The late-luteal leptin level, caloric intake and eating behaviors among women with premenstrual dysphoric disorder

Cognition and behaviour across the menstrual cycle in individuals with premenstrual dysphoric disorder - A systematic review

BACKGROUND

Premenstrual Dysphoric Disorder (PMDD) is a cyclical mood disorder whereby symptoms are triggered by normal hormonal changes during the menstrual cycle. A better understanding of psychological changes that occur with PMDD can inform non-pharmacological and non-invasive treatment interventions.

METHODS

A systematic review was conducted of quantitative studies that measured any aspect of cognition or behaviour at a minimum of two time points in the menstrual cycle in those with and without PMDD. A narrative synthesis is reported.

RESULTS

94 outcome measures were extracted from 21 papers and a total participant sample of 1222. Risk of bias was noted in relation to lack of power analysis and inappropriate statistical methods. Cognitive performance was most often tested but evidence of change with PMDD was limited and inconsistent. Findings of studies exploring cognitive processes and content suggest that a negative attentional bias is central to the psychological experience of PMDD.

LIMITATIONS

A quantitative synthesis could not be conducted due to limited reporting of key data.

CONCLUSIONS

Cognitive process, content, and behaviour are likely to be more informative in understanding PMDD than absolute cognitive abilities. Future studies should aim to investigate such in real-time and within the context of daily living.

Understanding comorbidity between eating disorder and premenstrual symptoms using a network analysis approach

Eating disorder symptoms are associated with ovarian hormones and fluctuate predictably across the menstrual cycle. However, the specific symptoms that underlie these associations remain unclear. The current study aims to examine which specific eating disorder and premenstrual symptoms confer risk and maintain comorbidity using network analysis. Eating disorder and premenstrual symptoms were measured using the Eating Pathology Symptoms Inventory and the Daily Record of Severity of Problems, respectively, in a large sample of young adult females. Network analysis was used to explicate the structure of eating and premenstrual symptom networks separately and together. Eating disorder networks replicated previous literature and identified body dissatisfaction as a core feature, but was unique in identifying monitoring calories as an additional core feature. Central symptoms identified in the premenstrual symptom network were symptoms interference with daily life and activities and negative emotions brought on by hormone changes. Bridge symptoms between networks were identified as relating to eating behaviors, interference with daily activities, joint and muscle pain, and negative emotions brought on by hormone changes. This study suggests that the links between eating disorder and premenstrual symptoms extend past their individual effects on eating behavior and are indicative of a shared underlying mechanism.

"Kambakutaisoto" and Emotional Instability Associated With Premenstrual Syndrome

Many women suffer from premenstrual syndrome (PMS), which can be considered a modern illness in this busy society; mental symptoms, such as irritability, often affect the surroundings and result in loss of self-confidence. The symptoms of PMS are diverse, and it is often difficult to treat psychiatric and social symptoms with low-dose estrogen progestin combination drug (LEP) alone. Selective serotonin reuptake inhibitors (SSRIs) are also effective; however, many are unable to take them owing to their side effects. “Kambakutaisoto” is a Kampo medicine consisting of “jujube,” “licorice,” and “wheat,” which is often described as “food”; however, it is highly effective in treating emotional instability attributed to PMS in sensitive young women. There are many reports on the effects of kambakutaisoto; the molecular nutritional findings of kambakutaisoto, which has dramatic effects despite its mild composition of crude drugs, have also been reported, suggesting an association with premenstrual exacerbation of functional hypoglycemia. A narrative review of its clinical effects on PMS and the results of molecular nutrition studies was performed.

Binge eating symptoms are associated with the severity of premenstrual symptoms among university students, cross sectional study from Palestine

BACKGROUND

Premenstrual syndrome (PMS) is considered one of the most prevailing disorders among childbearing age women that could considerably interfere with daily living activities life. PMS is underrecognized in Palestine. It is reported that binge eating symptoms are significantly related to premenstrual syndrome. In this regard, the study aimed to determine factors linked with premenstrual symptoms and to explore whether binge eating symptoms are linked with premenstrual syndrome.

