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Cognitive-behavioral therapy for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review
Abstract
We systematically reviewed empirical studies that investigated the use of cognitive-behavioral therapy (CBT) for premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Our multi-database search identified seven published empirical reports. Three were identified as randomized controlled trials (RCTs). The methods utilized to investigate therapeutic efficacy of CBT in these studies varied widely from case reports to RCTs with pharmacotherapy comparison groups. Initially we provide a brief overview of CBT and justifications for its potential use to treat PMS/PMDD. Next, we provide critical evaluations of the analyses used in each study focusing on the detection of intervention effects assessed by statistically significant time by group interactions. When possible we calculate effect sizes to elucidate the clinical significance of results. Our review revealed a dearth of evidence providing statistically significant CBT intervention effects. Issues such as overall time investment, latency to treatment effects, and complementary and combined therapies are considered. We present a theoretical argument for applying mindfulness- and acceptance-based CBT interventions to PMS/PMDD and suggest future research in this area. In conclusion, to produce the necessary evidence-base support for PMS/PMDD given the limited empirical evidence reported here, researchers are called on to produce methodologically rigorous investigations of psychosocial interventions for PMS/PMDD.
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In the citing paper
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
In the citing paper
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
In the citing paper
“The results of systematic review [10] and meta-analysis of randomized controlled trials [13, 14] suggest that cognitive behaviour therapy (CBT) can reduce premenstrual anxiety and depression, have a beneficial impact on behavioural change, and reduce interference of premenstrual symptoms on daily living [15, 16–18].”
In the citing paper
“Previous research on the efficacy of CBT in reducing premenstrual distress has also been criticised for the absence of wait-list control groups, small sample size, absence of random group assignment, and failure to use using repeated measures ANOVA to assess main effects of group, main effects of time, and time by group interactions [10].”
In the citing paper
“The finding of significant differences across time when the groups are collapsed (ignoring the intervention group assignment), confirms previous reports [10, 13, 14] that taking part in an intervention for PMDs can reduce psychological premenstrual symptoms and premenstrual distress [15, 16, 18, 20, 72, 73].”
In the citing paper
“Whilst CBT may be more costly than bio-medical treatments in the short term, as it requires more intensive clinician time and trained personnel [10]”
In the citing paper
“attrition was lower than that reported in previous CBT RCTs for PMDs [10]”
In the citing paper
“These findings support the argument that CBT can have a preventative effect for PMDs [10], by preventing the premenstrual increases in negative symptomatology or changing the way women come to relate to and report those symptoms.”
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Demarque, R., Rennó, J., Ribeiro, H. L., Cavalsan, J. P., Rocha, R., Cantilino, A., Ribeiro, J. D. A. M., Valadares, G. C., & da Silva, A. G. (2013) · Debates em Psiquiatria · doi:10.25118/2763-9037.2013.v3.379 · Cited by 4
(2011) · Elsevier eBooks · doi:10.1016/b978-0-7295-3908-1.10033-8 · Cited by 4
Micronutrient Intake and Premenstrual Syndrome
Chocano-Bedoya, P. O. (2022) · ScholarWorks@UMassAmherst (University of Massachusetts Amherst) · doi:10.7275/2387359 · Cited by 4
Okajima, J., & Okajima, I. (2025) · BioPsychoSocial Medicine · doi:10.1186/s13030-025-00327-x · Cited by 3
Depressive Disorders: Premenstrual Dysphoric Disorder
Pearlstein, T. B. (2015) · Wiley eBooks · doi:10.1002/9781118753378.ch51 · Cited by 2
Premenstrual Disorders in Adolescents: An Updated Review
Rome, E. S., Kaznoch, D., & Issac, V. E. (2026) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2026.06.003 · Cited by 2
Premenstrual dysphoric disorder: A new psychological entity
Cope, G. F. (2019) · Independent Nurse · doi:10.12968/indn.2019.5.28 · Cited by 2
Premenstrual Dysphoric Disorder and Peripartum Depression
Cox, E., Barker, L. C., Vigod, S. N., & Meltzer-Brody, S. E. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_58-1 · Cited by 2
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Mind over PMDD: A Glimpse into the Process of Pharmacotherapy-Psychotherapy Combination Treatment.
