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Perimenopause and menopause: what the research says

248 studies on perimenopause and menopause in PMS and PMDD, each explained in plain English. 16 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 76Review 51Study 38Cohort study 29Randomised trial 21Case-control study 11
Systematic review, 2026

Why do some women experience mood changes linked to their menstrual cycle?

Evidence shows these women have normal hormone levels but heightened sensitivity in their brains and cells to hormone changes. This explains PMDD and some postpartum and perimenopausal mood problems, and has led to new treatments.

Guideline, 2024

How should Xiangshao Granules be prescribed for premenstrual tension syndrome?

Experts from 29 major hospitals have created standardized guidelines on how to use Xiangshao Granules for premenstrual tension, including dosage and timing. These recommendations come from multidisciplinary experts' review of current evidence.

Systematic review, 2023

Does saffron help with PMS, labor pain, and menopause symptoms?

Yes, saffron improves mood and reduces psychological symptoms of PMS and menopause, and helps reduce labor pain and recovery time, though limited studies exist.

Cohort study, 2023

Do women with premenstrual disorders go through menopause earlier and have worse hot flashes?

Yes. Women with premenstrual disorders went into menopause about 2.67 times earlier and were more likely to have moderate or severe hot flashes (68.3% versus 55.3%).

Review, 2018

Which women are most likely to experience hot flashes during menopause?

Up to 80% of women experience hot flashes during menopause, lasting about 10 years on average. Black and Hispanic women are more likely to experience them, while Asian women are less likely.

Review, 2017

Can combining different types of treatments help PMS more than using one approach alone?

Yes. An integrative approach combining medicines, supplements, mind-body techniques, acupuncture, and lifestyle changes can effectively address PMS.

Review, 2012

How should premenstrual disorders be diagnosed and organized?

An international group of medical experts created a unified system for defining and classifying premenstrual disorders, which separates typical PMS from more complex conditions.

Review, 2012

How is PMS diagnosed and treated, especially in women approaching menopause?

PMS affects 30-40% of reproductive-age women and responds to medications that suppress ovulation or SSRIs. Treatment must be customized to each woman's needs for contraception, PMS control, and symptom relief during the transition to menopause.

Review, 2011

What are PMS and PMDD, and how common are they?

PMS affects 20-32% of women before menopause with moderate mood and physical symptoms. PMDD is more severe and affects 3-8% of women, causing significant problems at work or socially.

Systematic review, 2010

Does acupuncture treat premenstrual syndrome?

Evidence for acupuncture treating PMS is limited and understudied. Most evidence focuses on period pain and menopause, but all evidence has quality problems.

Randomised trial, 2006

Do herbal remedies help with PMS, pregnancy nausea, or hot flushes?

Preliminary evidence suggests chaste tree helps PMS, ginger helps pregnancy nausea, and black cohosh helps hot flushes, but the evidence is not strong enough to be certain.

Randomised trial, 2006

What herbs and dietary supplements have evidence for treating premenstrual syndrome?

A review of research found that calcium, vitamin B6, and chasteberry have the strongest evidence from clinical trials for treating premenstrual syndrome.

Randomised trial, 2005

Does stopping ovulation help irritable bowel syndrome that gets worse during the menstrual cycle?

Yes, stopping ovulation with leuprolide acetate significantly improved bowel symptoms related to the menstrual cycle. Adding tibolone (a hormone) did not improve bowel symptoms further but did improve quality of life more than leuprolide alone.

Cohort study, 2004

Do women with PMS have worse menopausal symptoms?

Yes, women with PMS are significantly more likely to experience hot flushes, depression, poor sleep, and low libido during menopause. This large five-year study provides strong evidence for this connection.

Cohort study, 1999

What causes negative mood during menopause?

The menopause transition itself and hormone levels do not directly cause negative mood. Instead, past premenstrual problems, negative attitudes to aging, life stress, health problems, smoking, low exercise, and relationship issues are the main causes.

Review, 1992

Is PMS really caused by hormones?

The evidence that PMS is caused by hormones is unclear. Psychological and individualized treatments may work better than hormone treatments for PMS.

Survey study, 2026

Are women who feel mood changes from birth control pills at higher risk for PMDD and postpartum depression?

Yes. Women who reported mood problems from the pill were 3.78 times more likely to have PMDD and 1.66 times more likely to have depression after childbirth, though genetic factors and depression history also matter.

Survey study, 2026

Does a history of mood problems with your period predict depression during menopause?

Yes, women with a history of mood changes before their period or depression after childbirth were more likely to have depression symptoms during menopause.

Review, 2026

How do hormone changes affect sleep in women?

Hormonal changes during your menstrual cycle, including PMS and PMDD, cause sleep problems that appear at different times in your cycle. It's hard for doctors to diagnose what's really causing the problem because these symptoms overlap with other sleep disorders.