METHODS

This descriptive study was performed among female undergraduates at Palestine Polytechnic University, using a cross-sectional design. A self-administrated questionnaire was used in order to collect data. Moreover, participants' nutritional status was assessed using anthropometric measurements. Descriptive statistics, independent t-test and Chi-square were performed.

RESULTS

A sum of 289 undergraduate females were involved in the final analysis. The results indicated that nearly half of undergraduates (47.8%) were classified as having binge eating symptoms. The most frequently noted premenstrual symptoms were lethargy, anger feelings, lack of interest, and anxiety. Chi-square analysis showed that moderate and severe psychological symptoms were significantly more prevalent among females with binge eating symptoms. Besides it was found that moderate and severe physical symptoms were significantly more prevalent among females with binge eating symptoms. Moreover, participants who reported no premenstrual syndrome symptoms were significantly less prevalent among females with binge eating symptoms. The findings also reveal that sociodemographic characteristics was not significantly correlated with premenstrual syndrome symptoms. In multiple adjusted models, both smoking (p < 0.05) and binge eating (p < 0.0001) were significantly related to PMS.

CONCLUSION

Findings reveals that moderate and severe psychological and physical symptoms were significantly more prevalent among females with binge eating symptoms. The current research also reported that the severity of PMS was not significantly related to sociodemographic variables.

Association of Premenstrual Dysphoric Disorder and Eating Behaviors Among Nursing Students: A Cross-Sectional Study

STUDY OBJECTIVE

Premenstrual dysphoric disorder (PMDD) is the most severe form for premenstrual distress. This study's objective was to understand the association among PMDD, premenstrual syndrome (PMS), and eating behaviors.

DESIGN

Cross-sectional design. The survey was composed of validated measures.

SETTING AND PARTICIPANTS

Female students at a nursing school.

MAIN OUTCOME MEASURES

PMDD and PMS diagnoses were made using the Premenstrual Symptoms Screening Tool (PSST). Eating behaviors were assessed using the Eating Attitudes Test (EAT-26) and the Three-Factor Eating Questionnaire-Revised 18 (TFEQ-R18).

RESULTS

Of the 504 participants, according to the PSST, 80 (15.9%) met the criteria for PMDD, 222 (44%) had moderate-to-severe PMS, and the remaining 202 (40%) participants showed mild or no premenstrual symptoms. The total EAT-26 scores were significantly higher in the PMDD group than in the other groups (P < .001). According to the cut-off value (20 points) of EAT-26, the total prevalence of disordered eating behaviors was also significantly higher in the PMDD group (45.5%) compared with the moderate-to-severe PMS group (16.5%) and the no/mild PMS group (13.6%) (P < .001). According to the TFEQ-R18 scores, significantly higher scores for emotional eating and uncontrolled eating were found in the PMDD group than in the other groups (P < .001 for each).

CONCLUSIONS

Given that PMDD is defined as a more severe form of PMS with more strict criteria, the findings in this study reflect that as the severity of premenstrual symptoms increase, disordered eating behaviors also increase. To the best of our knowledge, this is the first study to compare eating behaviors among PMDD, moderate-to-severe PMS, and no/mild PMS groups.

Leptin and ghrelin concentrations and eating behaviors during the early and late luteal phase in women with premenstrual dysphoric disorder

OBJECTIVES

In this study, we evaluated the changes in leptin and ghrelin concentrations, eating behavior, depression, and impulsivity and their correlations within the luteal phase among women with premenstrual dysphoric disorder (PMDD).

METHODS

In 63 women with PMDD and 53 healthy controls, we prospectively evaluated serum levels of leptin and ghrelin, Body Mass Index(BMI), and self-reported sweet cravings, cognitive restraint, uncontrolled eating, emotional eating, depression, and impulsivity during the early luteal (EL) and late luteal (LL) phases.

