Frequency of premenstrual anxiety, mood swings a public health issue, study finds

The UVA Health study found that most women have premenstrual symptoms every menstrual cycle, and those symptoms regularly affect their day-to-day lives. One of the most common symptoms, regardless of age, is mood swings or anxiety, the researchers found. At least 61% of women in all age groups surveyed reported mood-related symptoms every menstrual cycle, which the researchers say suggests "that premenstrual mood symptoms are a key public health issue globally."

"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. "More important, a majority of women reported that their premenstrual symptoms interfered with their everyday life at least some of the time."

Better Understanding Premenstrual Symptoms

To better understand the type of premenstrual symptoms women experience and how those symptoms affect their daily lives, the 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 or track their mood or physical symptoms during and after pregnancy.

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%), according to researchers from the UVA School of Medicine, Johns Hopkins University and Flo Health. Among the study respondents, 28.61% said their premenstrual symptoms interfered with their everyday life during every menstrual cycle, while an additional 34.84% said their premenstrual symptoms interfered with their everyday life sometimes.

"The incidence of reported premenstrual mood and anxiety symptoms varied significantly by country from a low of 35.1% in Congo to a high of 68.6% in Egypt," Payne said. "Understanding whether differences in biology or culture underlie the country level rates will be an important future research direction."

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, the researchers found. The increase in physical symptoms among older survey respondents "makes sense," the researchers said, as many of these symptoms are associated with perimenopause, a transition period to menopause marked by irregular menstrual cycles.

Payne is hopeful that this survey data will help women get better care by making healthcare providers more aware of how frequently these symptoms -- especially anxiety and mood-related symptoms -- occur.

"There are a number of treatment strategies that are available to treat premenstrual symptoms that interfere with a woman's every day functioning," she said. "Increasing awareness of how common these symptoms are, and that if they impact functioning that there are treatments available, will help women improve their quality of life."