The influence of the menstrual cycle on neuropsychiatric and physical symptoms has been widely studied in various psychiatric illnesses. However, research concerning Tourette Syndrome (TS) and menstruation remains notably limited and inconclusive. This gap in understanding is underscored by conflicting findings from earlier studies.
A 1992 study reported that 34% of female respondents experienced tic fluctuations linked to their menstrual cycles. Yet, a subsequent 2001 study found no significant relationship between menstrual cycle-related hormonal changes and tic symptoms across its participants. For over two decades, there has been no further published exploration of this topic, leaving these discrepant results unresolved.
To address this, a recent study aimed to assess tic changes across the menstrual cycle and identify clinical predictors of tic fluctuations in adult females with TS. The methods involved an online survey completed by 112 out of 315 eligible female adults with TS. Participants shared details about their age of TS symptom onset, history of obsessive-compulsive disorder (OCD) and attention-deficit/ hyperactivity disorder (ADHD) diagnoses, and current tic symptoms and severity. They also retrospectively reported fluctuations in tics and other physical and psychiatric symptoms throughout their menstrual cycle.
The results showed that 26% of the 112 respondents reported tic changes in relation to their menstrual cycles. Statistical analysis revealed that higher current tic severity and impairment, along with co-occurring cycle-related mood and anxiety changes, significantly predicted the presence of self-reported tic fluctuations during the menstrual cycle.
In discussion, these findings suggest that some females with TS do experience changes in tic symptoms during their menstrual cycles. However, the complex relationships between the menstrual cycle, tics, and other psychiatric symptoms require further research for clarification.
It is worth noting that this study had some limitations such less than half of eligible participants responded and their hormonal status remained unknown (e.g. use of contraceptives). The responders could have not remembered the exact symptoms during the menstruation, and it is also possible that individuals who noted worsening of their tics in relation to menstruation were more likely to participate in the survey than those who did not.
Summary of: Relationships between the menstrual cycle and neuropsychiatric and physical symptoms in females with Tourette syndrome
Daisy T Noriega-Makarskyy, Evan Realbuto, Ariadne Kaylor, Lisa Osiecki, Angela Essa, Dongmei Yu, Cornelia Illmann, Carol A Mathews, Jeremiah M Scharf.
Front Neurol 2025;16:1500766. doi: 10.3389/fneur.2025.1500766. eCollection 2025.