Questionnaire Studies of Paramenstrual Symptoms

Mood and Well-Being in Consecutive Menstrual Cycles

The level of consistency of cyclical change in well-being between consecutive menstrual cycles has important methodological, clinical, and theoretical implications. In this study, 109 women completed daily diaries of mood and physical well-being for two consecutive menstrual cycles. Scores in equivalent cycle phases were highly correlated, but the degree and direction of change from the pre-post menstrual phase were less consistent between cycles. Physical experiences proved more consistent across cycles than did emotional ones. Only 5.4% (nonsteroidal contraceptive users) and 7.8% (oral contraceptive users) of Cycle 2 emotional score variance could be accounted for by Cycle 1 scores compared to 15% and 22%, respectively, for physical scores. The data indicate that premenstrual experiences vary between menstrual cycles, and suggest that they cannot be adequately explained on the basis of simple biological determinism. Methodological and theoretical implications of the results are discussed.

Perceived stress and severity of perimenstrual symptoms: the BioCycle Study

OBJECTIVE

To examine the longitudinal relation between perceived stress in the previous month and perimenstrual symptom severity across two cycles among regularly menstruating, healthy women (n = 259).

METHODS

At baseline (11 days before the first cycle), participants completed the 4-item Perceived Stress Scale (PSS) for the previous month (first cycle exposure) and questionnaires on lifestyle factors. On cycle day 22 of a standardized 28-day cycle, participants again completed the PSS for the previous week (second cycle exposure) and each week rated the severity (none, mild, moderate, severe) of 17 psychological and physical symptoms (e.g., crying, cramping, pain). Mixed models estimated the association between perceived stress scores and number of moderate/severe symptoms and symptom severity scores, allowing both stress and perimenstrual symptoms to vary by cycle.

RESULTS

Adjusting for age, education, passive and active smoking, and waist/height ratio (WHtR), high stress (fourth quartile PSS) was associated with an increased risk of reporting >or=8 or more (OR 7.2, 3.3-15.8) and >or=5 (OR 2.5, 1.6-4.1) symptoms as moderate/severe during the perimenstrual period compared with lower stress (quartiles one, two, and three). Stress scores were positively (p < 0.0001) associated with increased symptom severity scores for total, psychological, and physical symptoms.

CONCLUSIONS

These analyses show that higher perceived stress precedes an increased severity of perimenstrual symptoms. Stress reduction programs may be an effective, nonpharmaceutical treatment for physical and psychological symptom relief.

Assessing the assessment measures for menstrual cycle symptoms: a guide for researchers and clinicians

A review of measures of menstrual cycle symptoms is provided. This will enable researchers and clinicians to make the appropriate choice of method for their study requirements. In recent years, these measures have taken the form of retrospective questionnaires (rating severity of symptoms from memory) and prospective diaries (daily checklists of symptoms). Many of these draw on aspects of the well-known retrospective questionnaires, the Menstrual Distress Questionnaire and Premenstrual Assessment Form, in their development and validation. Each measure will be briefly described, followed by comments on its development, psychometric properties and finally an evaluation of its strengths and weaknesses. It concludes with an examination of the implications arising from the review, and some recommendations that menstrual cycle researchers and clinicians may wish to consider, as they decide upon the most appropriate measure for their needs.

What are young undergraduate women's qualitative experiences of the menstrual cycle?

The dominant ideology of the premenstrual woman is that of a person who has no control over her moods, cognition and behaviour because of her fluctuating hormone levels. The social influence of this stereotype has been put forward as an explanation for discrepancies between retrospective and prospective accounts of premenstrual experiences. However, recent research has found that women can and do distinguish between their own experience and that of the stereotype. What their own experience is (positive as well as negative) was the question that we set out to answer in this study. Nine undergraduate women were interviewed about their menstrual cycle experiences. Using qualitative analysis of their subjective accounts, a clear distinction between self and other premenstrual experiences emerged. While the women did experience premenstrual symptoms, they considered them to be relatively minor in comparison to what they defined as premenstrual syndrome. Furthermore, none of them had previously considered any positive menstrual cycle related experiences but the management of menstruation was emphatically viewed as a 'hassle'. We conclude that women can and do distinguish their own experience from the premenstrual stereotype and this needs to be recognized in the treatment setting; there is a lack of positive discourse for the menstrual cycle which needs to be developed and more attention needs to be paid to menstrual management because it is of great concern to women but is currently not discussed openly.

The premenstrual syndrome: a brief history

This paper describes the origins and development of the modern concept of premenstrual syndrome (PMS). Symptoms associated with the premenstrual phase of the menstrual cycle have been acknowledged by physicians and in the general culture for little more than 60 years, while the notion that they define a clinical syndrome is exactly 40 years old. These symptoms are experienced as being primarily psychological (with emotional, somatic and behavioural components), their aetiology is as yet not known, their prevalence varies widely across different cultural groups, and they appear to respond to inactive placebos as effectively as to active preparations. However, the empirical basis for PMS is unclear, and the very use of the term 'syndrome' in this context has a number of connotations about which at least some researchers are exceedingly sceptical.

PREMENSTRUAL SYMPTOMS AND THE FEMALE EMPLOYEE

A survey was taken of working women concerning any premenstrual symptoms they may have experienced and the self-reported effects) on their job productivity. The sample consisted of n = 197 completed survey instruments. The most commonly listed symptoms (listed by more than 50% of the respondents) were: irritability, bloating, mood changes, depression, weight gain, headaches, and anger. These symptoms were reported as affecting job performance by 57% of the women and 40% indicated feeling less productive during the onset of premenstrual symptoms. The symptoms of mood changes, irritability, anger, and depression were significantly correlated with lower job performance as reported by the women. When the sample was divided into three groups based on age, there were no significant differences in the reporting of premenstrual symptoms and the severity of the symptoms. However, the three groups did show significant differences in the way the symptoms were reported to have affected their job performance. The younger group of women had a significantly higher proportion of respondents reporting that their premenstrual symptoms were adversely affecting their lives and job performance/productivity. Finally, when the sample was divided between managerial and non-managerial women, no significant differences were found.