Photo by Olayinka Babalola on Unsplash
Photo by Olayinka Babalola on Unsplash

Women with bad PMS may be at higher risk of perinatal depression, and vice versa

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Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Observational study: A study in which the subject is observed to see if there is a relationship between two or more things (eg: the consumption of diet drinks and obesity). Observational studies cannot prove that one thing causes another, only that they are linked.

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Women who develop perinatal depression may be more likely to have a premenstrual disorder at some point in their life, and women with a premenstrual disorder may be more likely to develop perinatal depression, according to international research. The team used Swedish health data to look at the rate of premenstrual disorders - serious physical or mood symptoms before a period - among about 85,000 women who had perinatal depression and nearly 850,000 women who did not have the condition. The researchers say almost 3% of the women with perinatal depression reported a history of premenstrual disorders compared to 0.6% of the women who didn't have it. They say the link between the two conditions appears to go both ways, which suggests they may be caused by a similar process.

Journal/conference: PLOS Medicine

Link to research (DOI): 10.1371/journal.pmed.1004363

Organisation/s: Karolinska Institutet, Sweden

Funder: The work was supported by the Chinese Scholarship Council (No. 201700260289 to QY), the Swedish Research Council for Health, Working Life and Welfare (FORTE) (No. 2020-00971 and 2023-00399 to DL), the Swedish Research Council (Vetenskapsrådet) (No. 2020-01003 to DL), Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics (grant to DL), Karolinska Institutet SFOepi Junior Scholar Grant (to DL) and the Icelandic Research Fund (No. 218274-051 to UAV). The funders had no role in study design, data collection and analysis, preparation of the manuscript or decision to publish.

Media release

From: PLOS

Positive associations between premenstrual disorders and perinatal depression

Researchers utilize data from Swedish nationwide registers of over 900,000 women

Women affected by premenstrual disorders have a higher risk of perinatal depression compared with those who do not, according to research published March 28th in the open access journal PLOS Medicine. The relationship works both ways: those with perinatal depression are also more likely to develop premenstrual disorders after pregnancy and childbirth. This study suggests that a common mechanism might contribute to the two conditions.

Menstruating women experience cyclical hormone fluctuations through puberty, menstrual cycle, pregnancy and menopause. Some women have difficult to manage symptoms of low mood and depression during these fluctuations. Between a fifth and a third of women are reportedly affected by premenstrual disorders and 11% of mothers suffer perinatal depression — depressive symptoms during pregnancy and up to 12 months after delivery.

Qian Yang and colleagues at the Karolinska Institutet, Sweden and University of Iceland used the Swedish nationwide registers from 2001 to 2018 and identified 84,949 women with perinatal depression and 849,482 unaffected women. The researchers matched the women on age and calendar year, and further controlled for demographic factors, smoking, BMI, parity and history of psychiatric disorders. Among women with perinatal depression, almost 3% had premenstrual disorders before pregnancy compared with 0.6% of matched unaffected women. Women with perinatal depression were also twice as likely to report premenstrual disorders when the menstruation resumed after childbirth, compared to those unaffected by perinatal depression.

The research sheds light on the association between the two conditions and supports a theory that they may share underlying biological mechanisms and/or risk factors. Understanding this association could help healthcare providers to better target support to women most likely to be affected.

The authors add, “This study reveals a strong bidirectional relationship between perinatal depression and premenstrual disorders, using data from over 900,000 pregnancies. The findings suggest that both disorders may exist on a continuum, and emphasize the importance of recognizing these susceptibilities in clinical practice.”

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