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Systematic review, 2025

Are PMS and PMDD more common in highly trained female athletes than in women who don't train intensively?

Female athletes had somewhat lower PMS rates and somewhat higher PMDD rates than non-athletes, but neither finding was statistically significant. We cannot be confident in these findings.

Strong study design 1,570 female athletes and 1,165 non-athletes from 12 studies

What they did

Systematic review and meta-analysis of 12 studies. Researchers compared 1,570 female athletes with 1,165 non-athletes to see if PMS and PMDD were more common in athletes.

What they found

PMS affected 8.6% to 65.8% of athletes, with 41.1% to 44.3% reporting impact on athletic performance. PMDD affected 1.3% to 13.1% of athletes. Meta-analysis showed 16% lower odds for PMS in athletes (p=0.409, not significant) and 16% higher odds for PMDD in athletes (p=0.660, not significant).

What it means for you

PMS rates vary widely in athletes and may not differ from non-athletes. PMDD appears uncommon in both groups. The findings are uncertain because they were not statistically significant, and more research is needed. Limited by the wide variation in how different studies measured PMS.

1,570

Female athletes studied

8.6-65.8%

PMS prevalence in athletes

41.1-44.3%

Athletes reporting impact on performance

About the study

Original title
Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among highly trained and elite female athletes: A systematic review and meta-analysis
Authors
Granda D, Szmidt MK, Surała O et al.
Journal
Biology of sport
Year
2025
Study design
Systematic review
What was tested
Professional-level physical training in sports
Open access
Yes
Original abstract

Premenstrual syndrome (PMS) involves psychological and physical symptoms affecting around 30% of reproductive-age women, while premenstrual dysphoric disorder (PMDD) is a more severe, less common form. The aim of the review was to determine whether PMS and PMDD are more common among highly trained female athletes compared to non-training women.The study protocol was registered with PROSPERO (CRD42022323111). A search of PubMed, Scopus and Web of Science (up to August 2024) identified 12 eligible studies, with 7 included in the meta-analysis. Data from 1570 female athletes and 1165 non-athletes were analysed. A total of 755 cases of PMS and 54 cases of PMDD were found in all included studies. The prevalence of PMS among athletes ranged from 8.6 to 65.8%, while the impact of symptoms on athletic performance was reported by 41.1 to 44.3% of respondents. The meta-analysis on PMS prevalence (n = 2005 women) indicated 16% lower odds for athletes compared to non-athletes, however, the result was not statistically significant (p = 0.409). The prevalence of PMDD among athletes ranged from 1.3 to 13.1%. Meta-analysis results (n = 1314 women) showed 16% higher odds ratio of PMDD prevalence among athletes compared to non-athletes, but the association was also not significant (p = 0.660). This is the first systematic review and meta-analysis on the susceptibility of women to PMS and PMDD symptoms in relation to physical activity at a professional level. The prevalence of PMS among athletes could be highly variable, while PMDD appears to be a relatively minor issue. Further research regarding PMS and PMDD in female athletes is warranted.

Reproduced under CC-BY.

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