Study Reveals Menstrual Symptoms, Psychology, and Lifestyle Factors Associated with PMS and PMDD

A research group including Shiori Itoi from the Department of Infertility, Comprehensive Center for Women's Medicine, and Dr. Naho Morisaki, Head of the Division of Women's Health Promotion at the Comprehensive Center for Women's Health, National Center for Child Health and Development (Location: Okura, Setagaya-ku, Tokyo; President: Takashi Igarashi), alongside MTI Ltd. (Location: Shinjuku-ku, Tokyo; President and CEO: Toshihiro Maeda), operator of the menstrual tracking app 'Luna-Luna', comprehensively evaluated background factors, psychosocial elements, and menstruation-related indicators associated with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) using cohort data from approximately 7,000 'Luna-Luna' users.

This study is a large-scale analysis that multi-dimensionally examined the psychosocial factors of PMS and PMDD by linking the menstrual management app's records with repeated questionnaires on an individual basis.

As a result of the analysis, PMS (23%) and PMDD (10%) were associated not only with a high burden of menstrual symptoms but also with background and behavioral factors such as current and past smoking, Adverse Childhood Experiences (ACEs) including domestic violence, low health literacy, and maladaptive stress coping (undesirable ways of dealing with stress). Furthermore, they were associated with high psychological distress, poor sleep quality, and a deterioration in work-life balance (the interaction between work and family).

The results of this research were published in the international academic journal 'International Journal of Gynecology & Obstetrics' (IJGO) in December 2025.

[Highlights of the Press Release] - PMS/PMDD were found to be more common in younger demographics, such as those in their 20s. - PMS/PMDD were associated with a higher number of menstrual symptoms. - Both PMS and PMDD were associated with background and behavioral factors such as current/past smoking, adverse childhood experiences, low health literacy, and maladaptive stress coping. - Both PMS and PMDD were associated with psychosocial burdens such as psychological distress, poor sleep, and deteriorated work-life balance. - In PMDD, an association with marital history and living with children was suggested, while in PMS, an association with high-risk drinking was observed.

[Background and Objectives] PMS and PMDD involve physical and mental symptoms that repeatedly appear before menstruation, affecting daily life, work, studies, and interpersonal relationships. Although premenstrual symptoms are often perceived merely as menstruation-related, it has been pointed out that they may be related to broader psychosocial factors such as sleep, stress, lifestyle habits, and family or work environments. In this study, large-scale data was used to multi-dimensionally examine factors related to PMS/PMDD.

[Research Overview] - Study Design & Participants Targeting users of 'Luna-Luna', a widely used menstrual management app in Japan, the study analyzed data by linking in-app questionnaires with individual menstrual logs. Based on responses regarding premenstrual symptoms, participants were classified into a control group, a PMS group, and a PMDD group. The analysis included 6,966 individuals, with PMS at 23% and PMDD at 10%. (Cumulative 22 million downloads as of June 2025)

- Evaluation Items Background/Behavioral Factors: Age, marital status, presence of children living together, smoking history, alcohol consumption, adverse childhood experiences, health literacy, stress coping, etc. Psychosocial Factors: Psychological distress, sleep quality, work-life balance (interaction between work and family), etc. Menstruation-related Indicators: Menstrual symptom burden, cycle characteristics, etc.

- Analysis Method Using age-adjusted multinomial logistic regression, factors associated with PMS and PMDD were estimated with the control group as the reference.

- Main Research Findings Factors commonly associated with both PMS and PMDD: Current and past smoking were associated with both PMS and PMDD. Associations were observed with a higher number of adverse childhood experiences and higher scores for maladaptive stress coping.