Hormonal Mood Disorders in Women: Health Care Delivery Experiences Across the Reproductive Life Course and Associations with Mental Health Outcomes

Purpose: The aims of this study were to (1) examine experiences of health care delivery and quality of care among women with hormonal mood disorders across the reproductive life course, and (2) investigate the associations of these factors with mental health status related to their hormonal mood disorder. Methods: Participants (467) with a self-reported diagnosis of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) or perimenopausal depression completed an online survey between June 2023 and September 2023. We performed a factor analysis to explore the underlying structure of items measuring perceptions of health care experiences. Descriptive statistics and logistic regression models were conducted to examine reported health care delivery and quality of care for hormonal mood disorders across the reproductive life course and associations with mental health status related to their hormonal mood disorder. Results: Nearly two-thirds of women with PMS/PMDD (62%) and over one in three with perimenopausal depression (41%) consulted more than one provider for medical help and underwent delays in diagnosis and treatment for more than one year (58% and 35%, respectively). Patients indicated negative health care experiences and quality of care across the reproductive life course. Among those, both patients with PMS/PMDD and patients with perimenopausal depression were almost three and four times more likely, respectively, to report fair/poor reproductive mental health outcomes. Discussion: This research offers insight into understanding reported deficiencies in health care delivery and quality of care for hormonal mood disorders and strategies for how to improve women’s mental health outcomes across the reproductive life course.