Association Between Smoking and Premenstrual Syndrome: A Meta-Analysis

Understanding premenstrual syndrome: experiences and influences among monastir university students

Menstrual health is increasingly recognized as a critical health issue by the World Health Organization, encompassing physical, psychological, and social dimensions. Approximately 1.8 billion women globally experience menstruation, with severe hormonal fluctuations leading to premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD), which significantly affects quality of life. This study investigates PMS symptoms among university students in Monastir (Tunisia) through a descriptive cross-sectional design involving 150 participants. Data was collected via a semi-structured questionnaire, assessing sociodemographic information and PMS symptoms using the validated A-PMS diagnostic tool. Results indicated that 100 % of participants experienced PMS, with 69.3 % reporting moderate to severe physical symptoms such as fatigue and pain, while 65.3 % noted significant psychological symptoms including anxiety and mood swings. Over half of the students reported mild impacts of PMS on relationships and academic performance, with 48 % experiencing absenteeism due to symptoms. Despite the prevalence of symptoms, the majority did not seek medical help. The findings highlight the critical need for educational institutions and healthcare professionals to address PMS and implement support strategies, thereby enhancing the well-being and academic success of young women. This research underscores the importance of raising awareness and developing effective interventions for menstrual health in this population.

Correlates of Premenstrual Syndrome in Polish Adolescents-Results from POLKA 18 Youth-Led Cross-Sectional Study

Objectives: This study aims to evaluate the prevalence of premenstrual syndrome (PMS) among Polish adolescents and explore its associations with mental health outcomes, lifestyle factors, and risk behaviours. Additionally, it seeks to examine the impact of PMS on quality of life, contributing to the foundation for initiatives that enhance adolescent menstrual health. Methods: This research is part of the POLKA 18 study, a youth-led cross-sectional survey conducted between April and December 2019. Final-year high school students were surveyed using paper-based, self-reported questionnaires. Statistical analysis was performed using the R programming language in RStudio, with a significance threshold of p-value < 0.05. Results: A total of 1545 valid responses were analysed. PMS was reported by 33.9% of respondents, with over 80% experiencing premenstrual symptoms. Adolescents with negative mental health outcomes, such as self-harm or suicidal ideation, were significantly more likely to report PMS (p ≤ 0.001). PMS was also strongly associated with anxiety and panic attacks (p < 0.001). Risk behaviours, including smoking (p = 0.006), illicit substance use (p < 0.01), and increased alcohol consumption in the past 30 days (p < 0.001), were more prevalent among adolescents with PMS. Furthermore, respondents with PMS reported poorer school performance (p = 0.002), higher stress levels (p < 0.001), and a more negative perception of their overall health (p < 0.001) compared to peers without PMS. Conclusions: PMS is significantly associated with mental health issues, engagement in risky behaviours, higher stress, and diminished self-perceived health and academic performance. These findings highlight the need for further research and the development of targeted interventions to improve adolescent menstrual health.

The predictive role of common symptoms of premenstrual syndrome in the clinical practice of nurses: a cross-sectional study

BACKGROUND

Female nurses with high occupational stress are one of the groups at risk of premenstrual syndrome (PMS). The symptoms of this syndrome may affect the reduction of work efficiency, accuracy in doing work, concentration, and increased absenteeism of nurses and can lead to significant economic losses. This study aimed to determine the predictive role of common PMS symptoms in the clinical performance of nurses in public hospitals in Sanandaj, Iran.

METHODS

The present study was a descriptive-analytical and cross-sectional study. In this study, 318 nurses participated in the census method based on the inclusion criteria. Data collection tools were premenstrual symptom screening questionnaires and nurses' clinical performance evaluations. Data analysis was done with Spearman's correlation tests, simple linear regression, multiple regression, t-test, one-way variance analysis, Tukey's post hoc tests, and LSD using SPSS version 22 statistical software.

RESULTS

The average PMS score of the participants was 30.8 ± 11.45, which indicates severe PMS. Nurses' average clinical performance score was 45.78 ± 35.29, indicating an average performance. The findings showed that PMS has a significant inverse correlation with clinical performance and its components. Simple linear regression showed that PMS can predict 26.5% of nurses' clinical performance variance. Simple regression showed that with an increase of one standard deviation in the PMS score, the nurses' clinical performance score decreased by 0.517 standard deviations and vice versa. However, by controlling confounding variables, with an increase of one standard deviation in the PMS score, the clinical performance score of nurses will decrease by 0.396 standard deviations and vice versa.