Nevo, G. A., & Nefsky, C. (2014) · Europe PMC (PubMed Central) · Cited by 2
Bakhshani, N., & Aghashahi, Z. (2013) · Cited by 2
Premenstrual Syndrome in Children with Type 1 Diabetes Mellitus
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Swansboro, B., & Brown, M. (2020) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-020-00566-9 · Cited by 3
“Firstly, both CBT and dialectical behavioral therapy (DBT) techniques [22] are considered one of the most effective interventions for treating mood symptoms in youth.”
BackgroundHPA axis dysfunction in women with premenstrual syndrome: A meta-analysis based on cortisol levels
Zhang, T., Zhang, K., & Zhou, R. (2023) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2023.00988 · Cited by 2
“…1 1 引言 女性月经周期会伴随相应的心理、躯体和植物性症状的周期性变化，这些症状会给女 性的身心健康带来严重伤害 (Halbreich et al., 2003)。具体症状包括：心理变化，如抑郁、 焦虑、情绪低落、注意力难以集中和感觉失控；身体变化，如痉挛、乳房疼痛、背部和关 节疼痛、胃肠道症状和痤疮；以及涉及睡眠和食欲的植物性症状 (Hartlage et al., 2012)。这 些症状达到一定严重程度时，会导致经前期综合征 (Premenstrual Syndrome, PMS; Yonkers et al., 2008)…”
Parveen, S., Kanthi, J. M., & Bhaskaran, R. (2024) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20241773 · Cited by 1
CONCEPT AND MANAGEMENT OF PREMENSTRUAL SYNDROME (MUTLAZIMA QABL HAIZ ) IN UNANI SYSTEM OF MEDICINE
Naushin, S., Ali, M., & Mustehasan (2018) · Journal of Drug Delivery and Therapeutics · doi:10.22270/jddt.v8i5-s.1992 · Cited by 1
Psychotherapy Modalities for Premenstrual Change: A Systematic Review
Buys, M. E. (2025) · Women & Therapy · doi:10.1080/02703149.2025.2534636 · Cited by 1
“CBT is one of a myriad of other under-explored options potentially available, and despite the widespread use of the modality, suggestions for alternative or integrative psychotherapeutic options for PMC have been made (Lustyk et al., 2009).”
InfluentialManagement of Premenstrual Disorders
Nakulan, A. (2017) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.30834/kjp.30.1.2017.64 · Cited by 1
Primary and Secondary Dysmenorrhea, Premenstrual Syndrome, and Premenstrual Dysphoric Disorder
Lentz, G. M. (2012) · Elsevier eBooks · doi:10.1016/b978-0-323-06986-1.00036-6 · Cited by 1
Diagnosis and Treatment of Premenstrual Syndrome
Anderson, Z. G. (2023) · Springer eBooks · doi:10.1007/978-3-031-14881-1_33 · Cited by 1
Metadata
- Authors
- Lustyk, M. K. B., Gerrish, W. G., Shaver, S., & Keys, S. L.
- Affiliations
- Seattle Pacific University (US)
- Corresponding author
- Gerrish, Winslow G.
- Venue
- Archives of Women s Mental Health
- Published
- 2009-02-27
- Volume
- 12
- Issue
- 2
- Pages
- 85-96
- ISSN
- 1434-1816 (ISSN-L)
- 1435-1102
- OpenAlex
- W2076474294
- Cited by
- 133
- References
- 48
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 11 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 9 · 2019: 10 · 2018: 6 · 2017: 10 · 2016: 5 · 2015: 9 · 2014: 5 · 2013: 9 · 2012: 5
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Archives of Women s Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy, premenstrual syndrome, premenstrual dysphoric disorder, psychosocial interventions, mindfulness-based interventions, acceptance-based therapy, treatment efficacy, menstrual disorders, effect size
- MeSH terms
- Adult, Female, Humans, Premenstrual Syndrome, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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