Is PMDD Genetic? A New Study Gives us Some Fascinating Clues

Pink and blue DNA strands representing genetic research into PMS and PMDD.

This was one of those studies that made me stop, put my coffee down and think, right, I need to read this properly. Let me explain.

Researchers looked at the genetics of more than 72,000 women to try to answer a question that many of us working in women’s health have been asking for years.

Why do some women experience severe premenstrual symptoms or PMDD, while others barely notice their cycle at all?

It's the first study of its kind at this scale and, while it doesn't answer every question, I do think it gives us some really interesting clues about what's actually going on. If you live with PMDD, work with women, or simply have an interest in the science behind women's health, I think this is one worth knowing about.

What is a genome-wide association study?

I’ll be honest, I had to look up “genome-wide association study”. It’s usually shortened to GWAS, which is far easier to say, and once you get past the name, it’s actually pretty fascinating.

Rather than searching for one single “PMDD gene”, researchers scan the DNA of thousands of people and look for tiny genetic differences that show up more often in people with a particular condition than in those without it. In simple terms, they’re looking for patterns across the genome.

Most complex health conditions aren’t caused by one gene acting alone. They’re usually influenced by lots of small genetic variations, with each one contributing a tiny amount to someone’s overall susceptibility. I think of it a bit like a jigsaw puzzle. One piece on its own tells you very little, but as more pieces are added, the picture slowly starts to take shape. That’s essentially what this study is trying to do.

Why is this such a big deal?

We’ve known for a while that PMDD seems to run in families. If your mother or sister has PMDD, your own chances of developing it appear to be higher too.

But that leaves us with an obvious question. Is that down to genetics, or could it be because families also share environments, experiences and behaviours?

Family studies can’t fully separate those things. This study gets us a little closer.

By analysing genetic data from more than 72,000 women across two Nordic populations, which is a huge sample, the researchers were able to start looking for biological differences that might help explain why some women are more susceptible than others.

That doesn’t mean we’ve suddenly solved PMDD. Far from it. There is still a huge amount we don’t know. But it does mean we’re beginning to move beyond simply recognising that PMDD runs in families and towards understanding what might be happening underneath it.

And that, for me, is where it starts to get really exciting.

So what did the researchers find?

Here’s where I think it gets really interesting.

Of the women included in the study, more than 17,000 reported premenstrual symptoms. When the researchers compared millions of genetic variants across the group, one region of the genome stood out. It sits close to a gene called CACNA1C.

Now, unless you’re a neuroscientist, that name probably won’t mean very much. But CACNA1C has been on researchers’ radar for years because genetic variations in and around it have repeatedly appeared in studies of psychiatric conditions, including depression, bipolar disorder and schizophrenia. It has also been linked to emotional regulation and the way the brain responds to stress. The gene helps regulate calcium channels, which play an important role in how brain cells communicate with one another.

That finding immediately made me think of another major study published earlier this year. Researchers in Sweden analysed health records from more than 3.6 million women and found a two-way relationship between premenstrual disorders and psychiatric conditions. Women diagnosed with a premenstrual disorder were around twice as likely to later receive a psychiatric diagnosis. The relationship also worked in the other direction, with women who already had a psychiatric condition being more likely to later receive a diagnosis of a premenstrual disorder. The strongest links were seen with depression and anxiety, but there were also associations with ADHD, bipolar disorder and personality disorders.

These are, of course, two very different studies asking different questions. One is looking at genetics, while the other is looking at patterns of diagnosis over time. But what I find so interesting is that they both seem to be pointing us in a similar direction.

PMDD doesn’t fit neatly into one box labelled “gynaecology”, “endocrinology” or “mental health”. It seems to sit at the intersection of all three, involving a much more complex relationship between hormones, the brain and our underlying biology.

And this is where the bigger picture starts to matter. One study on its own rarely changes the way we understand a condition. But when different research teams, using completely different methods, begin arriving at findings that seem to complement one another, it’s worth paying attention.

Does this mean PMDD is genetic?

The annoying answer is yes... and no.

What this study tells us is that there does seem to be a genetic contribution to premenstrual symptoms and PMDD. In other words, some women may be biologically more susceptible than others. But that doesn’t mean researchers have discovered “the PMDD gene”. Complex health conditions rarely work like that. It’s just not that straightforward.

