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95 years

of research on PMS and PMDD, 1931 to today

69 years from first description to first medicine

26 years in the manual’s appendix

16 years out of early drug trials

1931 First described

1953 PMS named

1977 Women kept out of trials

1987 First criteria

1993 Women back in

2000 First medicine

2013 Full diagnosis

2019 In ICD-11

2026 Today

754 papers in 2025

Papers published each year

A name, little science

Women left out

For further study

Recognized

1931 First described

1953 PMS named

1977 Women kept out of trials

1987 First criteria

1993 Women back in

2000 First medicine

2013 Full diagnosis

2019 In ICD-11

2026 Today

69 yearsfrom first description to first medicine

26 yearsin the manual’s appendix

16 yearsout of early drug trials

A name, little science

Women left out

For further study

Recognized

The glow on the right is papers published each year. It reaches 754 in 2025.

A river of light from 1931 to 2026. It passes through four eras: 1931 to 1976, A name, little science; 1977 to 1993, Women left out; 1994 to 2012, For further study; 2013 to 2026, Recognized. Shaded spans mark 69 years from first description to first medicine, 1931 to 2000; 26 years in the manual’s appendix, 1987 to 2013; 16 years out of early drug trials, 1977 to 1993. Papers published each year stay low until the 1980s and reach 754 in 2025.

69 years: Frank, 1931, Archives of Neurology and Psychiatry; FDA approval letter, Sarafem, July 6, 2000. 26 years: Epperson et al., 2012, American Journal of Psychiatry; American Psychiatric Association, changes from DSM-IV-TR to DSM-5. 16 years: Liu and Mager, 2016, Pharmacy Practice; FDA, Evaluation of Sex Differences in Clinical Investigations, 2025. Papers each year: the Niyora research library, counted to October 13, 2026.

Research

Women’s health research timeline: how slow progress has been

Doctors described the days before a period in 1931. The first medicine approved for PMDD came in 2000, and PMDD became a full diagnosis in 2013. This is the whole story on one page, with a source under every step.

Does this sound familiar?

If any of these sound like your life, you’re not imagining it, and it isn’t your fault. Each one has a history.

What’s changing

  • 2.4 years. The average wait for a diagnosis among people who noticed symptoms after PMDD became official in 2013. For those who noticed them before, it was 12.3 years. Border and Miller, 2026, Health Services Insights
  • 209 papers. Research on PMDD published in 2025, against 46 in 2000. See the chart.
  • 36 trials. PMS and PMDD clinical trials that started in 2025, against 5 in 2020. See the chart.

1931 to 1976

A name, and very little science

Doctors described the days before a period in medical journals, gave it a name, and mostly moved on.

  1. 1931

  2. 1953

1977 to 1993

Women left out of the evidence

For 16 years, FDA advice kept most women who could become pregnant out of the earliest drug trials. When NIH asked researchers to include women, its own auditors found the request wasn’t working.

  1. 1977

    The FDA advises keeping women out of early drug trials

    After the thalidomide tragedy, an FDA guideline says women who could become pregnant should be excluded from Phase 1 and early Phase 2 studies, unless the drug is for a life-threatening illness.

    Why it mattered “Could become pregnant” was read to include women on contraception and women with sterile partners. The FDA and researchers now describe the guideline as “rigid and paternalistic.”

    Source: Liu and Mager, 2016, Pharmacy Practice

  2. 1986

  3. 1987

    The first formal criteria, in an appendix

    The American Psychiatric Association’s DSM-III-R lists “late luteal phase dysphoric disorder” in Appendix A: at least five symptoms that start before a period and ease once it begins.

    Why it mattered Researchers could finally agree on who they were studying. It stayed outside the main manual for the next 26 years.

    Sources: Epperson et al., 2012, American Journal of Psychiatry; Endicott, 2000, Journal of Clinical Psychiatry; American Psychiatric Association, history of the DSM

  4. 1990

    Government auditors find NIH’s policy isn’t working

    In June 1990, the GAO tells Congress that NIH’s policy on including women “has not been well communicated or understood within NIH or the research community.”

    Why it mattered It also found NIH officials had taken little action on asking researchers to analyze results by gender.

    Source: US GAO, T-HRD-90-38, June 18, 1990

  5. 1990

  6. 1993

  7. 1993

    The FDA reverses its 1977 advice

    On July 22, 1993, a new FDA guideline lifts the restriction on most women who could become pregnant joining Phase 1 and early Phase 2 trials, and encourages them to take part.

