Premenstrual Anxiety, Mood Swings a Public Health Issue, Study Finds

As most women experience premenstrual mood swings and anxiety every menstrual cycle, researchers say these symptoms represent “a key public health issue globally.”

Researchers at the University of Virginia Medical Center found that most women experience premenstrual symptoms every menstrual cycle, and those symptoms regularly affect their day-to-day lives.

One of the most common symptoms is mood swings or anxiety, reported by at least 61% of women in all age groups during every menstrual cycle.

“Our study demonstrates that premenstrual mood symptoms are incredibly common worldwide,” said Jennifer L. Payne, MD, the study’s senior author and director of the Reproductive Psychiatry Research Program at the University of Virginia School of Medicine.

In the study, researchers analyzed more than 238,000 survey responses from women ages 18-55 from 140 countries on the Flo app, which helps women track their menstrual cycle.

The most common symptoms reported were food cravings, experienced by 85.28% of the women surveyed, followed by mood swings or anxiety (64.18%) and fatigue (57.3%).

More than one in four (28.61%) women surveyed said their premenstrual symptoms interfered with their everyday life during every menstrual cycle.

The study found that a group of symptoms – absentmindedness, low libido, sleep changes, gastrointestinal symptoms, weight gain, headaches, sweating or hot flashes, fatigue, hair changes, rashes, and swelling – was significantly more frequent among older survey respondents.

According to researchers, many of these physical symptoms are associated with perimenopause, a transition period to menopause marked by irregular menstrual cycles.

Causes are unknown

The exact causes of premenstrual syndrome (PMS), a combination of physical and emotional symptoms that women experience before their period, are unknown.

Researchers think PMS may happen due to hormonal changes, as estrogen and progesterone levels begin falling after ovulation in nonpregnant women. Hormone changes can cause a deficiency of serotonin, a substance in the brain that can affect mood and cause physical symptoms.

For many women, changes in diet and regular aerobic exercise reduce PMS symptoms, including fatigue and depression.

However, sometimes PMS symptoms are so severe that they cause problems with work or personal relationships. Such symptoms indicate that a woman may have a premenstrual dysphoric disorder (PMDD), which can be treated with selective serotonin reuptake inhibitors (SSRIs), also used to treat depression.

Any woman can develop PMDD, but those with a family history of PMS or PMDD or/and a personal or family history of depression or other mood disorders are more at risk.


UVA Health. Frequency of Premenstrual Anxiety, Mood Swings a Public Health Issue, Study Finds.

Office on Women’s Health. Premenstrual syndrome (PMS).

The American College of Obstetricians and Gynecologists. Premenstual Syndrome (PMS).

John Hopkins Medicine. Premenstrual Dysphoric Disorder (PMDD).

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