Instead, it’s more likely that lots of small genetic variations each contribute a tiny amount to someone’s overall susceptibility. Taken together, they may influence how likely someone is to develop PMDD, or how strongly their brain responds to the hormonal changes of the menstrual cycle. Genetics are part of the story, but they’re certainly not the whole story.

And this is where the existing science around PMDD becomes really important.

Women with PMDD generally don’t have abnormal levels of oestrogen and progesterone. Their hormones are usually fluctuating in the way we would expect across a typical menstrual cycle. The difference seems to lie in how the brain and nervous system respond to those changes.

That might sound like a small distinction, but it completely changes the way we think about the condition. Rather than asking, “What’s wrong with the hormones?”, researchers have increasingly been asking, “Why do some brains respond so differently to the same hormonal fluctuations?”

If two women experience broadly similar hormonal changes each month, but one develops severe anxiety, depression, rage, hopelessness or suicidal thoughts while the other feels relatively unchanged, something must be shaping that difference. This study raises the possibility that genetics could be one part of the explanation.

Not the whole picture, but clearly an important piece of it.

A question I’m sitting with

After reading the paper, I keep coming back to two questions.

If hormone levels are generally normal in women with PMDD, what does that mean for the way we diagnose, treat and support the condition?

Could it be that we’ve spent too much time focusing on the hormones themselves, when we should also be paying much closer attention to how the brain responds to them?

Why this matters beyond the research

One of the things I love about science is that good studies rarely hand us a neat, simple answer. More often, they help us ask better questions and look at a condition in a more informed way.

For years, women with PMDD have been told they’re overreacting, that everyone gets PMS, or that what they’re experiencing is simply anxiety or depression. Research like this doesn’t prove that those experiences have a single genetic cause, but it does add to a growing body of evidence that PMDD has a genuine biological basis. The more we understand that biology, the more likely we are to improve diagnosis, develop better treatments and, perhaps most importantly, help women feel believed.

I also think this matters well beyond healthcare. I spend a lot of time working with organisations, and PMDD is still too often treated as an awareness issue rather than a workplace issue. If the condition involves a complex interaction between hormones, the brain and our underlying biology, then support at work needs to go further than simply acknowledging that it exists.

It means understanding how symptoms can affect concentration, emotional regulation, decision making, confidence and performance. It also means creating a culture where women feel able to explain what they’re experiencing and ask for support without worrying that they’ll be dismissed, judged or seen as less capable.

My biggest takeaway

For me, this study isn’t exciting because it tells us PMDD is genetic. It’s exciting because it adds another piece to a puzzle researchers have been trying to solve for decades.

When you step back and look at it alongside the growing body of PMDD research, a clearer picture is beginning to emerge. One that moves us away from outdated ideas that women are simply “bad at coping” with their hormones, and towards a much more sophisticated understanding of the relationship between genetics, the brain and the endocrine system.

We still have a long way to go. There are plenty of unanswered questions, and much more research is needed. But I genuinely hope, and believe, that we’re entering a really exciting chapter in women’s health research. If studies like this continue, our understanding of PMDD over the next decade could look very different from where it is today.

Perhaps the biggest question isn’t whether PMDD is genetic. It’s why normal hormonal changes can produce such profoundly different experiences in different women.

I have a feeling that’s where the next generation of research is heading, and I’ll certainly be following it closely.

Read the full study

Hysaj, E., Jahołkowski, P., Shadrin, A. A., Bergstedt, J., Lu, Y., Bertone-Johnson, E., Bulik, C. M., Landén, M., Sandin, S., Kowalec, K., Hägg, S., Di Florio, A., Goldman, D., Schmidt, P. J., Valdimarsdóttir, U. A., Andreassen, O. A., & Lu, D. (2026). Genome-Wide Association Study of Premenstrual Symptoms in Two Nordic Populations. Biological Psychiatry: Global Open Science, 100784. https://doi.org/10.1016/j.bpsgos.2026.100784

Want to understand this in more depth?

If you’re a coach, therapist, psychologist, healthcare professional or independent wellbeing practitioner and want to better understand how hormones interact with mental health, behaviour and performance, The Hormone-Informed Practitioner Programme is designed to help you bring this knowledge into your work safely and confidently.

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