PMS symptoms are very common, but most women reporting these symptoms do not meet strict criteria for a diagnosis of PMS. Clinically significant PMS is thought to affect 3% to 8% of women, with a point prevalence of 20% to 30% in some studies.[1]American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 7: management of premenstrual disorders. Dec 2023 [internet publication].
https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/12/management-of-premenstrual-disorders
[7]Green LJ, O’Brien PMS, Panay N, et al; Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome: green-top guideline no. 48. BJOG. 2017 Feb;124(3):e73-105.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14260
http://www.ncbi.nlm.nih.gov/pubmed/27900828?tool=bestpractice.com
Rates of PMDD are estimated to be between 2% and 5%, and women affected by the condition experience an average of 3000 symptomatic days (or 3.8 years) of disability in their reproductive years.[1]American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 7: management of premenstrual disorders. Dec 2023 [internet publication].
https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/12/management-of-premenstrual-disorders
PMS has been reported across different age groups and countries.[8]Monagle L, Dan A, Krogh V, et al. Perimenstrual symptom prevalence rates: an Italian-American comparison. Am J Epidemiol. 1993 Dec 15;138(12):1070-81.
http://www.ncbi.nlm.nih.gov/pubmed/8266909?tool=bestpractice.com
[9]Rupani NP, Lema VM. Premenstrual tension among nurses in Nairobi, Kenya. East Afr Med J. 1993 May;70(5):310-3.
http://www.ncbi.nlm.nih.gov/pubmed/8306911?tool=bestpractice.com
[10]Sveinsdottir H, Marteinsdottir G. Retrospective assessment of premenstrual changes in Icelandic women. Health Care Women Int. 1991 Jul-Sep;12(3):303-15.
http://www.ncbi.nlm.nih.gov/pubmed/1885341?tool=bestpractice.com
It has been documented in adolescents, but literature in this age group is limited.[11]Vichnin M, Freeman EW, Lin H, et al. Premenstrual syndrome (PMS) in adolescents: severity and impairment. J Pediatr Adolesc Gynecol. 2006 Dec;19(6):397-402.
http://www.ncbi.nlm.nih.gov/pubmed/17174829?tool=bestpractice.com
Perimenopausal women may be at risk for worsening PMS or PMDD based on ovarian hormone changes; although, similarly, women with a history of PMS/PMDD may be at increased risk for depressive disorders at this time.[12]Sander B, Gordon JL. Premenstrual mood symptoms in the perimenopause. Curr Psychiatry Rep. 2021 Oct 6;23(11):73.
http://www.ncbi.nlm.nih.gov/pubmed/34613495?tool=bestpractice.com
Studies report PMS/PMDD in Middle Eastern, African, Icelandic, Mediterranean, and white US, Canadian, and British women. In the US, PMS/PMDD is more prevalent in white women than in black women.[13]Pilver CE, Kasl S, Desai R, et al. Health advantage for black women: patterns in pre-menstrual dysphoric disorder. Psychol Med. 2011 Aug;41(8):1741-50.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404818
http://www.ncbi.nlm.nih.gov/pubmed/21108869?tool=bestpractice.com
However, black, indigenous, and other people of colour are significantly underrepresented in studies on premenstrual disorders.[1]American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 7: management of premenstrual disorders. Dec 2023 [internet publication].
https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/12/management-of-premenstrual-disorders
Moreover, diagnostic criteria used for these studies differ, making a direct comparison of prevalence among different ethnicities challenging.[8]Monagle L, Dan A, Krogh V, et al. Perimenstrual symptom prevalence rates: an Italian-American comparison. Am J Epidemiol. 1993 Dec 15;138(12):1070-81.
http://www.ncbi.nlm.nih.gov/pubmed/8266909?tool=bestpractice.com
[9]Rupani NP, Lema VM. Premenstrual tension among nurses in Nairobi, Kenya. East Afr Med J. 1993 May;70(5):310-3.
http://www.ncbi.nlm.nih.gov/pubmed/8306911?tool=bestpractice.com
[10]Sveinsdottir H, Marteinsdottir G. Retrospective assessment of premenstrual changes in Icelandic women. Health Care Women Int. 1991 Jul-Sep;12(3):303-15.
http://www.ncbi.nlm.nih.gov/pubmed/1885341?tool=bestpractice.com
One study of 2,718 Asian, Latina, and Black premenopausal women aged 18-40 years found that those who experienced gender or racial discrimination were more likely to report premenstrual symptoms and PMDD.[14]Pilver CE, Desai R, Kasl S, et al. Lifetime discrimination associated with greater likelihood of premenstrual dysphoric disorder. J Womens Health (Larchmt). 2011 Jun;20(6):923-31.
https://www.liebertpub.com/doi/10.1089/jwh.2010.2456
http://www.ncbi.nlm.nih.gov/pubmed/21671777?tool=bestpractice.com
This association between racial discrimination and adverse mental health effects is consistent with other research.[1]American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 7: management of premenstrual disorders. Dec 2023 [internet publication].
https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/12/management-of-premenstrual-disorders