Review, 2026

Do PMDD, postpartum depression and perimenopausal depression have the same genetic causes?

It's unclear. Researchers have looked at several of the same genes in all three conditions but found inconsistent results. Most genetic research has focused on postpartum depression, not PMDD.

Survey study, 2025

Do women with bipolar disorder who had PMS or postpartum depression have worse mood problems during menopause?

Yes. Women with bipolar disorder who had premenstrual symptoms are 6.189 times more likely to have mood episodes during menopause, and those with postpartum depression are 2.635 times more likely to have depression during menopause.

Cohort study, 2025

When during the menstrual cycle do breast tenderness and swelling occur?

Breast tenderness and swelling happen mainly in the late luteal phase (after ovulation). They were higher in cycles with normal ovulation compared to cycles with ovulation problems.

Study, 2025

Do women have different symptom patterns before, during, and after menopause?

Yes. Women have different symptom patterns depending on whether they are before, during, or after menopause. All women experience fatigue, headache, anxiety, and brain fog regardless of life stage.

Review, 2025

Does creatine supplementation help women's health?

Creatine supplementation may improve muscle strength, exercise performance, mood, and cognitive function in women. However, most research so far is small and more studies are needed, especially in women approaching menopause.

Study, 2025

Does the time in your menstrual cycle change how heart tests show results?

Heart test results were similar at different cycle phases, but the body's response such as blood pressure and a heart protein marker was different, showing the menstrual cycle affects how your body responds to exercise.

Study, 2025

Does anger get worse before your period?

Yes. Anger and irritability are clearly more severe before your period across reproductive ages.

Study, 2025

Can blood markers that predict depression after childbirth also predict PMDD?

A blood marker linked to depression after childbirth also showed promise in identifying women with PMDD, particularly during the luteal phase of the menstrual cycle.

Systematic review, 2025

Do drugs that stop ovulation help women with PMS?

The abstract is incomplete and does not provide the main results, so no clear answer can be determined from the information given.

Cohort study, 2025

Does how consistently you sleep during your cycle affect your metabolism?

Overall sleep variability was linked to lower insulin resistance. However, very short or very long sleep nights were linked to higher leptin and insulin levels.

Review, 2025

How does progesterone affect mood and brain function?

Progesterone influences how your brain processes emotions and manages stress. In women with PMDD, targeting progesterone receptors can improve mood symptoms before your period.

Survey study, 2025

Do women with ringing in the ears have more menstrual problems?

Yes. Women with ringing in their ears are more likely to have severe menstrual pain from a known cause and heavy periods, even after accounting for other factors like age and stress.

Survey study, 2024

Does the menstrual cycle affect hair and scalp health?

Yes. Women with irregular menstrual cycles are more likely to have hair and scalp problems. Hair and scalp disorders seem to change during different phases of the menstrual cycle.

Study, 2024

How do finger temperature, heart rate, and sleep change across the menstrual cycle?

Finger temperature and heart rate changed across the menstrual cycle, but sleep measures stayed the same in these healthy women. Heart rate was lowest during menses in both younger and older women.

Lab study, 2023

Does sleep change across the menstrual cycle?

No clear difference in healthy women. Objective sleep measurements remained stable across the menstrual cycle. Women approaching menopause reported feeling they slept worse overall compared to younger women, though their actual sleep duration was similar.

Survey study, 2022

What are the biggest research gaps in women's health, especially for menstrual conditions?

Research is lacking in many important areas, especially communication between women and doctors about health, and support for menstrual conditions like PMDD and heavy periods. There is more research on menopause but not on how to help women manage other conditions.

Study, 2022

Which premenstrual symptoms change with the menstrual cycle in midlife women?

Mood, muscle and nerve, and body-wide symptoms worsen before the period in women reporting PMS. Hot flashes and sleep problems do not follow this pattern, and menopausal transition stage does not affect any symptoms.

Review, 2021

Do herbal products help with PMS?

Chaste tree shows effectiveness for PMS, but more research is needed. Evidence for other herbs is still developing.

Cohort study, 2020

How common is worsening asthma around the menstrual cycle in women with AERD?

24% of women with AERD reported menstrual asthma, meaning their asthma symptoms worsened around their period. This finding is reasonably reliable from a survey-based study.

Review, 2019

How does the menstrual cycle affect migraine in women?

Hormone changes during the menstrual cycle affect migraine. Menstrual migraine has long attacks and is difficult to treat.

Study, 2018

Do irregular periods and menopause affect thinking and memory in women with schizophrenia?

Yes. Women with schizophrenia who had irregular periods performed worse on tests of processing speed, word fluency, and word memory compared to women with regular periods. Women past menopause had worse performance on visual-spatial thinking.

Lab study, 2018

How does depression affect menstrual function and fertility in women?

Women with depression are more likely to have PMS and irregular periods. Depression also appears linked to fewer pregnancies and children. Depression starting at puberty has the worst effects on menstrual and reproductive health.