    Why it mattered Pregnancy testing and contraception counseling took the place of a blanket rule. The guideline also asks drug makers to consider how the stage of the menstrual cycle affects a drug, where they can.

    Sources: FDA, Evaluation of Sex Differences in Clinical Investigations, 2025; Liu and Mager, 2016, Pharmacy Practice

1994 to 2012

Still “for further study”, and the first medicines

PMDD got its name and its first approved treatments while the psychiatric manual still listed it as needing more research.

  1. 1994

    It’s renamed premenstrual dysphoric disorder

    DSM-IV renames late luteal phase dysphoric disorder as PMDD and keeps it in Appendix B, “Criteria Sets and Axes Provided for Further Study.”

    Why it mattered Clear criteria helped research grow. The experts who later proposed moving it into the main manual said that would give it “greater legitimacy.”

    Sources: Epperson et al., 2012, American Journal of Psychiatry; American Psychiatric Association, changes from DSM-IV-TR to DSM-5; American Psychiatric Association, history of the DSM

  2. 1998

    The difference is in the response, not the hormones

    In an NIH study in the New England Journal of Medicine, women with PMS felt better when their ovarian hormones were switched off, and their symptoms came back when estrogen or progesterone was added. Women without PMS had no mood change on the same hormones.

    Why it mattered The authors concluded the symptoms are “an abnormal response to normal hormonal changes.” The 2017 gene study below builds on this.

    Source: Schmidt et al., 1998, New England Journal of Medicine

  3. 2000

  5. 2002–2006

    Three more approvals, then a long pause

    Sertraline (May 2002), paroxetine CR (August 2003) and the birth control pill drospirenone with ethinyl estradiol, sold as YAZ (October 2006), are approved for PMDD.

    Why it mattered Every medicine with PMDD on its FDA label today is one of these two kinds: an SSRI, or a drospirenone pill.

    Sources: FDA approval letter, Zoloft for PMDD, 2002; FDA approval letter, Paxil CR for PMDD, 2003; FDA approval letter, YAZ, October 2006; openFDA drug label search for “premenstrual dysphoric disorder”

2013 to today

Recognized, and still catching up

PMDD is now a full diagnosis in both of the world’s main diagnostic manuals. Funding, and doctors’ awareness, are moving more slowly.

  1. 2013

  3. 2016

    NIH asks every study to consider sex

    From January 25, 2016, NIH expects “sex as a biological variable” to be built into the design, analysis and reporting of the animal and human studies it funds.

    Why it mattered It came 23 years after the law on clinical trials, and carried the same idea into lab research.

    Source: Douthard, Whitten and Clayton, 2022, NIH Office of Research on Women’s Health

  4. 2017

    A clue inside the cells

    NIH scientists grow cells from women with PMDD and from women without it, and find differences in a gene complex, ESC/E(Z), that responds to estrogen and progesterone.

    Why it mattered It’s evidence, at the level of cells, that PMDD involves a real difference in how the body responds to normal hormones.

    Source: Dubey et al., 2017, Molecular Psychiatry

  5. 2019

  6. 2021

    Funding follows men’s diseases more than women’s

    An analysis of NIH funding against disease burden finds that in nearly three-quarters of diseases that mostly affect one sex, the funding pattern favors males.

    Why it mattered When a disease mostly affects women, it tends to get less research money than its burden would call for.

    Source: Mirin, 2021, Journal of Women’s Health

  7. 2024

    A global report puts a number on the gap

    The World Economic Forum and McKinsey Health Institute report that women spend 25% more of their lives in poor health than men, and that NIH spends 11% of its budget on research specific to women’s health.

    Why it mattered It lists PMS among ten conditions whose treatment would make up more than half the economic gain of closing the gap, and puts PMS alone at $115 billion.

    Sources: World Economic Forum, January 17, 2024; McKinsey Health Institute, January 17, 2024

  8. 2024

    A careful count of how common PMDD is

    A meta-analysis of 44 studies and 50,659 people finds PMDD in 3.2% when the diagnosis is confirmed with daily ratings, and 1.6% in community samples with a confirmed diagnosis.

    Why it mattered Studies that skipped daily ratings found 7.7%. The authors say rates from those studies are likely “artificially high.”

    Source: Reilly et al., 2024, Journal of Affective Disorders

  9. 2026

    A shorter wait since PMDD became official

    In an Australian study of 267 people who sought PMDD care, those who noticed symptoms before 2013 waited 12.3 years on average for a diagnosis. Those who noticed them later waited 2.4 years.

