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Systematic review, 2021

Are women with PMS or PMDD more likely to think about or attempt suicide?

Yes. Pooling results from multiple studies, women with PMDD had a much higher chance of suicide attempts and suicidal thoughts than women without these premenstrual problems.

Strong study design Data combined from 13 studies (10 used in the main statistical pooling) of women with PMS or PMDD.

What they did

Researchers combined the results of 13 existing studies (10 of them pooled into a formal statistical analysis) that looked at whether premenstrual syndrome or premenstrual dysphoric disorder was linked to suicidal thoughts, plans, or attempts. They searched three research databases up to July 2020.

What they found

Women with PMDD were almost seven times more likely to attempt suicide than women without premenstrual disturbances (OR 6.97, 95% CI 2.98 to 16.29). There was also a link to suicidal thoughts. A separate comparison for suicide attempt showed no clear difference (OR 1.85, 95% CI 0.77 to 4.46, p = 0.17).

What it means for you

Premenstrual syndrome and PMDD are linked to a higher risk of suicidal thoughts and attempts, so the authors say doctors should routinely check for suicide risk in women with moderate to severe premenstrual symptoms. The underlying studies were observational, so this shows a link, not proof that PMS or PMDD directly causes suicidal behaviour.

OR 6.97

Higher odds of suicide attempt in PMDD

10

Studies combined in the analysis

OR 1.85, p=0.17

Odds ratio in the non-significant comparison

About the study

Original title
Suicidal Risk in Women with Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Systematic Review and Meta-Analysis
Authors
Prasad D, Wollenhaupt-Aguiar B, Kidd KN et al.
Journal
Journal of women's health (2002)
Year
2021
Study design
Systematic review
What was tested
None tested; this was a review combining existing studies on premenstrual disturbance and suicide risk.
Open access
Yes
Original abstract

Purpose: Women with premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) experience substantial functional impairment and decreased quality of life. While previous research has highlighted a relationship between premenstrual disturbances and suicide risk, no meta-analysis has been conducted to quantitatively assess the findings. Methods: A systematic review and meta-analysis was conducted by searching the literature in three databases (Pubmed, PsycINFO, and EMBASE) on July 15, 2020. Studies that assessed the relationship between suicidality (attempt, ideation, and/or plan) and premenstrual disturbance (PMDD, PMS, and/or premenstrual symptoms) were included. Results: Thirteen studies were included in the qualitative review ( n = 10 included in meta-analysis). Results revealed that women with PMDD are almost seven times at higher risk of suicide attempt (OR: 6.97; 95% CI: 2.98-16.29, p p p = 0.03), but not for suicide attempt (OR: 1.85; 95% CI: 0.77 to -4.46, p = 0.17). Conclusions: Women with PMDD and PMS are at higher risk of suicidality compared with women without premenstrual disturbances. These findings support routine suicidal risk assessments for women who suffer from moderate-to-severe premenstrual disturbance. Furthermore, psychosocial treatments for women diagnosed with PMS/PMDD should consider and target suicidality to minimize risk and improve well-being.

Reproduced under CC-BY.

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