---
title: Does substance use change across the menstrual cycle, especially in women with PMS or PMDD?
description: Yes. Women use more nicotine before and during their period, especially those with PMDD or PMS, and alcohol use also increases during these phases.
url: https://niyora.com/research/papers/addictive-behaviors-across-the-menstrual-cycle-a-systematic-review-2021/
---

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- Does substance use change across the menstrual cycle, especially in women with PMS or PMDD?

Systematic review, 2021

# Does substance use change across the menstrual cycle, especially in women with PMS or PMDD?

Yes. Women use more nicotine before and during their period, especially those with PMDD or PMS, and alcohol use also increases during these phases.

 Strong study design

Women in 34 studies examining addictive behaviors across menstrual cycle phases

## What they did

Systematic review of 34 studies on the relationship between menstrual cycle phase and addictive behaviors including alcohol, smoking, cannabis, caffeine, and gambling. Researchers screened 1,568 articles total from medical databases.

## What they found

Strong evidence showed nicotine use increased during the premenstrual and menstrual phases, with particularly high use among women with PMDD or PMS. Alcohol use also increased during these phases, especially in those with PMDD or PMS. Results for cannabis, caffeine, and gambling were less consistent or not well studied.

## What it means for you

The menstrual cycle affects some addictive behaviors, particularly smoking. Women with PMDD or PMS may be especially vulnerable to increased smoking and alcohol use around their period. This matters when treating substance use disorders in women.

34

studies reviewed

1,568

articles initially screened

## About the study

Original title Addictive behaviors across the menstrual cycle: a systematic review Authors Joyce KM, Good KP, Tibbo P et al. Journal Archives of women's mental health Year 2021 Study design Systematic review What was tested None - observational review of existing studies Read the paper [doi.org/10.1007/s00737-020-01094-0](https://doi.org/10.1007/s00737-020-01094-0)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Alcohol, smoking and substance use](https://niyora.com/research/topics/comorbidity-substance-use/)

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## Related studies

Survey study, 2025

Does PMDD or PMS affect quality of life?

Cohort study, 2026

Does cannabis use vary across the menstrual cycle in people with premenstrual disorders?

Survey study, 2021

Do women with PMDD use more cannabis premenstrually to cope with mood symptoms?

Survey study, 2001

How common is premenstrual dysphoric disorder and how is it related to other psychiatric conditions?

Survey study, 1994

Do women with PMDD use more cigarettes, alcohol, or drugs at certain times in their cycle?

Survey study, 1989

Do women's memories of premenstrual depression match their daily mood ratings?

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