CONCLUSIONS

Paying attention to reducing or controlling PMS symptoms may help improve nurses' performance. Therefore, hospital and nursing managers can improve the performance and efficiency of their workforce by identifying nurses and other employees suffering from PMS and planning and using different methods to reduce its symptoms.

Effect of progressive muscle relaxation exercises on symptoms of premenstrual syndrome: A single-blind randomızed controlled trial

AIM

This study was carried out to determine the effect of progressive muscle relaxation exercises (PMR) on premenstrual syndrome (PMS) symptoms.

METHODS

The study was designed in a single-blind randomized controlled type. The study was conducted in a hospital in Western Türkiye. Seventy-nine single women who experienced PMS who met the inclusion criteria were randomly assigned to the experimental group in which PMR would be applied, and the control group to continue their routine coping habits regarding PMS. PMR were applied to the experimental group every day for 8 weeks. At the end of 8 weeks, the experimental and control groups were re-evaluated with the Premenstrual Syndrome Scale (PMSS).

RESULTS

At the beginning of the study, it was observed that the individual, health characteristics and PMSS mean scores of the women in the experimental and control groups were similar (p > 0.05). At the end of eight weeks, it was seen that the mean PMSS score of the experimental group was lower than that of the control group, and the difference was statistically significant (p < 0.001). When in-group comparisons were made at the end of the exercise program, no significant difference was found in the mean PMSS score of the control group compared to the beginning (p > 0.05). The PMSS score of the experimental group decreased significantly and the difference was statistically significant (p < 0.001).

CONCLUSION

In this study, it was seen that PMR were effective in improving PMS.

Premature ovarian insufficiency: a review on the role of tobacco smoke, its clinical harm, and treatment

Premature ovarian insufficiency (POI) is a condition in which the quantity of follicles and the quality of oocytes gradually decrease. This results in an estrogen secretion disorder and abnormal follicle development, which can lead to related diseases, early onset of menopause, sexual dysfunction, and an increased risk of cardiovascular issues, osteoporosis, and depression, among others. This disease significantly impacts the physical and mental health and overall quality of life of affected women. Factors such as genetic abnormalities, oophorectomy, radiotherapy for malignancy, idiopathic conditions, and an unhealthy lifestyle, including smoking, can accelerate the depletion of the follicular pool and the onset of menopause. Extensive research has been conducted on the detrimental effects of tobacco smoke on the ovaries. This article aims to review the advancements in understanding the impact of tobacco smoke on POI, both in vivo and in vitro. Furthermore, we explore the potential adverse effects of common toxicants found in tobacco smoke, such as polycyclic aromatic hydrocarbons (PAHs), heavy metals like cadmium, alkaloids like nicotine and its major metabolite cotinine, benzo[a]pyrene, and aromatic amines. In addition to discussing the toxicants, this article also reviews the complications associated with POI and the current state of research and application of treatment methods. These findings will contribute to the development of more precise treatments for POI, offering theoretical support for enhancing the long-term quality of life for women affected by this condition.

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.

Development and validation of risk prediction model for premenstrual syndrome in nurses: results from the nurses-based the TARGET cohort study

Objective

Premenstrual syndrome (PMS) stands as a significant concern within the realm gynecological disorders, profoundly impacting women of childbearing age in China. However, the elusive nature of its risk factors necessitates investigation. This study, therefore, is dedicated to unraveling the intricacies of PMS by focusing on nurses, a cohort with unique occupational stressors, to develop and validate a predictive model for assessing the risk of PMS.

Methods

This investigation employed a multi-center cross-sectional analysis drawing upon data from the TARGET Nurses' health cohort. Utilizing online survey versions of the Premenstrual Syndrome Scale (PMSS), a comprehensive dataset encompassing physiological, social, psychological, occupational, and behavioral variables was collected from 18,645 participants. A stepwise multivariate logistic regression analysis was conducted to identify independent risk factors for PMS. Furthermore, a refined variable selection process was executed, combining the Least Absolute Shrinkage and Selection Operator (LASSO) method with 10-fold cross-validation. The visualization of the risk prediction model was achieved through a nomogram, and its performance was evaluated using the C index, receiver operating characteristic (ROC) curves, and the calibration curves.