    Why it mattered Only 19% were diagnosed the recommended way, with daily ratings over two cycles. Part of the drop is timing, since newer cases haven’t had as long to wait.

    Source: Border and Miller, 2026, Health Services Insights

How many studies a year look at PMS and PMDD

Each bar is one year of published papers on PMS, PMDD and closely related conditions. Before 1983, no year had 100. In 2025 there were 754, and 28% of them were about PMDD.

1930: 2, of which 0 on PMDD 1931: 1, of which 0 on PMDD 1932: 1, of which 0 on PMDD 1933: 1, of which 0 on PMDD 1934: 0, of which 0 on PMDD 1935: 0, of which 0 on PMDD 1936: 0, of which 0 on PMDD 1937: 0, of which 0 on PMDD 1938: 1, of which 0 on PMDD 1939: 2, of which 0 on PMDD 1940: 1, of which 0 on PMDD 1941: 1, of which 0 on PMDD 1942: 3, of which 0 on PMDD 1943: 6, of which 0 on PMDD 1944: 1, of which 0 on PMDD 1945: 5, of which 0 on PMDD 1946: 6, of which 0 on PMDD 1947: 5, of which 0 on PMDD 1948: 3, of which 0 on PMDD 1949: 6, of which 0 on PMDD 1950: 12, of which 0 on PMDD 1951: 24, of which 0 on PMDD 1952: 12, of which 0 on PMDD 1953: 32, of which 0 on PMDD 1954: 20, of which 0 on PMDD 1955: 28, of which 0 on PMDD 1956: 26, of which 0 on PMDD 1957: 27, of which 0 on PMDD 1958: 26, of which 0 on PMDD 1959: 39, of which 0 on PMDD 1960: 27, of which 0 on PMDD 1961: 26, of which 0 on PMDD 1962: 30, of which 0 on PMDD 1963: 50, of which 0 on PMDD 1964: 55, of which 0 on PMDD 1965: 29, of which 0 on PMDD 1966: 29, of which 0 on PMDD 1967: 26, of which 0 on PMDD 1968: 38, of which 0 on PMDD 1969: 35, of which 0 on PMDD 1970: 31, of which 0 on PMDD 1971: 42, of which 0 on PMDD 1972: 33, of which 0 on PMDD 1973: 31, of which 0 on PMDD 1974: 43, of which 0 on PMDD 1975: 52, of which 0 on PMDD 1976: 50, of which 0 on PMDD 1977: 51, of which 1 on PMDD 1978: 41, of which 1 on PMDD 1979: 72, of which 0 on PMDD 1980: 65, of which 0 on PMDD 1981: 70, of which 0 on PMDD 1982: 87, of which 0 on PMDD 1983: 103, of which 2 on PMDD 1984: 96, of which 3 on PMDD 1985: 132, of which 2 on PMDD 1986: 131, of which 3 on PMDD 1987: 165, of which 3 on PMDD 1988: 166, of which 5 on PMDD 1989: 190, of which 14 on PMDD 1990: 179, of which 9 on PMDD 1991: 156, of which 7 on PMDD 1992: 157, of which 18 on PMDD 1993: 151, of which 9 on PMDD 1994: 151, of which 13 on PMDD 1995: 167, of which 25 on PMDD 1996: 130, of which 19 on PMDD 1997: 184, of which 42 on PMDD 1998: 169, of which 26 on PMDD 1999: 186, of which 44 on PMDD 2000: 192, of which 46 on PMDD 2001: 210, of which 58 on PMDD 2002: 209, of which 70 on PMDD 2003: 184, of which 53 on PMDD 2004: 178, of which 51 on PMDD 2005: 188, of which 51 on PMDD 2006: 203, of which 55 on PMDD 2007: 184, of which 54 on PMDD 2008: 219, of which 65 on PMDD 2009: 203, of which 43 on PMDD 2010: 206, of which 52 on PMDD 2011: 210, of which 59 on PMDD 2012: 205, of which 58 on PMDD 2013: 213, of which 51 on PMDD 2014: 264, of which 60 on PMDD 2015: 241, of which 46 on PMDD 2016: 253, of which 54 on PMDD 2017: 295, of which 70 on PMDD 2018: 314, of which 68 on PMDD 2019: 294, of which 71 on PMDD 2020: 344, of which 77 on PMDD 2021: 393, of which 86 on PMDD 2022: 492, of which 123 on PMDD 2023: 560, of which 145 on PMDD 2024: 581, of which 160 on PMDD 2025: 754, of which 209 on PMDD 2026 (so far): 736, of which 224 on PMDD
165 papers in 1987, when the first criteria appeared. 192 in 2000, the year of the first approved medicine. 213 in 2013, when PMDD became a full diagnosis. The dashed bar is 2026 up to October 13.
See every number
Year Papers About PMDD
1930 2 0
1931 1 0
1932 1 0
1933 1 0
1938 1 0
1939 2 0
1940 1 0
1941 1 0
1942 3 0
1943 6 0
1944 1 0
1945 5 0
1946 6 0
1947 5 0
1948 3 0
1949 6 0
1950 12 0
1951 24 0
1952 12 0
1953 32 0
1954 20 0
1955 28 0
1956 26 0
1957 27 0
1958 26 0
1959 39 0
1960 27 0
1961 26 0
1962 30 0
1963 50 0
1964 55 0
1965 29 0
1966 29 0
1967 26 0
1968 38 0
1969 35 0
1970 31 0
1971 42 0
1972 33 0
1973 31 0
1974 43 0
1975 52 0
1976 50 0
1977 51 1
1978 41 1
1979 72 0
1980 65 0
1981 70 0
1982 87 0
1983 103 2
1984 96 3
1985 132 2
1986 131 3
1987 165 3
1988 166 5
1989 190 14
1990 179 9
1991 156 7
1992 157 18
1993 151 9
1994 151 13
1995 167 25
1996 130 19
1997 184 42
1998 169 26
1999 186 44
2000 192 46
2001 210 58
2002 209 70
2003 184 53
2004 178 51
2005 188 51
2006 203 55
2007 184 54
2008 219 65
2009 203 43
2010 206 52
2011 210 59
2012 205 58
2013 213 51
2014 264 60
2015 241 46
2016 253 54
2017 295 70
2018 314 68
2019 294 71
2020 344 77
2021 393 86
2022 492 123
2023 560 145
2024 581 160
2025 754 209
2026 (so far) 736 224

