Background: Premenstrual Dysphoric Disorder (PMDD) is a depressive disorder that occurs in a cyclical pattern due to hormonal changes in the menstrual cycle. Symptoms are most severe during the premenstrual phase, with existing treatments providing limited relief. Theta burst stimulation (TBS) has demonstrated efficacy in treating depression and may be a promising approach to treating mood and other psychological symptoms of PMDD.

Methods: Twelve women with PMDD completed the Daily Record of Severity of Problems (DRSP), a measure of daily PMDD symptoms, every day for a three-month period. Months 1 and 2 were defined as the pre-treatment phase. During Month 3, the treatment phase, participants received daily 10-minute sessions of prolonged intermittent TBS (piTBS) over 5 continuous days during their premenstrual phase (determined by an ovulation test), delivered at an intensity of 120% of their resting motor threshold.

Results: There was a decrease in premenstrual symptom elevation of the total DRSP from pre-treatment (25.03%) to treatment phase (9.96%). Looking at each DRSP symptom domain, premenstrual symptom elevation decreased from pretreatment to treatment phase across all domains; depression (23.67% to 9.62%), anxiety (23.96% to 10.93%), mood lability (30.21% to 12.86%), anger (26.28% to 14.39%), interest (29.16% to 17.32%), concentration (27.29% to 10.20%), lethargy (31.65% to 3.59%), appetite (27.99% to 7.92%), sleep (24.58% to 1.95%), overwhelmed (21.26% to 12.21%) and physical symptoms (20.47% to 9.91%).

Conclusion: These preliminary findings demonstrate that piTBS reduces symptom elevation (i.e. improves symptoms) during the premenstrual phase and may be an effective treatment for women with PMDD.