A lack of consistent evidence for cortisol dysregulation in premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD)

Author: Kiesner J, et al (2015), Psychoneuroendocrinology

A review on the association between PMS/PMDD and cortisol levels and its reactivity examined three types of studies: correlational studies, environmental-change studies, and pharmacological-challenge studies. A total of 38 articles were selected based on the search criteria of testing an association between cortisol levels and reactivity with PMS/PMDD. The majority of the reviewed studies showed null effects, which supports the following conclusion. After interpreting all the data, it was determined that for women with or without PMS/PMDD there was very little evidence that supports a distinguishable difference of cortisol levels or differences in cortisol response/reactivity. Therefore, this review concludes that the HPA axis is relatively stable and non-dysfunctional in this disorder and that PMS/PMDD does not reflect a stress-response syndrome. It is proposed that future research look closer at the specific symptoms for PMS/PMDD to see if they differ with the daily changes in cortisol levels, cortisol awakening response, diurnal slope, and/or response to challenge.

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Keywords: Cortisol, Hypothalamic-pituitary axis, Premenstrual dysphoric disorder, Premenstrual syndrome