Results

Among the diverse variables explored, this study identified several noteworthy predictors of PMS in nurses, including tea or coffee consumption, sleep quality, menstrual cycle regularity, intermenstrual bleeding episodes, dysmenorrhea severity, experiences of workplace bullying, trait coping style, anxiety, depression and perceived stress levels. The prediction model exhibited robust discriminatory power, with an area under the curve of 0.765 for the training set and 0.769 for the test set. Furthermore, the calibration curve underscored the model's high degree of alignment with observed outcomes.

Conclusion

The developed model showcases exceptional accuracy in identifying nurses at risk of PMS. This early alert system holds potential to significantly enhance nurses' well-being and underscore the importance of professional support.

The prevalence, risk factors and lifestyle patterns of Jordanian females with premenstrual syndrome: a cross-sectional study

Aim

The study aims to assess factors associated with premenstrual syndrome (PMS) and the frequency of using painkillers to relieve premenstrual pain.

Methods

This is a cross-sectional study of 1580 premenopausal women. An online self-administered questionnaire consists of sociodemographics, and the diagnostic criteria using the Arabic Premenstrual Syndrome Scale (A-PMS).

Results

The prevalence of PMS among Jordanian females was 94%. Moreover, a significant correlation was found between several factors, including BMI, family history of PMS, smoking, and herbal tea consumption and the psychological, physical and behavioral symptoms of PMS. Furthermore, analgesic use for pain relief and food cravings were significantly associated with psychological, physical and behavioral PMS symptoms.

Conclusion

PMS is highly prevalent and affects women in different life aspects.

The longitudinal predictive effect of self-reported frequency of premenstrual syndrome on depression: Findings from the Australian Longitudinal Study on Women's Health

Background

Previous studies have revealed a high comorbidity between premenstrual syndrome (PMS) and depression; however, whether PMS can longitudinally predict depression has not been examined in large sample studies.

Methods

This study surveyed 8,133 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Participants completed seven repeated measurements at 3-year intervals starting in 2000 (aged 22-27 years). Binary logistic and multivariate ordered logistic regression models were used to examine the predictive role of self-reported frequency of PMS symptoms in 2000 on self-reported diagnosis of depression and frequency of depressive symptoms, respectively, for each follow-up survey.

Results

Self-reported frequency of PMS symptoms in the year 2000 predicted self-reported diagnosis of depression in most follow-up surveys. Specifically, compared to women who reported "never" had PMS symptoms in 2000, those who reported "often" had them were more likely to report a diagnosis of depression in 2006 (OR = 1.72), 2012 (OR = 1.88), 2015 (OR = 1.49), and 2018 (OR = 1.90); and those who reported "sometimes" had PMS symptoms in 2000 were more likely to report a diagnosis of depression in 2012 (OR =1.37) and 2018 (OR = 1.59). Furthermore, self-reported frequency of PMS symptoms in 2000 predicted self-reported frequency of depressive symptoms in each follow-up survey. Compared to women who reported "never" had PMS symptoms in 2000, those who reported "sometimes", or "often", had PMS symptoms reported depressive symptoms more frequently.

Conclusion

Self-reported frequency of PMS can predict the self-reported frequency of depressive symptoms and the subsequent diagnosis of depression.

Dietary, Psychological and Lifestyle Factors Associated with Premenstrual Symptoms

Purpose

To measure the associations of diet, psycological distress, and lifestyle factors with premenstrual symptoms (PMSx) in women in Riyadh, Saudi Arabia.

Patients and Methods

An interview-based, cross-sectional study was conducted on 1831 women aged 18-50 years seen in primary healthcare centers and teaching institutes in Riyadh from December 2015 to June 2016. Question topics included sociodemographics, physical activity, smoking, and dietary habits information. PMSx were assessed using a symptom checklist with 6 domains: anxiety/mood changes; abdominal/back/joint pain; increased appetite/weight gain, breast pain/tenderness, severe headache, and ≥3 PMS symptoms (any). Multivariable logistic regression analyses were conducted to provide adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for factors associated with each PMSx domain.