Clinical trials, by the year they started

Registered trials on PMS, PMDD and closely related conditions. 161 of the 280 started in 2022 or later.

2000: 4 2001: 2 2002: 3 2003: 1 2004: 7 2005: 7 2006: 1 2007: 2 2008: 5 2009: 5 2010: 4 2011: 5 2012: 3 2013: 7 2014: 3 2015: 10 2016: 5 2017: 4 2018: 8 2019: 8 2020: 5 2021: 12 2022: 29 2023: 33 2024: 35 2025: 36 2026 (so far): 28
6 more trials started before 2000, 1 is planned to start after 2026 and 1 has no start date. ClinicalTrials.gov opened in 2000, so earlier trials are undercounted.
See every number
Year Trials started
2000 4
2001 2
2002 3
2003 1
2004 7
2005 7
2006 1
2007 2
2008 5
2009 5
2010 4
2011 5
2012 3
2013 7
2014 3
2015 10
2016 5
2017 4
2018 8
2019 8
2020 5
2021 12
2022 29
2023 33
2024 35
2025 36
2026 (so far) 28

About these numbers

Papers come from Europe PMC, PubMed and OpenAlex, with retracted papers left out. Trials come from ClinicalTrials.gov and the ISRCTN registry. Both run to October 13, 2026. ClinicalTrials.gov opened in 2000, so older trials are missing.

Medical publishing grew in every field over these decades, so the shape of the bars says more than their height. You can read the papers themselves in the research library, or just the PMDD studies.

What this means for you today

The slow part was the science and the funding. The diagnosis itself is now settled, and that changes what you can ask for.

  • PMDD is an official diagnosis

    It’s in the DSM-5 and in the WHO’s ICD-11 as GA34.41. If a doctor seems unsure, those two names are worth bringing up.

    APA; WHO ICD-11

  • Two months of daily notes

    A confirmed diagnosis rests on symptoms rated daily over at least two cycles. In the Australian study, only 19% were diagnosed this way.

    Reilly et al., 2024; WHO ICD-11; Border and Miller, 2026

  • Approved treatments exist

    Some SSRIs and a drospirenone birth control pill are FDA-approved for PMDD. A doctor can help you weigh them.

    openFDA label search

Niyora is a PMS and PMDD support app. On a hard day, Moon gives you somewhere to write what happened and calm down before you answer anyone.

How to get diagnosed What PMDD is Why the research is slow What nobody has studied yet