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Survey study, 2025

What is the link between stress hormones, psychological distress, and resilience in women with PMDD and PMS?

Women with PMDD have higher stress and anxiety than others. In the PMDD group, women with stronger resilience had lower levels of cortisol, the stress hormone, in their hair.

Early or limited evidence 80 women over 18 with regular menstruation: 20 with PMDD, 25 with PMS, 35 controls

What they did

Studied 80 women with regular menstruation: 20 with PMDD, 25 with PMS, and 35 without either. Assessed symptoms using the Premenstrual Symptoms Screening Tool. Measured resilience, perceived stress, depression, anxiety, and loneliness using standard scales. Measured cortisol levels in hair samples using a lab test.

What they found

Women with PMDD had higher perceived stress and anxiety than the control group, and higher anxiety than the PMS group. In the PMDD group only, hair cortisol concentration had a negative moderate correlation with resilience (r = minus 0.509, p = 0.022), meaning women with PMDD who were more resilient had lower cortisol levels.

What it means for you

Women with PMDD experience more stress and anxiety than those without PMDD. When women with PMDD develop stronger resilience, their stress hormone levels decrease. This suggests that building resilience through psychological support could be beneficial for PMDD. The study was small and done at one site, so results may not apply broadly.

20

Number with PMDD (25%)

-0.509

Correlation between resilience and hair cortisol in PMDD group

0.022

P-value for resilience-cortisol correlation

About the study

Original title
Hair cortisol concentration, psychological distress and resilience in women with premenstrual dysphoric disorder and premenstrual syndrome
Authors
Kevser Yildirim Ciftci, Elif Akcay, Ceylan Bal et al.
Journal
Turkish Journal of Biochemistry
Year
2025
Study design
Survey study
Participants
80
What was tested
None - observational study only
Open access
Yes
Original abstract

Abstract Objectives Women frequently experience premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS), which can lead to both physical symptoms and severe psychological distress that can impact daily functioning. Also, these women may be exposed to chronic stress, for which hair cortisol concentration (HCC) serves as a potential biomarker. In the present study, the relationship between HCC, psychological distress and resilience in women with PMDD and PMS were evaluated. Methods A total of 80 women older than 18 years ages and menstruating regularly for at least two years participated in this study. Sociodemographic characteristics and menstrual cycle features were self-reported by all participants. Premenstrual syndrome symptoms were assessed with the Premenstrual Symptoms Screening Tool (PSST). Resilience, perceived stress, depression, anxiety, stress and loneliness were evaluated using the Brief Resilience Scale (BRS), Perceived Stress Scale (PSS), Depression, Anxiety, Stress Scale (DASS-21) and UCLA Loneliness Scale. HCC was measured using ELISA. Results Participants of study were divided into three groups based on PSST as follows: PMDD (n = 20, 25 %), PMS (n = 25, 31.3 %), and control (n = 35, 43.8 %). In the PMDD group, perceived stress and anxiety were higher compared to the control group and anxiety scores were higher than the PMS group. Out of the three groups, HCC had negative moderate correlation with resilience scores only in the PMDD group (r = −0.509, p = 0.022). Conclusions Women with PMDD experience severe affective symptoms and exhibit higher resilience as HCC concentrations decrease. These findings highlighted that enhancing resilience through psychological support could be a beneficial intervention for the PMDD group.

Reproduced under CC-BY.

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