Effect of Aerobic Exercises in Improving Premenstrual Symptoms Among Healthy Women: A Systematic Review of Randomized Controlled Trials

Investigating the associations between chronotype, physical activity, premenstrual syndrome, hunger, and food choice among Turkish women

This study aimed to investigate the relationship between chronotype and premenstrual syndromes with food preferences and appetite among 931 women aged 18-40 who attended a private nutrition clinic in Istanbul. The survey data were analyzed using SPSS v27. Based on voluntary participation, questionnaires consisting of sociodemographic questions, the Morningness-Eveningness Questionnaire (MEQ), Premenstrual Syndrome Scale (PSS), Simplified Appetite Questionnaire (SAQ), International Physical Activity Questionnaire (Short Form) (IPAQ), and Food Choice Test (FCT) were administered to women. As the age of the participants increased, a decrease in the 'PSS Total' score and an increase in the 'MEQ Total' score were observed (p < 0.05). As the age of the participants increased, a decrease in the 'PSS Total' score and an increase in the 'MEQ Total' score were observed (p < 0.05). As body weight and BMI values increased, increases in the evening chronotype,'PSS Total', 'SAQ Total', and FCT's 'Price', 'Convenience', 'Weight Control', 'Natural Content', 'Health', and 'Emotional Appeal' scores, and 'MEQ Total' score decreased were observed (p < 0.05). As the 'SAQ Total' scores increase, the 'PSS Total' score also increases (p < 0.05), while the 'MEQ Total' score decreases (p < 0.01). The increase in the scores of the FCT sub-factors 'Health', 'Mood', 'Convenience', 'Emotional Appeal', 'Natural Content', 'Price', 'Weight Control', 'Ethical Concern', and 'Familiarity' caused an increase in the 'PSS Total' score (p < 0.05). As the FCT sub-factors 'Mood', 'Emotional Appeal', 'Convenience', and 'Price' scores increased, the 'MEQ Total' score decreased (p < 0.001). As the IPAQ total score increased, the 'MEQ Total' score also increased (p < 0.001), and there was no decrease in the 'PSS Total', 'SAQ Total', and FCT sub-factor scores. In conclusion, as PMS increased, physical activity scores decreased, appetite increased, and food preferences tended towards emotionally attractive foods and an evening chronotype.

The behavioral and physiological correlates of affective mood switching in premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD), a more severe manifestation of premenstrual syndrome (PMS), is characterized by emotional, behavioral, and physical symptoms that begin in the mid-to-late luteal phase of the menstrual cycle, when estradiol and progesterone levels precipitously decline, and remit after the onset of menses. Remotely monitoring physiologic variables associated with PMDD depression symptoms, such as heart rate variability (HRV), sleep, and physical activity, holds promise for developing an affective state prediction model. Switching into and out of depressive states is associated with an increased risk of suicide, and therefore, monitoring periods of affective switching may help mitigate risk. Management of other chronic health conditions, including cardiovascular disease and diabetes, has benefited from remote digital monitoring paradigms that enable patients and physicians to monitor symptoms in real-time and make behavioral and medication adjustments. PMDD is a chronic condition that may benefit from real-time, remote monitoring. However, clinical practice has not advanced to monitoring affective states in real-time. Identifying remote monitoring paradigms that can detect within-person affective state change may help facilitate later research on timely and efficacious interventions for individuals with PMDD. This narrative review synthesizes the current literature on behavioral and physiological correlates of PMDD suitable for remote monitoring during the menstrual cycle. The reliable measurement of heart rate variability (HRV), sleep, and physical activity, with existing wearable technology, suggests the potential of a remote monitoring paradigm in PMDD and other depressive disorders.