Case-control study, 2017

Does heart rate change across your menstrual cycle if you have insomnia during menopause?

Yes. Women with insomnia in the menopausal transition have heart rates about 4 beats per minute higher than controls throughout both phases of the cycle.

Cohort study, 2016

Do women eat differently at different times in their menstrual cycle?

Women eat more protein and report stronger food cravings during the second half of the cycle (luteal phase), especially for chocolate, sweets, and salt.

Review, 2016

How do reproductive hormones affect mood and behavior in women?

Reproductive hormones are powerful regulators of mood and behavior. Changes in hormone levels during the menstrual cycle, pregnancy, and menopause can trigger mood problems in women who are biologically sensitive to these changes.

Cohort study, 2015

Does drinking alcohol affect reproductive hormones or menstrual cycle regularity?

Recent alcohol drinks raise reproductive hormone levels, but moderate drinking does not appear to disrupt menstrual cycle regularity in the short term.

Case-control study, 2015

How does menstrual cycle phase affect sleep in midlife women with and without insomnia?

Sleep is more disrupted during the luteal phase (high progesterone) than the follicular phase in midlife women, with more awakenings and less deep sleep. Women with insomnia had consistently worse sleep than women without insomnia in both phases.

Randomised trial, 2015

Does menstrual cycle phase change how the body responds to stress when sleep-deprived?

Sleep deprivation affected the heart and blood pressure similarly in both menstrual cycle phases. However, resting blood pressure was slightly lower during the luteal phase.

Review, 2014

Are mental health problems linked to gynecological conditions like PMS and PMDD?

Yes. Anxiety and depression are common with PMS and PMDD and are frequently undetected and untreated, affecting women's work, social and personal lives.

Survey study, 2014

Do women who had PMS develop more hot flashes in menopause?

No. Women with a history of premenstrual symptoms did not have more or worse hot flashes after menopause. However, those with a PMS history did report more problems with memory, mood, sleep, and feeling less attractive during the menopause transition.

Study, 2014

Does team-based learning help medical students understand PMS and related conditions?

Medical students in teams scored much higher on tests (averaging 94.33%) than when taking tests individually (averaging 72.80%), though they found applying the knowledge to complex cases harder (averaging 53.33%).

Cohort study, 2013

How do menstrual cycle phase and hormonal birth control affect sleep?

Women on hormonal birth control had better sleep quality and fewer breathing interruptions during sleep compared to women not on birth control. The effect of birth control was stronger than menstrual cycle phase.

Survey study, 2013

Do past PMS symptoms predict how severe your menopause symptoms will be?

Yes. Women with more severe pain, concentration problems, or water retention during the premenstrual phase were more likely to have severe physical symptoms during menopause.

Survey study, 2013

Are menstrual symptoms common in middle-aged women and do they relate to hot flushes?

Cramping is common (54%) but mood symptoms are less frequent (8-9%). Cramping and back pain were associated with hot flushes, suggesting hormonal changes may affect both.

Randomised trial, 2013

Do women with depression whose symptoms worsen before their period respond differently to antidepressants?

About two-thirds of depressed women report premenstrual worsening, and these women tend to have more chronic depression and medical problems. However, premenstrual worsening does not predict which antidepressants will work.

Cohort study, 2012

Does a history of depression increase the risk of heavy menstrual bleeding?

Yes. Women who had a past history of depression were about 1.89 times more likely to report heavy menstrual bleeding. Depression history was not linked to other bleeding problems or premenstrual symptoms.

Cohort study, 2012

Does PMS affect how stiff arteries become and blood pressure?

Yes, women with PMS showed increased artery stiffness during the later cycle phases and menstruation. Women who reported PMS symptoms before menopause had higher rates of high blood pressure and stiffer arteries after menopause. The study does not prove PMS causes these changes.

Study, 2012

Does the menstrual cycle phase affect fainting episodes in women with fainting problems?

No. The cycle phase doesn't change how often fainting happens or how well the test works. However, fainting episodes last longest during the period, and one type of fainting reaction is less common in the week after ovulation.

Survey study, 2012

What non-hormonal medications and therapies help severe PMS and PMDD?

SSRIs (a type of antidepressant) are well-established for severe PMS and PMDD, taken either continuously or during the luteal phase. Cognitive-behaviour therapy, calcium, and chasteberry may also help, though the strength of evidence varies.

Review, 2012

Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause?

Yes. Depression tied to hormonal changes appears in the same women across three life stages (premenstrual, after birth, and menopause). Transdermal estrogen patches may be more effective as first-line treatment than antidepressants.

Review, 2011

Can estrogen hormones treat depression linked to the menstrual cycle?

Yes, transdermal estrogen can treat depression linked to the menstrual cycle, pregnancy, and menopause by suppressing cyclical hormone changes. The challenge is balancing multiple hormones and managing progestogen side effects.