Repetitive Transcranial Magnetic Stimulation in the Management of Premenstrual Syndrome: A Prospective Pilot Study

Treatment options for premenstrual syndrome (PMS) include lifestyle changes, nutritional supplements, selective serotonin reuptake inhibitors (SSRIs), and hormone therapy. However, these approaches are sometimes ineffective or cause adverse effects. Currently, neuromodulation for premenstrual symptoms remains underrecognized. This study aimed to assess the effects of repetitive transcranial magnetic stimulation (rTMS) on PMS symptoms.

A prospective pilot study was conducted in which 10 women with PMS were followed up over 2 menstrual cycles. Symptomatic progression was analyzed by assessment instruments at the beginning, middle, and end of the luteal phase in both cycles. The participants underwent 10 to 12 right dorsolateral prefrontal cortex (DLPFC) rTMS sessions during the luteal phase in the second menstrual cycle, and the symptomatic scores of the second cycle (with rTMS) were compared with those of the first cycle (without rTMS).

The intermediate and final assessments indicated a statistically significant decrease in depressive (P = 0.034 and P < 0.001, respectively) and anxiety symptoms (P = 0.019 and P = 0.001, respectively) in the second cycle compared with the first. The rTMS was generally well tolerated without significant adverse effects. The study sample was small, and a control group was not included. Furthermore, the timeframe was short, with only 2 menstrual cycles assessed.

rTMS may provide positive treatment effects for women with PMS, especially in the middle and end of the luteal phase. Future controlled studies to verify its effectiveness are warranted.