Prevalence and predictors of premenstrual syndrome among college-aged women in Saudi Arabia

Prevalence, Pattern, and Predictors of Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) in Asir Region, Saudi Arabia

BACKGROUND

The prevalence and consequences of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) among Saudi women are not well understood. Consequently, the purpose of this research is to ascertain the frequency, course, and contributing factors of PMDD and PMS in the Asir area of Saudi Arabia.

METHODS

A cross-sectional study was conducted in Asir, Saudi Arabia, using a pre-designed questionnaire distributed among adult female patients to five primary healthcare facilities (PHCs) that were chosen at random in the Asir Region. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS, version 15).

RESULTS

The study included 506 participants; 81% of them were Saudi and 19% were non-Saudi. A percentage (46.2%) of the participants were aged between 21 and 30 years old. A total of 369 (72.9%) participants have PMS. Regarding PMS symptoms, 79.1% reported mood changes, 59.3% tantrums, 56.7% change in appetite, 47% acne, 41.9% back and joint pain, and 43.1% reported sleep disorders. Almost half (42.1%) of the participants receive treatment to relieve the symptoms of PMS (72% of them receive paracetamol and 6.1% receive nonsteroidal anti-inflammatory drugs (NSAIDs)). Some (6.4%) exercise during the menstrual cycle to relieve symptoms of PMS, while 31% eat healthy foods at the time of period to relieve the symptoms of PMS.

CONCLUSION

The prevalence of PMS/PMDD was among the reported figures worldwide. There was a significant association between age and the use of contraceptives with symptoms of PMS/PMDD among the studied sample.

Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors

Premenstrual Syndrome (PMS) is a disorder between gynecology and psychiatry which includes cognitive, affective, and somatic symptoms from mild to severe. The most severe form of PMS is premenstrual dysphoric disorder (PMDD) and it is considered a form of depressive disorder. An association between diet composition and the occurrence of PMS and its severity have been suggested. As such, this manuscript discusses the relationships between diet composition, dietary patterns and eating behaviors, and PMS. PubMed, Embase, Cochrane, and Web of Science databases were searched for related studies up to 18 January 2024. A text search with the following keywords singly or in combination was conducted: "Premenstrual syndrome", "Nutrition", "Diet composition", "Dietary patterns", and "Eating behaviors". Studies published so far showed that low intake of simple carbohydrates, fats, salt, and alcohol, and high of fresh, unprocessed foods rich in B vitamins, vitamin D, zinc, calcium, and omega-3 fatty acids may help prevent the onset of PMS and reduce the severity of its symptoms. However, further studies are needed to formulate definitive recommendations for the use of vitamins, micronutrients and other dietary ingredients supplementation in women with PMS to improve functioning, overall well-being, and physical health. Large, randomized, double-blind clinical trials across diverse populations are necessary to formulate clear recommendations for supplementation in women with PMS.

Effects of a Healthy Diet on Reducing Symptoms of Premenstrual Syndrome and Improving Quality of Life among Omani Adolescents: A Randomized Controlled Open-Label Trial

Premenstrual syndrome (PMS) continues to impact the health outcomes and emotional well-being of reproductive-age women, globally. Several studies have provided conflicting evidence concerning the role of dietary approaches in improving PMS symptoms. Accordingly, this study aimed to evaluate the possible influence of a healthy diet and motivational strategies on PMS symptoms and health-related quality of life among Omani adolescents. This open-label, randomized, prospective controlled trial was conducted at two randomly selected secondary schools, in Al Seeb Willayah, in Muscat region. Adolescents with PMS symptoms, who were in grade 10 or 11, aged 16 years or above, had regular menstrual cycles, and were not known to have psychiatric disorder were included in this study. Participants in the intervention group received an individual face-to-face dietary consultation and motivational phone consultation. The health outcomes, including the PMS symptoms in both groups, and quality of life, were recorded using the Daily Record of Severity of Problems questionnaire (DRSP) and the 14-item Self-Reporting-Based Perceived Stress Scale tools, respectively. The primary outcome was the difference in the mean premenstrual symptom scores between the two groups. Secondary outcomes included the quality of life and stress levels of participants. The study period was from 1 February and ended 30 June 2021. SPSS was used to analyze the data, and intention-to-treat analysis was utilized. A total of 72 adolescents with PMS were randomized into intervention and control groups (n = 36 each). Both groups were similar at baseline (p-value > 0.05). No significant association was found between a healthy diet and PMS symptoms (p-value > 0.05). In addition, no significant association was found between a healthy diet and quality of life at follow-up (p-value = 0.216). The outcomes of this study refuted any possible relationships between a healthy diet and PMS symptoms. Accordingly, dietary consultations may not facilitate the clinical management of PMS symptoms in adolescent females.

