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Case-control study, 2025

Is the stress hormone system different in women with PMDD?

Women with PMDD had significantly lower cortisol levels throughout the menstrual cycle compared to controls (p=0.0004 in follicular phase, p=0.0007 in luteal phase), suggesting PMDD may have a different mechanism than other depression types.

Moderate study design 26 women with PMDD and 25 controls, both menstrual cycle phases

What they did

Researchers tested the stress hormone system in 26 women with PMDD and 25 controls without PMDD. Testing was done during both the follicular and luteal phases using a combined dexamethasone suppression and CRH stimulation test, plus 24-hour urine cortisol measurements.

What they found

No significant differences were found in plasma cortisol or ACTH levels between groups in response to the test. However, the PMDD group had significantly lower 24-hour urine cortisol levels compared to controls during both the follicular phase (p=0.0004) and luteal phase (p=0.0007).

What it means for you

Women with PMDD have lower cortisol than expected, which differs from major depression. This suggests PMDD may be more similar to stress disorders like PTSD. The main limitation is that this was a relatively small study.

26

women with PMDD

25

controls without PMDD

0.0004, 0.0007

p-values for lower cortisol in PMDD

About the study

Original title
Cortisol and ACTH response to Dex/CRH testing and 24-hour urine free cortisol levels in women with and without premenstrual dysphoric disorder
Authors
Zou CX, Guerrieri GM, Martinez PE et al.
Journal
Psychoneuroendocrinology
Year
2025
Study design
Case-control study
Participants
26
What was tested
Dexamethasone and CRH stimulation test, 24-hour urine cortisol measurement
Open access
Yes

Topics