Premenstrual syndrome (PMS) symptom emergence across the cycle in relation to hormonal and psychological components in a community sample

For many individuals, the days leading up to menstruation are associated with aversive mood, behavioral, and physical symptoms, a condition known as premenstrual syndrome (PMS). Severe levels of these symptoms can lead to clinical diagnosis of premenstrual dysphoria (PMDD). Although prior research has uncovered important psychological and hormonal predictors of PMS/PMDD symptoms in clinical populations, more research is needed to understand how these factors relate in a subclinical population. A test of the menstrual timing and hormonal links to symptom experience alongside factors related to stress would be advantageous for identifying mechanistic underpinnings of symptom severity, factors that might indicate early risk for clinical diagnosis, as well as subclinical factors affecting people's wellbeing. In a community sample of naturally cycling women (N = 257), we conducted within-subject analyses of PMS symptom reporting and levels of salivary progesterone and cortisol across the cycle and in relation to stress and trait neuroticism. On average, women in this study reported increased PMS symptoms in the days leading up to menstrual onset and decreased symptoms at mid cycle, a pattern that was linked to progesterone levels. Higher levels of experienced stress and trait neuroticism were also positively correlated with PMS symptoms. Yet, main effects for PMS symptom and stress timing across the cycle occurred above and beyond controlling for neuroticism. This research has implications for a broader understanding of the connection between the menstrual cycle and psycho-social experiences as well as risk for clinical psychopathology.