Effectiveness of 8-Week Exercise Programs in Improving Menstrual Characteristics in Female Adolescents in Saudi Arabia

Background: This study aimed to evaluate the effectiveness of 8-week exercise programs (aerobic, stretching, and aerobic plus stretching) in improving menstrual characteristics in female adolescents in Saudi Arabia. Methods: In this quasi-experimental study, seventy-eight healthy female adolescents aged 12-18 from secondary and high schools in Riyadh participated. Participants were divided into three groups and subjected to different types of exercises (aerobic, stretching, and aerobic plus stretching) for 20-30 min, three times a week. Menstrual pain, stress, and attitudes were assessed using the Numerical Rating Scale, Adolescent Stress Questionnaire Short Version, and Adolescent Menstrual Attitude Questionnaire, respectively. Assessments were conducted before the intervention and after the third menstrual period post-intervention. Results: The aerobic exercise group experienced a significant reduction in the mean length of the menstrual cycle (p = 0.025). The aerobic plus stretching group had the most significant reduction in mean menstrual pain scores (p < 0.0001). Stress scores were significantly reduced in the stretching group (p < 0.0001). Conclusion: We conclude that combining aerobic and stretching exercises significantly reduces menstrual pain, while aerobic exercise decreases menstrual cycle length and pain.

Impact of traditional Chinese Baduanjin exercise on menstrual health among international female students studying in China: a randomized controlled trial

Background

Menstrual symptoms were the common complaints of international female students during the acculturation period, and the symptoms negatively affected the daily life and school performance of those women. The present study aimed to evaluate the effectiveness of the traditional Chinese Baduanjin exercise on reducing menstrual symptoms for international female students studying in China during the acculturation period.

Methods

We conducted a randomized controlled trial among 62 international female students who suffered menstrual symptoms during the first 6 months after arriving in China. The study was carried out at three campuses of the two largest universities in the capital of a province in south-central China from March to October 2021. After screening, participants were randomly assigned to a control or intervention group. The intervention group engaged in 24 weeks of Baduanjin exercise for at least 30 min per day. The menstrual symptoms, sociocultural adaptation, perceived stress, and sleep quality were evaluated at baseline, the 12th week, and the 24th week. The chi-square test or Fisher's exact test, paired sample t-test, and multivariate analysis of variance (MANOVA)were adopted to analyze the data using SPSS 25.0.

Results

Totally, 62 participants were enrolled in this study from 30 countries. Their mean age was 27.87 ± 5.58 years. None of the participants reported an adverse event. The results of the MANOVA test showed that the traditional Chinese Baduanjin exercise reduced the total score of MSQ among international female students (intervention: 47.83 ± 8.71 vs. control: 65.12 ± 16.86; F = 19.49, P < 0.01). In addition, the results of the MANOVA indicated statistically significant decreases in scores for the two subscales of MSQ: premenstrual symptoms (intervention: 17.07 ± 3.33 vs. control: 28.42 ± 7.56; F = 44.70, P < 0.01)and menstrual pain (16.03 ± 4.53 vs. 19.58 ± 5.14; F = 6.50, P < 0.05). Moreover, the results showed that traditional Chinese Baduanjin exercise reduced the scores of the sociocultural adaptation level, the perceived stress level, and sleep quality and improved the blood progesterone hormone and blood estrogen hormone.

Conclusion

Regular Baduanjin exercise is a safe, acceptable, and effective form of exercise to promote international female students' menstrual health, reduce stress levels, and improve sleep quality.

Trial registration

www.chictr.org.cn, Chinese Clinical Trial Registry: ChiCTR2300072376.

Effects of a training intervention tailored to the menstrual cycle on endurance performance and hemodynamics

BACKGROUND

This study aimed to compare the effects of block periodized training and training adapted to the menstrual cycle (MC) phases on endurance performance, cardiovascular parameters, recovery, and MC-related symptoms in active females.

