Association between severe premenstrual disorders and change of romantic relationship : A prospective cohort of 15,606 women in Sweden

Abstract

Background: Premenstrual disorders (PMDs) affect women's quality of life, yet the impact on romantic relationships remains unclear. This study aimed to examine the association between severe PMDs and relationship disruption and initiation. Methods: We conducted a prospective cohort study of 15,606 women during 2009–2021 in Sweden. PMDs were assessed with the modified Premenstrual Symptom Screening Tool at baseline (one-time retrospective self-report), while relationship status was obtained from national population registers during follow-up. Poisson regression was employed to assess the risk of relationship change. Results: At baseline (mean age 33.5 years), 1666 (10.6 %) women met the criteria for severe PMDs. All women were followed for 9.1 years on average for any change of relationship status. Among married/cohabiting women, PMDs were positively associated with relationship disruption (Incidence risk ratio, IRR =1.21, 95 % CI: 1.01–1.43, p = 0.03). A more pronounced association was suggested for premenstrual dysphoric disorder (IRR = 1.22, 95 % CI: 1.01–1.45, p = 0.03) than severe premenstrual syndrome (IRR = 1.01, 95 % CI: 0.43–1.96, p = 0.98) and among women without depression/anxiety (IRR = 1.21, 95 % CI: 1.00–1.47, p < 0.05) than among those with (IRR = 0.99, 95 % CI: 0.61–1.54 p = 0.96) and IRR = 1.01, 95 % CI: 0.57–1.72, p = 0.97). Among single women, a null association was found between PMDs and relationship initiation (IRR = 1.05, 95 % CI: 0.95–1.15, p = 0.32). Limitations: PMDs were not assessed using prospective symptom charting. Conclusions: Married/cohabiting women with probable severe PMDs have an increased risk of relationship disruption. PMDs were not associated with relationship initiation in single women. Healthcare professionals should recognize relationship challenges in women with severe PMDs, and they may require support to maintain healthy relationships.