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To characterize the temporal dynamics of portable digital-marker across the menstrual cycle and its biological basis in PMDs, we investigated the menstrual fluctuation of wearable device-based real-time heart rate variability (HRV) through menstrual cycles and its associations with premenstrual disorders (PMDs) symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective study of female participants nested from the Care of Premenstrual Emotion Cohort was conducted. Daily HRV metrics were collected by the Huawei Fitness Tracker over 1\u20132 menstrual cycles. PMDs symptoms were assessed with the Daily Record of Severity of Problems on a daily basis. HRV variability across cycles was described using descriptive statistics and splines, while associations between HRV metrics and PMDs symptoms were estimated using a mixed-effect model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 193 participants (with 68 prospectively confirmed PMDs) were included, with measures from 293 menstrual cycles. In both women with and without PMDs, SDNN, rMSSD, and HF decreased before menses and increased afterwards; the increase trends were more pronounced in women without PMDs. During the week before or after menses, levels of these HRV metrics were inversely associated with PMDs symptoms among women with PMDs (e.g., rMSSD, postmenstrual week, \u03b2 = -0\u00b7036 per SD, 95% CI: -0\u00b7065 to -0\u00b7048), whereas null association was noted for those without PMDs (\u03b2 = -0\u00b7001, 95% CI -0\u00b7011 to 0\u00b7009;\n                      <jats:italic>P<\/jats:italic>\n                      -for-difference\u2009&lt;\u20090\u00b7001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Wearable device-estimated HRV fluctuate across menstrual cycles, with varying strengths of association with PMDs symptoms between individuals with and without PMDs, which may facilitate the development of digital biomarkers for future PMDs diagnostics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00737-026-01740-z","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T07:11:18Z","timestamp":1783408278000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Wearable-measured heart rate variability and premenstrual disorder symptoms across menstrual cycle"],"prefix":"10.1007","volume":"29","author":[{"given":"Qing","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"1740_CR3","doi-asserted-by":"publisher","unstructured":"Abbas K, Usman G, Ahmed M et al (2020) Physical and psychological symptoms associated with premenstrual syndrome and their impact on the daily routine of women in a low socioeconomic status locality. 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All data collection, storage, and analysis procedures were designed to protect participants\u2019 anonymity, and participants were compensated for their participation. In addition, each participant signed a hard copy of the informed consent form, which has been securely stored at West China Hospital, Sichuan University. The COPE study was approved by the Institutional Review Board of West China Hospital, Sichuan University (No. 2023\u2009\u2212\u2009179) on September 19, 2022.","order":2,"name":"Ethics","label":"Ethical statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This manuscript has been submitted as a preprint on medRxiv at\n                      \n                      ,\n                      \n                      .","order":3,"name":"Ethics","label":"<b>Reprints and permission information<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"106"}}