METHODS

Fourteen naturally menstruating, moderately trained females (age: 24±3 years; BMI: 22.3±2.7) were randomized into an intervention (INT) and a control (CON) group. Throughout an 8-week intervention period, both groups participated in a polarized training program. In the INT, the training sessions were adapted to the MC with higher training loads within the mid and late follicular phase. Before and after the intervention maximal oxygen consumption (VO2max), velocity and heart rate at ventilatory thresholds one and two (vVT1, vVT2, hrVT1, hrVT2), systolic and diastolic blood pressure (sBP, dBP), root mean square of successive RR interval differences (RMSSD), standard deviation of NN intervals (SDNN), pulse wave velocity (PWV), and the premenstrual assessment form (PAF) were assessed.

RESULTS

There were no significant time × group interaction effects in all physiological parameters (VO2max: P=0.890; vVT1: P=1.000; hrVT1: P=0.464; vVT2: P=0.356; hrVT2: P=0.762 sBP: P=0.948; dBP: P=0.203; RMSSD: P=0.257; SDNN: P=0.241; PWV: P=0.818), or psychological parameters (PAF: P=0.745).

CONCLUSIONS

Tailoring a polarized training program to the MC did not augment training responses compared to a regular training program in active females. However, a substantial portion of the training intervention in the CON was coincidentally matched to the MC.

Prevalence of premenstrual syndrome and its associations with dietary and other lifestyle factors among university female students in Dubai: A cross-sectional study

BACKGROUND

Premenstrual syndrome is a relatively prevalent condition that affects a significant number of menstruating women worldwide. It can range from mild to severe and may interfere with daily activities.

OBJECTIVE

This study aims to investigate the prevalence of premenstrual syndrome and its associated factors among female university students in Dubai.

DESIGN

This study was designed as a cross-sectional study.

METHODS

The analysis for this study involved 217 female university students (aged ⩾18 years old) who completed a self-reported online questionnaire. Participants were recruited through simple random sampling, and the study received ethical approval from the Zayed University Ethical Committee.

RESULTS

All participants reported that they experienced at least one premenstrual syndrome symptom with different levels of severity. The prevalence rate of psychological, physical, and behavioral symptoms was 83.0%, 79.4%, and 76.6%, respectively. The most frequently reported premenstrual psychological symptoms were loss of control (69.6%). Most reported physical premenstrual symptoms included lethargy/fatigue/decreased energy (56.7%); premenstrual syndrome symptoms interfered with participants' daily routines (45.2%). Normal body mass index, no smoking, milk consumption, cruciferous vegetables, fruits, animal foods, fish oil supplements, and no fast-food consumption were all significant factors associated with decreasing premenstrual syndrome.

CONCLUSIONS

Premenstrual syndrome is a common menstrual disorder among university students that interferes with their daily routines. Dietary habits and other lifestyle factors were highly related to premenstrual syndrome. Therefore, health promotion programs are highly recommended to encourage healthy diets and lifestyles for females as early as adolescence at the school level.

Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity

Most women who menstruate experience various physical, psychological, and behavioral changes during the period between ovulation and menstruation. This study focuses on defining and diagnosing premenstrual disorders, distinguishing between premenstrual symptoms (PS), PMS, and premenstrual dysphoric disorder (PMDD). It highlights the prevalence of these conditions and their impact on women's quality of life, including social, occupational, and psychological aspects. Furthermore, the study examines the role of physical activity, particularly aerobic exercise, in managing premenstrual symptoms. Several systematic reviews are cited, suggesting that regular physical activity can effectively reduce both physical and psychological symptoms associated with PMS. In conclusion, the management of PMS involves a multifaceted approach, with exercises, dietary modifications, stress management, cognitive-behavioral therapy, and medications all playing roles. Physical activity, especially aerobic exercise, has been found to be an effective non-pharmacological therapy for alleviating PMS symptoms and improving overall well-being. However, more research is needed to determine the optimal type and dosage of exercise for individual women with PMS.

