiety, and stress and improved mental health and quality of life compared to placebo. This was a larger, high-quality study.

Guideline, 2024

How should Xiangshao Granules be prescribed for premenstrual tension syndrome?

Experts from 29 major hospitals have created standardized guidelines on how to use Xiangshao Granules for premenstrual tension, including dosage and timing. These recommendations come from multidisciplinary experts' review of current evidence.

Systematic review, 2024

Does yoga help reduce PMS symptoms?

Yes, yoga appears to help reduce emotional, behavioral, and physical PMS symptoms and improve quality of life. The evidence comes from a systematic review of 14 randomized controlled trials.

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.

Systematic review, 2021

Does damask rose help reduce menstrual pain, headache, fatigue, anxiety, and bloating?

Damask rose significantly reduced menstrual-related headache, fatigue, and bloating, but did not clearly reduce menstrual pain or anxiety. More research on pain and anxiety is needed.

Study, 2021

Does soy isoflavones help reduce PMS symptoms?

Yes. A randomized controlled study found that soy isoflavones clearly helped reduce both mood symptoms and pain compared to a control group.

Review, 2020

How do reproductive hormones affect the brain and behavior during the menstrual cycle?

Reproductive hormones like estradiol and progesterone change significantly during the menstrual cycle and affect mood, thinking, perception, and behavior through effects on the brain. The same applies to hormones in oral contraceptives.

Systematic review, 2019

Does psychotherapy reduce depression and anxiety in women with PMS?

A review of 7 trials found a large decrease in depression levels (standardized mean difference -0.978), but the abstract is incomplete so we cannot know if this was statistically significant or what the full conclusions were.

Review, 2018

Which women are most likely to experience hot flashes during menopause?

Up to 80% of women experience hot flashes during menopause, lasting about 10 years on average. Black and Hispanic women are more likely to experience them, while Asian women are less likely.

Randomised trial, 2017

Does the combined oral contraceptive pill affect mood?

Yes, but effects vary by cycle phase. The pill causes small increases in anxiety and irritability between periods but improves depression in the days before menstruation.

Non-randomised trial, 2008

Can the Sheehan Disability Scale measure whether treatments work?

Yes. The scale was able to tell the difference between treatments that worked and treatments that didn't in clinical trials.

Systematic review, 2008

What treatments work best for PMS and PMDD?

Antidepressants called SSRIs are proven effective for severe PMDD and are the first medication to try. Lifestyle changes and exercise are recommended for all women with PMS or PMDD.

Review, 2003

How do menstrual cycle hormones affect the brain and cause mood disorders like PMDD?

A hormone called allopregnanolone acts on brain receptors. Changes in this hormone during the cycle may cause mood and behavioral symptoms in up to 20% of people through three mechanisms: direct effects, building tolerance, and withdrawal effects.

Randomised trial, 2003

Are SSRI antidepressants effective for PMDD?

Yes, SSRIs are effective first-line treatments for PMDD. Both continuous dosing and intermittent dosing during the luteal phase lead to rapid improvement in symptoms and functioning.

Randomised trial, 1999

Does calcium reduce PMS symptoms?

Yes, this large study of 497 women found that calcium supplementation reduced PMS symptoms during the luteal and menstrual phases. This is strong evidence from a well-designed trial.

Randomised trial, 1999

Do SSRIs reduce premenstrual dysphoria symptoms?

Yes. SSRIs work significantly better than placebo and faster than when used for depression or anxiety. Intermittent dosing (taking medication only before the period) may work even better than daily dosing.

Randomised trial, 1997

Does Vitex agnus castus work better than vitamin B6 for premenstrual tension syndrome?

Both reduced symptoms by similar amounts (47-48%), but more women on Vitex reported excellent results and had no remaining complaints, suggesting Vitex may work better for PMTS.

Randomised trial, 1995

Does fluoxetine help premenstrual dysphoria?

Yes. Fluoxetine at 20 mg or 60 mg per day significantly reduced tension, irritability, and dysphoria compared to placebo. The 20 mg dose had fewer side effects than the 60 mg dose.

