TMS Therapy For Women: A Non-drug Approach To Hormonal Depression and Anxiety

Why Women's Mental Health Matters

Women are almost twice as likely to experience depression during their lifetime (Kuehner., 2017), due to a complex interplay of biological, hormonal and social factors. Hormonal fluctuations linked to reproductive transitions including the menstrual cycle, pregnancy, postpartum period, and menopause can significantly influence mood and emotional wellbeing (Kundakovic et al., 2022).

These physiological changes often overlap with major life events, such as caregiving responsibilities, relationship changes, and work-related stress, which can further affect mental health (Turner et al., 2004).

Certain mental health conditions disproportionately affect women, such as premenstrual dysphoric disorder (PMDD) and postpartum depression. Yet, these conditions are frequently underdiagnosed or dismissed as “normal hormonal changes,” leaving many women to suffer in silence without the help and support they need (Falana et al., 2019).

While antidepressants remain a first-line treatment, side effects or a preference for non-pharmacological approaches lead many women to seek alternatives. Transcranial Magnetic Stimulation (TMS) is one such option — a safe, evidence-based, non-invasive treatment that offers hope for people looking for an effective, medication-free approach to improving mental health. Clinics like Smart TMS specialise in providing TMS for women seeking targeted support for hormonal depression and anxiety.

What is TMS therapy and how does it work?

TMS is an NICE-approved, non-invasive brain stimulation treatment used for treatment-resistant depression and other mood disorders. It works by delivering magnetic pulses to specific areas of the brain, such as the prefrontal cortex — areas that are often underactive in individuals with depression (McClintock et al., 2018).

For women seeking an effective, medication-free approach, TMS for depression and TMS for anxiety offers a scientifically validated alternative to traditional therapies. While much of the research on TMS has focused on major depressive disorder in mixed-gender populations, emerging evidence suggests it may also be effective for mood disorders linked to hormonal changes in women.

Clinical trials and systematic reviews have shown that TMS can significantly reduce depressive symptoms, improve cognitive function, and enhance quality of life, even in cases where standard treatments have not been successful (McClintock et al., 2018; Lefaucheur et al., 2020). More targeted research in female-specific mental health conditions is underway, but the current findings are promising.

TMS For Women At Different Life Stages

TMS For Premenstrual Dysphoric Disorder (PMDD)

PMDD is a severe mood disorder occurring in the luteal phase of the menstrual cycle — the days leading up to menstruation — with symptoms such as irritability, low mood, anxiety, and physical discomfort. It affects approximately 1.8–5.8% of menstruating women (Reilly et al., 2024) and can significantly disrupt work, relationships, and quality of life.

Early research suggests that TMS for women with PMDD may be beneficial. In a recent pilot study, women with PMDD receiving TMS reported significant improvements across multiple symptom domains including mood, anxiety, sleep, and physical symptoms (Thomas et al., 2025). While evidence is still emerging, these results highlight the potential of TMS as a treatment option for PMDD pending further research.

TMS For Postnatal Depression

Postnatal depression is a form of depression that can occur any time within the first year after childbirth, affecting more than one in every ten women. Many women do not realise they have postnatal depression as it can develop gradually and negatively affects both physical and mental health.

Symptoms include persistent low mood, fatigue, loss of interest, difficulty sleeping, social withdrawal, and intrusive or distressing thoughts (NHS., 2022). These symptoms can impact caregiving abilities, quality of mother-infant interaction and family functioning (Ganho-Avila et al., 2019).

A meta-analysis by Wang et al. (2023) found that TMS for depression significantly improved depressive symptoms and cognitive performance in women with postpartum depression. Research also indicates that TMS is safe, well tolerated, and does not interfere with lactation in postpartum women (Cox et al., 2020). These findings position TMS as a promising non-pharmacological option for postpartum depression.

TMS For Perimenopause And Menopause Mood Changes

Perimenopause (the transition to menopause) and menopause bring significant hormonal shifts, particularly in oestrogen and progesterone levels, which can contribute to mood disturbances, irritability, anxiety, and depression. These symptoms may occur alongside physical changes such as hot flushes, sexual problems, sleep disruption, and fatigue, which impact daily life (Riecher-Rossler., 2020).

The considerable symptom overlap with depressive and anxiety disorders provides a strong rationale for increasing research into TMS for anxiety and depression during this life stage.

Traditional treatment options often include hormone replacement therapy (HRT) or antidepressants. However, these may not be suitable for all women due to medical contraindications, side effects, or personal preference. Smart TMS provides a drug-free alternative that directly targets brain regions involved in mood regulation, offering potential relief without hormonal interference.

