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Efficacy of psychological interventions for premenstrual syndrome: A systematic review and meta-analysis of randomized controlled trials

Journal
Journal of affective disorders (Q1)
Published
14 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Yue Liu, Ruilin Wu, Xin Liu, Ye Sun, Fang Wang, Lisha Dai
PMID
42448050
DOI
10.1016/j.jad.2026.122264

Why clinicians should know about it

Abstract

BACKGROUND: Premenstrual syndrome (PMS) is common among reproductive-aged women. Pharmacological treatments often cause side effects. This systematic review and meta-analysis evaluated the efficacy of psychological interventions for PMS symptom severity and related emotional distress. METHODS: We systematically searched seven electronic databases from their inception to March 2026 to screen randomized controlled trials (RCTs) of psychological interventions for premenstrual syndrome (PMS). We used Review Manager 5.4 software to evaluate the risk of bias in included studies in accordance with the Cochrane Risk of Bias tool. Data were pooled using the DerSimonian-Laird random-effects model in Stata 18.0, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. The study was conducted in accordance with the PRISMA guidelines and registered with PROSPERO (CRD420261345418). RESULTS: A total of 20 RCTs involving 1369 women were included. The meta-analysis indicated that psychological interventions reduced the severity of PMS symptoms. One trial (Çitil, 2024) was identified as an extreme outlier based on non overlapping confidence intervals. After excluding it in a sensitivity analysis, the pooled effect remained significant. (SMD = -1.57, 95% CI [-1.94, -1.21], p < 0.001). The interventions significantly alleviated PMS-related depressive symptoms (SMD = -1.08, 95% CI [-1.46, -0.70], p < 0.001), anxiety symptoms (SMD = -1.03, 95% CI [-1.36, -0.69], p < 0.001), and anger/irritability symptoms (SMD = -0.85, 95% CI [-1.47, -0.24], p < 0.001). CONCLUSIONS: Psychological interventions may reduce PMS symptoms and related emotional distress. Psychological interventions may represent a useful non-pharmacological option for PMS management.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.