Survey study, 1994

How many different ways do researchers measure PMS in clinical trials?

Researchers use many different measurement tools across studies. 65 different questionnaires were found in 350 trials of PMS drugs, making it hard to compare whether treatments actually work.

Cohort study, 1993

How common are premenstrual and menstrual symptoms in women?

Menstrual symptoms are very common in women in the community and increase with age. Women with anxiety are more likely to report menstrual problems.

Survey study, 2026

Are menstrual characteristics linked to depression and anxiety in teenage girls?

Yes. Girls with earlier periods, irregular cycles, long cycles, severe period pain, and worse premenstrual symptoms have higher depression and anxiety scores, and these links get stronger as girls get older.

Survey study, 2026

How does PMS affect test anxiety in nursing students?

PMS was linked to higher test anxiety both directly and indirectly through delaying sleep and reduced ability to pay attention. The indirect pathway through sleep delays and attention difficulties accounted for 50% of the link between PMS and test anxiety.

Survey study, 2026

Are there different types or patterns of PMDD among Chinese college students?

Yes. There are two patterns: one with severe emotional and physical symptoms, and another with milder symptoms. Women with painful periods were more likely to have the severe pattern.

Survey study, 2026

What dietary, lifestyle, and psychological factors are associated with PMS in young women?

Stress and sleep problems were independently associated with PMS. Diet and weight were not independently associated with PMS after accounting for other factors. This is a cross-sectional study, so these are associations, not proof of cause and effect.

Randomised trial, 2026

Does online muscle relaxation training or lifestyle changes reduce PMS symptoms and improve work performance?

Yes, both approaches significantly reduced PMS symptoms and improved work performance. Progressive muscle relaxation was slightly more effective for pain and overall symptom severity.

Randomised trial, 2026

Does yoga or Pilates help manage PMS symptoms?

Yes, both yoga and Pilates reduced depression, anxiety, stress, and improved quality of life over 6 weeks, with yoga producing slightly larger improvements. However, this was a very small pilot study.

Randomised trial, 2026

Does education about PMS symptoms help reduce pain and stress?

Yes. Women who received education about PMS symptoms had lower pain and stress levels than the control group, especially if their symptoms were more severe to begin with.

Survey study, 2026

Does exercise help college women with period problems and mental health?

Yes. College women who do moderate to vigorous exercise have less severe period problems, lower stress, fewer depression symptoms, and better sleep quality.

Study, 2026

Does rimegepant help prevent migraines that happen around your period?

Yes, in this study rimegepant worked well. Women who took it around their period had fewer, shorter, and less severe migraines, and their quality of life improved. However, this was a small study without a comparison group.

Study, 2026

Does how women's body responds to stress change across their menstrual cycle?

Yes. During the luteal phase (the second half of the cycle), women's blood pressure and anxiety rose more when they faced a stressor, compared to other phases. This suggests the luteal phase involves different stress reactivity.

Survey study, 2026

What factors affect PMS in university students and does it impact schoolwork?

About 15% of students had significant PMS. More than half said it affected their schoolwork. Strong family support reduced PMS, and students with PMS were less likely to have very dysfunctional families.

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.

Study, 2026

Does increased brain reward sensitivity protect mood during the premenstrual phase?

Possibly. When estradiol levels drop before the period, some women's brains show increased sensitivity to rewards. Women who had bigger increases in reward sensitivity experienced smaller increases in depression symptoms.

Study, 2026

How do mood, heart rate, and muscle strength change during the menstrual cycle?

Heart rate patterns change across the cycle, especially during the mid-luteal phase when progesterone is highest. Muscle strength appears stable, but feeling energetic links with muscle activity. Depression increases during the early-cycle phase.

Survey study, 2026

Is worry about climate change linked to worse PMS symptoms?

Higher climate change anxiety was associated with worse PMS symptoms. Climate anxiety is just one of many factors affecting PMS severity.

