--- title: Do stress and rumination increase with PMS severity? | Niyora description: Yes. Women with more severe PMS symptoms had higher levels of stress, anxiety, depression and rumination. Momentary stress and rumination also increased durin url: https://niyora.com/research/papers/stress-and-rumination-in-premenstrual-syndrome-pms-identifying-stable-and-2022/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do stress and rumination increase with PMS severity? Survey study, 2022 # Do stress and rumination increase with PMS severity? Yes. Women with more severe PMS symptoms had higher levels of stress, anxiety, depression and rumination. Momentary stress and rumination also increased during the premenstrual phase of the cycle. Moderate study design 380 women with no to mild, moderate to severe, or PMDD levels of PMS symptoms. ## What they did Cross-sectional study in two parts. 380 women answered one-time questionnaires about depression, stress, anxiety, and rumination. A smaller group of 237 women also completed daily diaries about stress and rumination during both the follicular and premenstrual phases of their cycle. ## What they found Women with higher PMS severity consistently scored higher on depression, anxiety, stress and rumination. Daily stress and ruminative thinking increased with higher PMS symptoms at each measurement time. However, stress and rumination levels did not significantly differ between the follicular and luteal phases, possibly due to measurement timing issues. ## What it means for you Stress and rumination appear to be important in PMS and could be targets for psychological treatment. Limitation: cross-sectional design cannot prove cause and effect, measurement timing uncertainty acknowledged by authors, wide range of PMS severity may mask phase-specific effects. 380 women with trait measures 237 women with daily diary measures p < .001 correlation with stress, anxiety, depression, rumination ## About the study Original title Stress and rumination in Premenstrual Syndrome (PMS): Identifying stable and menstrual cycle-related differences in PMS symptom severity Authors Kappen M, Raeymakers S, Weyers S et al. Journal Journal of affective disorders Year 2022 Study design Survey study Participants 380 What was tested None (observational study). Open access Yes Read the paper [doi.org/10.1016/j.jad.2022.09.052](https://doi.org/10.1016/j.jad.2022.09.052) Original abstract Since the inclusion of Premenstrual Dysphoric Disorder (PMDD) as a mood disorder in the DSM-5, Premenstrual Syndrome (PMS) symptoms have received more attention from researchers and clinicians. In this large-scale study, we investigated core psychological concepts relevant to mood disorder vulnerability between people with 1) no to mild, 2) moderate to severe, and 3) PMDD levels of PMS symptoms. Several trait measures related to mood disorders including depressive symptoms, feelings of stress and anxiety, and ruminative thinking were measured (single measurement, N = 380) along with state (momentary) reports of stress and stress-related perseverative thinking (measured twice, once in the follicular and once in the premenstrual/luteal phase, N = 237). We consistently observed that participants with higher severity of PMS symptoms also scored higher on depression, anxiety, stress, and rumination (trait measures). We also found consistent increases in momentary stress and stress-related perseverative ruminative thinking with increased PMS symptoms at each of our two test moments (in the middle of the follicular and premenstrual/luteal phase respectively). Interestingly, we did not find significant differences between our two test moments for any group, despite PMS being characterized by specific systems in the premenstrual/luteal phase. However, this could be due to noise surrounding the testing moments due to the temporal resolution of the questionnaires and the menstrual cycle estimation method. Nevertheless, these results suggest that stress and rumination are important psychological mechanisms to consider in PMS. Future PMS research studying stress and rumination on a day-to-day basis in combination with hormonal measures is warranted. Reproduced under CC-BY. ## Topics [Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Anxiety and tension](https://niyora.com/research/topics/symptom-anxiety/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Stress](https://niyora.com/research/topics/symptom-stress/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Review, 1999 Is premenstrual dysphoric disorder a distinct clinical disorder? Case-control study, 2007 Does serotonin function change differently in PMDD versus PMS versus healthy women? Cohort study, 2025 How common is PMS in Chinese teenage girls, and what factors are linked to it? Randomised trial, 2024 Does curcumin reduce depression, anxiety, and stress in women with PMS and dysmenorrhea? Review, 2003 How do menstrual cycle hormones affect the brain and cause mood disorders like PMDD? Randomised trial, 1995 Does fluoxetine help premenstrual dysphoria? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