Effects of Pilates on Pain, Physical Function, Sleep Quality, and Psychological Factors in Young Women with Dysmenorrhea: A Preliminary Randomized Controlled Study

The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms, premenstrual syndrome, and risk factors of dysmenorrhea. Thirty young women with primary dysmenorrhea were randomly assigned into a Pilates group (PG; n = 15) and a waitlist control group (CG; n = 15). The Pilates was performed twice a week for 12 weeks. Menstrual pain and symptoms were measured by visual analogue scale (VAS) and the Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed using the premenstrual symptoms screening tool (PSST). Additionally, back flexibility, hip muscle strength, sleep duration and quality, perceived stress, state-trait anxiety, and depression were evaluated. The VAS, CMSS severity and frequency, and PSST symptoms and functional impairments decreased in the PG compared to the CG (p < 0.001 or p < 0.01) with large effect sizes. Back flexibility and the strength of hip flexors, hip extensors, and hip abductors significantly increased in the PG compared to the CG (all p < 0.01) with large effect sizes. Sleep quality (p < 0.01) and stress (p < 0.05) improved in the PG. Sleep duration, anxiety, and depression did not change in either group. In conclusion, the 12-week Pilates intervention ameliorates dysmenorrhea, partly mediated by improved physical function and sleep quality.

Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms

Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.

Effects of Yoga for Coping with Premenstrual Symptoms in Taiwan-A Cluster Randomized Study

Home-based yoga practice has not been approved as a method for alleviating premenstrual symptoms in Taiwan. This study was a cluster randomized trial. A total of 128 women self-reporting at least one premenstrual symptom were enrolled in the study, of which there were 65 participants in the experimental group and 63 participants in the control group. Women in the yoga group were provided with a yoga DVD program (30 min) to practice for three menstrual months, at least three times a week. All participants were given the Daily Record of Severity of Problems (DRSP) form to measure premenstrual symptoms. After the yoga exercise intervention, the yoga group had statistically significantly fewer and/or less severe premenstrual depressive symptoms, physical symptoms, and anger/irritability. Other disturbances and the impairment of daily routine, hobbies/social activities, and relationships also occurred significantly less often in the yoga group. The study found that yoga is useful to relieve premenstrual symptoms. Moreover, home-based yoga practice is more pertinent in the pandemic era. The strengths and drawbacks of the study are discussed and further study is recommended.

The relationship between physical activity and premenstrual syndrome in senior high school students: a prospective study

Reproductive-aged women experience somatic and affective symptoms of premenstrual syndrome (PMS) which affect their daily life and work, but there are limited tracking data on senior high school-age female students. To investigate the characteristics and incidence of PMS, and to detect the relationship between physical exercise participation and PMS in female students of senior high school. A prospective study was conducted among senior high school female students aged 14-16 years. The participant was asked to finish two questionnaires. One questionnaire collected information about demographic data and PMS symptoms which were recorded on a daily calendar named Daily Record of Severity of Problems (DRSP) per day. Another questionnaire was physical exercises participation questionnaire, collecting times of physical education (PE) class participation, exercise times, exercise type participation in morning exercise and recess exercise, times of morning exercise, times of recess exercise per week, recess exercise time, and autonomous exercise participation of students. The data were prospectively recorded for three consecutive months. Odds ratio (OR) with 95% confidence intervals (CI) was performed for results of the multivariate logistic regression analysis model. A total of 233 participants completed the prospective study, 78 (33.5%) participants experienced PMS. The incidence of the participants with mild PMS was 20.2% while moderate PMS was 11.6% and severe PMS was 1.7%. The most common somatic symptom was fatigue while the most common affective symptom was cannot concentrate. Participants with PE classes less than 2 times per week were 4.43 times (OR 4.43, 95% CI 1.18-16.6, p < 0.05) more possible to experience PMS than those with 2 times PE classes per week. PMS is a frequent phenomenon in senior high school female students. Female students with 2 times PE classes per week show a lower incidence of PMS. This study encouraged senior high school-age females to take more physical exercises per week and could be helpful to create a no-pharmacology coping strategy.