Results

Except for breast pain, drinking >5 cups of Arabic coffee was associated with increased odds of anxiety/mood [aOR 2.44 (95% CI 1.44, 4.12)], pain [1.83 (1.13, 2.98)], appetite/weight gain [1.66 (1.10, 2.50)], headache [1.57 (1.00, 2.56)] and ≥3 symptoms [1.50 (1.07, 2.11)]. A significant association was noted between sugar intake and anxiety/mood symptoms [1.53 (1.07, 2.19)] and abdominal/back pain symptoms [1.84 (1.17, 2.88)]. Increased severity of psychological distress was associated with all symptom domains: anxiety/mood [2.75 (1.92, 3.94)]; pain [1.45 (0.92, 2.28)]; appetite/weight gain [2.01 (1.53, 2.65)]; breast pain [2.19 (1.68, 2.88)]; headache [1.86 (1.37, 2.54)] and ≥3 symptoms [3.52 (2.49, 4.95)]. Low physical activity was significantly associated with odds of breast pain symptoms [1.29 (1.04, 1.59)]. Smokers were 3.41 (1.19, 9.77) times as likely to report any ≥3 symptoms compared to nonsmokers.

Conclusion

Several potentially modifiable factors, such as diet and stress, were positively associated with PMSx. Thus, we suggest that increasing women's awareness of healthy lifestyles, particularly diet and stress reduction, may help to reduce the occurrence of premenstrual symptoms.

Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase of the menstrual cycle and impair daily life activities and relationships. Depending on the type and severity of physical, emotional or behavioral symptoms, women of reproductive age followed for at least two prospective menstrual cycles may receive one of the two diagnoses. PMDD is the most severe form of PMS, predominantly characterized by emotional and behavioral symptoms not due to another psychiatric disorder. PMS and PMDD are common neuro-hormonal gynecological disorders with a multifaceted etiology. Gonadal steroid hormones and their metabolites influence a plethora of biological systems involved in the occurrence of specific symptoms, but there is no doubt that PMS/PMDD are centrally based disorders. A more sensitive neuroendocrine threshold to cyclical variations of estrogens and progesterone under physiological and hormonal therapies is present. Moreover, altered brain sensitivity to allopregnanolone, a metabolite of progesterone produced after ovulation potentiating GABA activity, along with an impairment of opioid and serotoninergic systems, may justify the occurrence of emotional and behavioral symptoms. Even neuro-inflammation expressed via the GABAergic system is under investigation as an etiological factor of PMS/PMDD. Pharmacological management aims to stabilize hormonal fluctuations and to restore the neuroendocrine balance. The rationale of suppressing ovulation supports prescription of combined hormonal contraception (CHC). Its effect on mood is highly variable and depends on biochemical characteristics of exogenous steroids and on type and severity of symptoms. Hormonal regimens reducing the estrogen-free interval or suppressing menstruation seem better choices. Psychoactive agents, such as serotonin reuptake inhibitors (SSRIs), are effective in reducing the symptoms of PMS/PMDD and may be prescribed continuously or only during the luteal phase. Novel therapeutic approaches include inhibition of progesterone receptors in the brain, i.e., with ulipristal acetate, reduced conversion of progesterone with dutasteride, and modulation of the action of allopregnanolone on the brain GABAergic system with sepranolone.

Suicidality in patients with premenstrual dysphoric disorder-A systematic review and meta-analysis

BACKGROUND

Whether premenstrual dysphoric disorder (PMDD) is correlated with the risk of suicidality and the extent of its effect on suicidality are unclear. The present study was conducted to elucidate the association between PMDD and suicidality from relevant studies.

METHODS

Four electronic databases, namely, Scopus, Embase, PubMed, and Web of Science, were searched from inception to November 15, 2020. Quality assessment, data synthesis, and sensitivity analysis were performed on the included studies.

RESULTS

Six studies with 8 532 participants were included in this meta-analysis. PMDD was associated with an increased risk of suicidal ideation (odds ratio [OR]=2.34, 95% confidence interval [CI]=1.50-3.18, I²=0.0%, p=0.99, k=4). Patients with PMDD had a greater risk of experiencing suicide attempt (OR=2.13, 95% CI=1.05-3.21, I²=0.0%, p=0.81, k=5). PMDD was associated with an increased risk of suicidal plan (OR=2.24, 95% CI=1.03-3.45, I²=0.0%, p=0.96, k=2).

LIMITATIONS

The diagnosis of PMDD should be considered "provisional" in all the included studies.

CONCLUSIONS

Among PMDD sufferers there would be a group of particularly suicidal women. Clinicians who treat patients with PMDD should be vigilant for signs of suicidal ideation and behavior to implement better treatment and preventive measures.