Evening primrose oil for perimenopause mood: does it work?

No trial has tested evening primrose oil for mood specifically in perimenopause. The closest evidence comes from premenstrual syndrome, and a 2021 review suggests some women may have a similar hormone-sensitivity pattern in perimenopause.

There, the results don't support it. A 1996 systematic review of PMS trials concluded evening primrose oil was of little value for managing symptoms, and the two best-controlled trials found no benefit over placebo.

The authors noted the trials were small, so a modest effect couldn't be fully ruled out. Nothing since has changed that picture.

For stronger trial evidence on perimenopause mood specifically, see perimenopause mood swing treatment, which covers SSRIs and cognitive behavioral therapy. Evening primrose oil may still help other symptoms, but the research doesn't support a mood effect yet.

The evidence against evening primrose oil for premenstrual and perimenopausal mood symptoms is fairly consistent.

None of these trials recruited perimenopausal women reporting mood symptoms specifically, so even this evidence is indirect. For more on the mood question specifically, see evening primrose oil and mood.

If a supplement is going to help, expect some signal within two to three menstrual cycles. Most evening primrose oil trials for PMS ran anywhere from two to six cycles total.

In the 1990 trial, symptom scores dropped fastest in the first cycle, in both the treatment and placebo groups. That's part of why researchers concluded the improvement wasn't coming from the oil itself.

That timeline matters when you're deciding whether to keep taking it. If nothing's shifted after two or three cycles of daily use, a fourth cycle is unlikely to be different.

For general guidance on timing across different symptoms, see how long evening primrose oil takes to work.

Evening primrose oil is generally well tolerated at typical doses.

• Stomach upset
• Nausea
• Loose stools
• Headache

These are the most commonly reported side effects, and they're usually mild. If a side effect doesn't ease, stop taking it.

Gamma-linolenic acid, the active compound in evening primrose oil, affects inflammation and blood clotting. It's worth paying attention to any new symptoms rather than assuming they're unrelated.

For the full list of reported effects, see evening primrose oil side effects.

Ask first if any of these apply to you, since gamma-linolenic acid can affect clotting and may lower the seizure threshold:

• You're on blood-thinning medication
• You have a seizure disorder
• You're pregnant or trying to conceive

If you're already taking other supplements or prescriptions for perimenopause symptoms, mention evening primrose oil to whoever manages your prescriptions so they can flag any interactions.

See a doctor if mood symptoms take a week or more of most months, or if you have thoughts of hurting yourself. Bring two months of daily notes so the pattern is clear from the start.

Guidelines for perimenopausal mood changes favor options with more evidence behind them than evening primrose oil:

• SSRIs, which some people take every day and others only during the days symptoms show up
• Certain hormonal treatments
• Cognitive behavioral therapy

A 2021 review found that women with a history of PMDD can be more sensitive to the hormone shifts of perimenopause. That may explain why mood symptoms resurface or get worse during this transition, even in people who'd been stable for years before it.

A doctor decides which of these fits your history and current symptoms. For the fuller picture, read perimenopause mood changes.

Evening primrose oil won't do anything for you in the next ten minutes, and that's fine. The moment you're in usually needs something faster.

1. Leave the room
2. Set a timer for 20 minutes
3. Let the immediate reaction pass before you decide what to say or do next

Writing down exactly what happened, in order, often makes it easier to see which part is the hormone shift and which part is a real problem worth addressing.

Niyora is a PMS and PMDD support app. If you want somewhere to put the fight before you answer, Niyora's Moon lets you write what happened, see it from another angle and draft a reply you can hold for 20 minutes before sending it.

For other ideas to try alongside supplements, see PMS supplements: what actually helps.