Conclusion - A New Chapter in Women's Mental Health

TMS therapy is paving the way for a new era in women’s mental health care. Whether you're a new mother, navigating menopause, or simply seeking an alternative to antidepressants, TMS for women offers a promising, non-pharmaceutical path to healing.

While TMS is not yet considered a first-line treatment for many of these conditions, its growing evidence base and favourable safety profile make it an important option for women seeking alternatives to medication.

Get in touch with Smart TMS today to arrange your personalised TMS assessment. Our experienced team can help determine if TMS for depression or TMS for anxiety is right for you, supporting you at every stage of your mental health journey. Book your consultation now and take the first step towards lasting change.

References 

1. Kuehner, C. (2017). Why is depression more common among women than among men?. The lancet psychiatry, 4(2), 146-158. 
2. Riecher-Rössler, A. (2020). Menopause and mental health. In Mental health and illness of women (pp. 147-173). Singapore: Springer Singapore. 
3. Falana, S. D., & Carrington, J. M. (2019). Postpartum Depression: Are You Listening?. The Nursing clinics of North America, 54(4), 561–567. https://doi.org/10.1016/j.cnur.2019.07.006 
4. Kundakovic, M., & Rocks, D. (2022). Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms. Frontiers in neuroendocrinology, 66, 101010. https://doi.org/10.1016/j.yfrne.2022.101010 
5. Turner, M. J., Killian, T. S., & Cain, R. (2004). Life course transitions and depressive symptoms among women in midlife. International journal of aging & human development, 58(4), 241–265. https://doi.org/10.2190/4CUU-KDKC-2XAD-HY0W 
6. McClintock, S. M., Reti, I. M., Carpenter, L. L., McDonald, W. M., Dubin, M., Taylor, S. F., ... & Lisanby, S. H. (2018). Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. The Journal of clinical psychiatry, 79(1), 16cs10905. 
7. Ganho-Avila, A., Poleszczyk, A., Mohamed, M. M., & Osorio, A. (2019). Efficacy of rTMS in decreasing postnatal depression symptoms: a systematic review. Psychiatry Research, 279, 315-322. 
8. Wang, T., Wu, H., Jiang, Y., Huang, W., Yu, D., Zhang, X., & Mu, Q. (2023). Effects of rTMS in postpartum depression: a meta-analysis. The Journal for Nurse Practitioners, 19(2), 104488. 
9. NHS. (2022, August 4). Overview – Postnatal depression. NHS UK. https://www.nhs.uk/mental-health/conditions/post-natal-depression/overview/ 
10. Cox, E. Q., Killenberg, S., Frische, R., McClure, R., Hill, M., Jenson, J., ... & Meltzer-Brody, S. E. (2020). Repetitive transcranial magnetic stimulation for the treatment of postpartum depression. Journal of affective disorders, 264, 193-200. 
11. Reilly, T. J., Patel, S., Unachukwu, I. C., Knox, C. L., Wilson, C. A., Craig, M. C., ... & Cullen, A. E. (2024). The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis. Journal of affective disorders, 349, 534-540. 
12. Thomas, E., Gurvich, C., & Chen, L. (2025). Theta Burst Transcranial Magnetic Stimulation to Treat Premenstrual Dysphoric Disorder: An Open Label Pilot Study. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 18(1), 378. 
13. Lefaucheur, J. P., Aleman, A., Baeken, C., Benninger, D. H., Brunelin, J., Di Lazzaro, V., Filipović, S. R., Grefkes, C., Hasan, A., Hummel, F. C., Jääskeläinen, S. K., Langguth, B., Leocani, L., Londero, A., Nardone, R., Nguyen, J. P., Nyffeler, T., Oliveira-Maia, A. J., Oliviero, A., Padberg, F., … Ziemann, U. (2020). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 131(2), 474–528. https://doi.org/10.1016/j.clinph.2019.11.002 
14. Trapp, N. T., Purgianto, A., Taylor, J. J., Singh, M. K., Oberman, L. M., Mickey, B. J., Youssef, N. A., Solzbacher, D., Zebley, B., Cabrera, L. Y., Conroy, S., Cristancho, M., Richards, J. R., Flood, M. J., Barbour, T., Blumberger, D. M., Taylor, S. F., Feifel, D., Reti, I. M., McClintock, S. M., … National Network of Depression Centers Neuromodulation Task Group (2025). Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 170, 206–233. https://doi.org/10.1016/j.clinph.2024.12.015