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Efficacy of psychological interventions for premenstrual syndrome: A systematic review and meta-analysis of
Yue Liu1, Ruilin Wu1, Xin Liu1
1Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; School of Marxism, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China.
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 and Çitil Canbay, 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.