Higher risk for suicide among women with vs. without premenstrual disorders

Key takeaways:

• Overall, women with vs. without premenstrual disorders did not have increased mortality risk.
• Women diagnosed with premenstrual disorders before age 25 years had higher suicide risk vs. later or no diagnosis.

All women with vs. without premenstrual disorders had higher risk for suicide, whereas those diagnosed at younger than 25 years had increased all-cause mortality risk, according to study results published in JAMA Network Open.

“Despite the dearth of research on long-term consequences of premenstrual disorders, there are some indications of an association between premenstrual disorders and mortality. For instance, women with premenstrual disorders present with elevated blood pressure levels and a 40% higher risk of developing hypertension. Women with diabetes with premenstrual disorders have been found to have a greater risk of uncontrolled blood glucose levels,” Marion Opatowski, PhD, from the unit of integrative epidemiology at the Institute of Environmental Medicine at the Karolinska Institutet, Sweden, and colleagues wrote. “In addition, premenstrual disorders are highly comorbid with psychiatric disorders, which are associated with elevated risk of both nonnatural and natural-cause mortality.”

Opatowski and colleagues conducted a nationwide, population-based cohort study using data from population and health registers in Sweden to identify 67,748 women of reproductive age with a first diagnosis of premenstrual disorders from 2001 to 2018. These women were matched with 338,740 women without premenstrual disorders to assess long-term consequences and mortality risk among women with premenstrual disorders.

Primary outcomes were dates and underlying causes of death obtained from the National Cause of Death Register.

Overall, women with premenstrual disorders were diagnosed at a mean age of 35.8 years. During a follow-up period of 6.2 years, 367 women with and 1,958 women without premenstrual disorders died.

Women with premenstrual disorders did not have an increased overall mortality risk compared with women without (adjusted HR = 0.91; 95% CI, 0.82-1.02). However, women with vs. without premenstrual disorders had an increased risk for death due to nonnatural causes (HR = 1.59; 95% CI, 1.25-2.04), particularly for suicide (HR = 1.92; 95% CI, 1.43-2.6). In addition, women diagnosed with premenstrual disorders before age 25 years had higher all-cause mortality (HR = 2.51; 95% CI, 1.42-4.42) and death from suicide (HR = 3.84; 95% CI, 1.18-12.45) and natural causes (HR = 2.59; 95% CI, 1.21-5.54).

“This supports the importance of careful follow-up for young women with premenstrual disorders and highlights the need to develop suicide prevention strategies for all women with premenstrual disorders,” the researchers wrote.