Premenstrual Dysphoric Disorder Affects Five Times as Many Individuals as Postpartum Depression,But Receives 80% Less NIH Research Funding

Premenstrual dysphoric disorder (PMDD) and postpartum depression are both reproductive affective disorders. Postpartum depression affects approximately 12% ¹ of the 3.66 million births ² in the U.S. annually, amounting to 440,130 women affected per year. PMDD affects 3–8% ³ of all reproductive aged women. Conservatively estimating 3% of women aged 15–50 (n = 77,449,729), ⁴ this amounts to 2.32 million women in the U.S. affected by PMDD per year. Thus, annually PMDD affects over 2 million U.S. women, compared with only 440,130 affected by postpartum depression. This makes PMDD more than 5 times more common than postpartum depression in terms of number of individuals affected. However, National Institutes of Health (NIH) funding of research on PMDD is starkly lower than funding of postpartum depression research. According to NIH RePORTER, there are currently 139 active studies funded by NIH on postpartum depression, while there are only nine studies funded on PMDD. (Search parameters were Fiscal Year: Active projects; Text Search: “premenstrual dysphoric disorder,” “postpartum depression”; Limit Project search to: Project title, Project terms, Project abstracts.) Thus, postpartum depression receives more than 15 times the amount of grants as PMDD, even though PMDD affects vastly more women in the US than postpartum depression. In terms of dollars, the total amount of NIH funding awarded to postpartum depression studies is $60.7 million, while the total amount awarded to PMDD studies is $11.3 million for active projects in NIH RePORTER. Therefore, postpartum depression receives over 5 times the NIH research dollars as PMDD. This translates into 80% less funding for PMDD than postpartum depression. Per-1-million-individuals-affected, NIH funds 316 postpartum depression studies, but only four PMDD studies, a 79-fold difference. In fact, rate of funding for postpartum depression dwarfs that of major depression, which affects 21 million Americans per year ⁵ ; NIH funds 34 studies per-1-million-Americans-affected with major depression. Given the more than 2 million American women affected by PMDD, NIH might consider improving its investment in research on this understudied and overlooked disorder.

In addition to the nearly 2 million with PMDD, many others experience premenstrual mood changes that are significant but not impairing to the level of PMDD, occurring within the context of premenstrual syndrome (PMS). ³ In addition, studies suggest around 60% of the 13 million American women who have major depression ⁵ experience premenstrual exacerbation of mood symptoms, ⁶ amounting to over 7 million women affected. While postpartum depression is certainly an important women’s health issue, only a fraction of women undergoes pregnancy and childbirth, ⁷ whereas all biological women with ovaries and a uterus experience monthly menstrual cycles and eventually perimenopause. Experiencing a menstrual cycle or perimenopause is a more universal experience than pregnancy and childbirth among women. Postpartum depression appropriately receives significant focus and funding within the area of women’s mental health; however, women’s mental health also matters outside the context of pregnancy or childbearing. A recent analysis of research publications found that women’s health research in general medical journals tended to focus on reproductive health, particularly pregnancy. ⁸ With the recent White House executive order that aims to prioritize funding for women’s health research, NIH should also consider menstrual cycle related mental health, including PMDD, PMS, and premenstrual exacerbation of psychiatric illness.