Trait and Phasic Emotion Regulation Strategies in Women with Premenstrual Syndrome and Premenstrual Dysphoric Disorder

Background: Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are characterized by cyclical affective symptoms. Studies have begun to investigate the mechanisms underlying these symptoms, placing a key focus on emotion regulation. However, it remains unclear how emotion regulation is involved in PMS/PMDD.Aim: This review aims to (1) examine the relationship between PMS severity and trait-level use of emotion regulation strategies, (2) characterize differences in emotion regulation strategies across menstrual phases between women with PMS/PMDD and those with no/mild PMS. Method: Eligible studies were initially identified through CINAHL, ProQuest, PsycNet, PubMed, Scopus, and Web of Science in February 2025 and last identified in November 2025. Risk of bias was assessed using the Downs & Black instrument.Results: PMS severity was positively correlated with trait-level use of maladaptive emotion regulation strategies (e.g., suppression, rumination, catastrophizing, and self-blame) and negatively correlated with trait-level use of adaptive strategies (e.g., acceptance and reappraisal). Women with PMS/PMDD habitually relied more on maladaptive strategies (e.g., catastrophizing and rumination) and less on adaptive strategies (e.g., awareness, acceptance, and reappraisal) compared to women without PMS/PMDD. Interestingly, acceptance, awareness, and rumination showed significant phase-dependent fluctuations across the menstrual cycle. Women with PMS/PMDD exhibited lower state acceptance and awareness and higher state rumination during the luteal phase relative to the follicular phase. No phase-related differences were observed in women without PMS/PMDD.Conclusions: Women with PMS used more maladaptive emotion regulation strategies and fewer adaptive emotion regulation strategies. Several of these strategies fluctuate across the menstrual cycle, which may constitute a hallmark feature of PMS and PMDD. These results highlight the importance of evaluating menstrual cycle–linked emotion regulation when differentiating PMS/PMDD from other mood disorders.