The characteristics of 100 women presenting to a gynecological clinic with premenstrual complaints

Women's sleep in health and disease

A huge amount of knowledge about sleep has accumulated during the last 5 decades following the discovery of rapid eye movement (REM) sleep. Nevertheless, there are numerous areas of considerable ignorance. One of these concerns the particularities of sleep in women. Most basic and clinical studies have been performed in male subjects, and only very recently research groups around the world have addressed women's sleep in health and disease. In this review, we summarize the present knowledge on the influence of oestrogens on the brain and on the distinctive changes of sleep across the menstrual cycle, during pregnancy and menopause. In addition, studies in female rodents are reviewed as well as the knowledge on female peculiarities regarding the interactions between sleep regulation and age-related changes in circadian rhythms. We also address specific aspects of sleep loss and sleep disorders in women. Finally, very recent studies on the sociology of sleep are summarized and future directions in the field are discussed.

Psychosocial and Lifestyle Correlates of Premenstrual Symptoms among Military Women

BACKGROUND

This study examines the prevalence and correlates of self-reported premenstrual symptoms among a large, population-based sample of reproductive age, active-duty women.

METHODS

Data were obtained from a combined dataset of two large-scale mail surveys designed to represent the total force. Subjects included in the present study were 6026 active-duty women of all branches of military service stratified by service, paygrade group, race/ethnicity, and location. A multivariate approach is used to evaluate the interrelationships among psychosocial and lifestyle correlates of premenstrual symptoms or pain after controlling for demographic differences in women who reported premenstrual symptoms or pain during the past 3 months (cases) and those who did not (controls).

RESULTS

Premenstrual symptoms were reported by nearly 2 of every 3 reproductive age women. Women reporting premenstrual symptoms were more likely to report other symptoms of menstrual dysfunction, two or more current medical conditions, migraines, and healthcare provider visits in the past year. After controlling for the protective effects of taking Depo-Provera (Upjohn, Kalamazoo, MI) and ever being pregnant, younger age, trying to lose weight, heavier drinking, poorer self-perceived health, and overall job stress were the most significant predictors of premenstrual symptoms. The greatest risk factor was a high level of job stress, with an almost 3-fold increase in risk relative to those without symptoms.

CONCLUSIONS

Work stress may mediate the relationship among depression and premenstrual symptoms. Further research is needed to elucidate the biological interrelationships among work stress, hormonal function, and premenstrual symptomatology.

Management of premenstrual dysphoric disorder

Premenstrual dysphoric disorder is a complex disorder characterized by severe physical and psychological symptoms. The pathophysiology and effective treatment of premenstrual dysphoric disorder are presented. Evidence for the effective treatment of premenstrual dysphoric disorder by correction of neuroendocrine abnormalities or suppression of cyclical ovarian activity is reviewed.

Relationships of premenstrual dysphoric disorder to major depression and anxiety disorders: a re-examination

Clarifying the relationships of premenstrual dysphoric disorder (PMDD) to depressive and anxiety disorders may contribute to the understanding of risk factors and etiologies associated with the disorders. A current belief is that women with PMDD have a higher percentage of past psychiatric disorders than women without the disorder, an assumption that may be premature. This review carefully examines existing literature on the nature of the relationships between PMDD and major depression and anxiety disorders. A re-evaluation of the literature and the resulting implications for risk factors and etiology, as well as for obstetric and gynecological practice, are provided.

Exploring the bio-psycho--social approach to premenstrual experiences

A bio-psycho-social approach to the premenstrual syndrome suggests that cyclical hormonal changes are acknowledged and interpreted in light of the expectations and the attitudes acquired in the process of socialization. In this study, attitudes toward menstruation and premenstrual experiences of 229 Israeli students of different ethnic groups and gender role orientations were explored. The findings were consistent with previous reports: attitudes toward menstruation and premenstrual experiences were associated with exposure to premenstrual symptoms in women family members and negative messages during adolescence; respondents of a more traditional background perceived menstruation as relatively debilitating and bothersome but also a natural event and reported more severe experiences. However, models aimed at estimating the causal relationship indicated that attitudes toward menstruation depend on premenstrual experiences rather than predict them. The difficulties of investigating such reciprocal relationships of menstrual attitudes and premenstrual experiences cross-culturally and longitudinally are discussed.

Influence of premenstrual syndrome on family, social life, and work performance

Premenstrual syndrome is characterized by mental and physical symptoms that vary with different phases of the menstrual cycle. Symptoms start shortly after ovulation, increase in severity, and reach a maximum during the last five premenstrual days. After the onset of menstrual bleeding, the symptoms rapidly disappear and are usually gone within three to four days. Diagnostic procedures using prospective daily symptom ratings have recently been developed, allowing a more precise diagnosis of the cyclical mood changes and leading to a clearer picture and definition of the condition. Results from community studies show that the severity of the cyclical mood changes varies within a population of women of fertile age, from those having no cyclical mood changes to those severely handicapped by the symptoms for 14 days of the month. The severity assessment of subjective symptoms is difficult since severity is difficult to compare among individuals. In this article the authors review the different approaches to estimating severity of premenstrual syndrome and compare the different approaches with approaches used for other conditions with subjective symptoms. Two possible approaches are discussed in detail. One measures symptoms by counting the number of days with and without symptoms. The other estimates how much the symptoms affect patients' family life, social life, and work performance. Differences between retrospective and prospective assessments are also discussed.