This research adds to the scarce evidence on the long-term consequences of premenstrual disorders on the health of women of reproductive age, particularly on the risk of mortality. It should be remembered that both premenstrual syndrome and premenstrual dysphoric disorder are characterised by the cyclical presence of a wide variety of affective, somatic and behavioural symptoms in the week before menstruation, with a major negative impact on the quality of life of the young women who suffer from them. Despite being common, their exact aetiology is unknown and their diagnosis can be delayed for years. For all these reasons, the World Health Organisation considers them a public health problem in modern societies. 

Using a matched cohort study with a follow-up of up to 18 years, the authors analysed Swedish national health and population registers, comparing a group of women diagnosed with these disorders with a control group, i.e. unaffected women. The comparative analysis reveals that women with premenstrual disorders do not have an increased risk of mortality from all causes, including natural causes, unless they were diagnosed before the age of 25, in which case the risk more than doubles.  

In relation to non-natural causes, the results show an elevated risk of suicide, regardless of age at diagnosis. These findings confirm previous evidence of high suicide prevalence in premenstrual disorders, but also raise new questions to be explored in future research. For example, why women with menstrual disorders have a lower risk of death from natural causes, particularly cardiovascular events. In this regard, the authors point to the potential cardioprotective effect of first-choice treatments for these conditions, such as selective serotonin reuptake inhibitors with antidepressant effect, or hormone replacement therapy. Other factors associated with this observation could be a greater concern for health, which would imply greater contact with the health system, treatment of co-morbidities and behavioural changes. 

However, it should not be forgotten that some of the limitations of the study, such as possible errors in the classification of both study groups, or the unavailability of data related to other confounding factors (smoking, body mass index, etc.), could also influence the results obtained. Finally, the findings may not be fully extrapolable to other countries, due to differences in socio-demographic and cultural characteristics. 

In any case, as the authors conclude, this research supports the importance of careful follow-up of young women with premenstrual disorders, as well as the need to develop suicide prevention strategies for these conditions. Hence, once again, it is necessary to insist that, in order to meet Sustainable Development Goals 3 and 5 - ‘Good Health and Well-being’ and ‘Gender Equality’, respectively - promulgated by the World Health Organisation, the scientific community must join forces to advance in the knowledge of various aspects related to women's health, which are still unknown in the 21st century.