RESULTS

Compared with the controls, the women with PMDD had higher BMI, higher leptin concentrations in the EL and LL phase, and leptin concentrations increased from the EL to the LL phase. However, there is no significant difference in ghrelin. Women with PMDD increased sweet cravings and uncontrolled eating from EL to LL phase. No significant correlation was observed between the EL-LL changes in leptin or ghrelin concentrations and those in eating behaviors. Both depression and impulsivity correlated with sweet craving and uncontrolled eating. Depression mediated the association between PMDD and uncontrolled eating. The BMI of women with PMDD positively correlated with their EL-LL change in leptin, and LL depression levels and emotional eating.

CONCLUSION

Young women with PMDD had higher leptin concentrations and BMI in the luteal phase. The LL leptin level was not the primary factor responsible for the increased uncontrolled eating of PMDD. Whether the increased eating and depression in the LL phase contribute to the risk of obesity or hyperleptinemia among women with PMDD need to be evaluated in the future.

Association of premenstrual syndrome and premenstrual dysphoric disorder with bulimia nervosa and binge-eating disorder in a nationally representative epidemiological sample

OBJECTIVE

Bulimia nervosa (BN) and binge-eating disorder (BED) are associated with significant health impairment. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) comprise both psychological (disturbances in mood and affect) and physiological (bloating and changes in appetite) symptoms that may trigger binge-eating and/or purging.

METHOD

Female participants were drawn from the Collaborative Psychiatric Epidemiological Surveys, conducted from 2001 to 2003. Weighted multivariable logistic regression modeled the association between lifetime PMS and PMDD and lifetime odds of BN or BED.

RESULTS

Among 8,694 participants, 133 (1.0%) had BN and 185 (1.8%) BED. Additionally, 366 (4.2%) had PMDD and 3,489 (42.4%) had PMS. Prevalence of PMDD and PMS were 17.4 and 55.4% among those with BN, 10.7 and 48.9% among those with BED and 3.4 and 59.1% among those with subthreshold BED. After adjustment for age, race/ethnicity, income, education, body mass index, age at menarche, birth control use, and comorbid mental health conditions, PMDD was associated with seven times the odds of BN (OR 7.2, 95% CI 2.3, 22.4) and PMS with two times the odds of BN (OR 2.5, 95% CI 1.1, 5.7). Neither PMDD nor PMS were significantly associated with BED.

DISCUSSION

Women with PMS and PMDD have a higher odds of BN, independent of comorbid mental health conditions. PMS and PMDD may be important comorbidities to BN to consider in clinical settings, and future research should investigate whether PMS and PMDD affect the onset and duration of bulimic symptoms as well as the potential for shared risk factors across disorders. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:641-650).

Levels of Adipokines and Some Steroids During the Menstrual Cycle

The cyclical effects of hormones during the menstrual cycle (MC) are not just responsible for driving ovulation, but also have significant influence on dietary intake and appetite, as well as psychological and behavioral changes. The aim of our study was to describe changes and relationships between the MC and selected steroids, adipokines and food intake-related hormones. Twenty-seven women with regular menstrual cycles were included in the study, and their hormonal spectrum was measured in regular intervals starting from the first day of their cycle. Classical changes in gonadotropins, estrogens and progesterone during the menstrual cycle are accompanied by less striking but significant changes in 17-hydroxyprogesterone and testosterone. No significant changes show dehydroepiandrosterone and its 7-oxygenated metabolites. Adipokines show a tendency to increase during ovulation, while ghrelin and resistin decrease. There is also a remarkable association of sex hormone-binding globulin on the day of the cycle. Our results demonstrate that changes to adipokines during the menstrual cycle are not substantial, but nonetheless can play a role in the changes of food intake described in the literature. Precise descriptions of physiological changes in healthy women are important in helping us understand the significance of the changes accompanying various pathological states.