Survey study, 2026

What lifestyle and work factors are linked to PMDD symptoms in Chinese nurses?

42.4% of Chinese nurses have PMDD symptoms. Risk is higher in those who work night shifts, do not exercise, drink alcohol, are overweight in a certain range, or have depression, anxiety, or poor sleep.

Case-control study, 2026

Does PMDD affect how the brain handles motivation when facing difficult choices?

Women with PMDD showed less motivation in low-conflict situations and reduced brain activity in reward centers compared to healthy women. This suggests PMDD affects how the brain processes rewards and risks.

Study, 2026

What are premenstrual syndrome and premenstrual dysphoric disorder?

Between 5% and 8% of women have moderate-to-severe symptoms that cause significant problems with work, relationships, and daily life. These are called PMS or PMDD. PMDD is the most severe form.

Survey study, 2026

Does the Chinese version of the PMS screening questionnaire work well?

Yes. The Chinese version is reliable and valid for identifying PMS and PMDD in Chinese college students.

Survey study, 2025

Do menstrual problems and poor sleep affect mood and thinking in teenage girls?

Yes. Clear links exist between menstrual pain or PMS symptoms and anxiety, depression, and social problems in adolescent girls. Sleep also matters. Girls with later bedtimes or shorter sleep plus pain had worse mood and thinking problems.

Survey study, 2025

Do women with PMS have higher anxiety, stress, and different personality traits?

Yes. Women with PMS had significantly higher anxiety sensitivity and stress levels, higher neuroticism and psychoticism traits, and slightly lower extraversion than women without PMS.

Systematic review, 2025

Does the menstrual cycle affect how your body and emotions respond to stress?

There is modest evidence that during the luteal phase (the second half of your cycle), you show greater heart rate changes and emotional reactions to stressful situations. This may explain some PMS symptoms.

Study, 2025

Do women have different symptom patterns before, during, and after menopause?

Yes. Women have different symptom patterns depending on whether they are before, during, or after menopause. All women experience fatigue, headache, anxiety, and brain fog regardless of life stage.

Randomised trial, 2025

Does relaxation training help women with PMDD?

Yes. Relaxation training significantly reduced PMDD symptoms, anxiety, depression, and disability in women with PMDD, and improved their quality of life.

Randomised trial, 2025

Can hypnosis ease anxiety, stress and low mood in women with PMS?

Yes, in this small trial women who had hypnosis sessions ended up with lower depression, anxiety and stress scores than women who had no treatment, but the study was small and not blinded.

Study, 2025

Does anger get worse before your period?

Yes. Anger and irritability are clearly more severe before your period across reproductive ages.

Randomised trial, 2025

How do leptin levels and combined medical treatments affect premenstrual symptoms in obese women?

Obese women with premenstrual tension syndrome had higher leptin levels and nervousness than healthy women. Combined treatments including diet, exercise, and medication significantly reduced both leptin levels and nervousness.

Case-control study, 2025

Does sleep quality affect brain activity and anxiety-depression symptoms in PMS?

Yes. Poor sleep quality in PMS patients is linked to different brain activity patterns. The relationship between certain brain changes and anxiety-depression symptoms is partly explained by sleep quality.

Survey study, 2025

How do personality traits like neuroticism affect PMS severity and sexual satisfaction?

Yes, personality traits significantly predict both PMS severity and sexual satisfaction. Women with higher neuroticism had more severe PMS with anxiety, depression, and fatigue, while those with higher extraversion had milder PMS and better sexual satisfaction.

Randomised trial, 2025

Does Nigella sativa reduce PMS symptoms in women?

Yes, Nigella sativa supplements reduced PMS symptoms and increased estrogen levels in women with moderate to severe PMS. This is a well-designed study, but the sample size is not reported in the abstract.

Survey study, 2025

How do premenstrual symptoms change with age?

Physical symptoms vary with age. Acne and oily skin are most common at ages 20-29, and headache at 30-49. Emotional symptoms like irritability and anger are most severe at all ages.