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.

Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis

This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≥ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04−1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01−2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04−0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13−1.45), family history of PD (OR: 3.80; 95% CI: 2.18−6.61), stress (OR: 1.88; 95% CI: 1.30−2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04−1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16−1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01−3.54) and smoking (OR: 1.94; 95% CI: 1.08−3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04−3.50) and smoking (OR: 1.86; 95% CI: 1.31−2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health.

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.

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

Background

Premenstrual symptoms in women of reproductive age are associated with substantial distress and functional impairments. A healthy lifestyle is the first step to manage premenstrual symptoms. Recreational physical activities have been recommended as an alternative to medical management in easing premenstrual symptoms.

Objective

The objective of this systematic review is to analyze the effects of aerobic exercises in improving premenstrual symptoms among healthy women.

Methods

Randomized controlled trials (RCTs) published from inception to February 2022, were searched using keywords in electronic databases such as, SCOPUS, PubMed, PEDro, Cochrane and web of science. RCTs published in English, comparing the effects of aerobic exercise with other interventions or controls were included. PEDro scale and Cochrane collaboration tool for risk of bias was used to assess the methodological quality of included trials. Data from the included study and the participant’s characteristics, interventions, outcome and results were extracted.

Results

Five RCTs with 492 participants were included in this systematic review. Methodological quality assessed by PEDro (4.8/10) and Cochrane collaboration tool for risk of bias were moderate. Allocation concealment, blinding of participants and outcome assessors were the most common bias in all included studies. Walking, swimming and running were the common aerobic exercises performed in the RCTs. Aerobic exercise is effective in improving physical physiological symptoms among women with premenstrual syndrome (PMS).

Conclusion

Aerobic exercises are effective in improving premenstrual symptoms. This review provides moderate evidence for improving hematological parameters during PMS. Further RCTs with long term follow up and quality of life would consolidate our findings.

Licit Substance Use and Premenstrual Syndrome Symptom Severity in Female College Students

INTRODUCTION

Premenstrual syndrome (PMS) affects the majority of women and is characterized by physical, behavioral, and mood symptoms, which can have a profound impact on quality of life. PMS symptoms have also been linked to licit substance use. This study examined the relationships between daily/problem use (DPU) of caffeine (Caf⁺), alcohol (Alc⁺), and tobacco (Cig⁺) and PMS symptomology in a sample of college women.

METHODS

Participants (N = 196) completed an anonymous one-time health survey. Demographic, PMS symptomatology, and DPU of licit substance variables were examined. Independent t-tests compared PMS symptom scores in women with and without Caf⁺, Cig⁺, and Alc⁺ use. One-way analysis of variances examined the associations between PMS symptom severity and number of DPU-positive substances.

RESULTS

PMS subscale severity (pain [F(2,190) = 4.47, p = 0.013], affective [F(2,192) = 8.21, p < 0.001], and water retention [F(2,191) = 13.37, p < 0.001]) and total PMS symptom severity [F(2,189) = 10.22, p < 0.001] showed a dose response effect, with the number of licit substances with DPU significantly associated with PMS symptom severity.

CONCLUSIONS

This study findings provide important new information about the relationship between PMS symptoms and at-risk substance use. These are cross-sectional data, however, and affirm a need for longitudinal research to better understand the associations, with a focus on potential benefits of education and intervention.

The Influence of Running and Dancing on the Occurrence and Progression of Premenstrual Disorders

Background: The aim of the study was to assess the influence of both physical activity, such as running and dancing, and the personal characteristics of the studied women on the occurrence and progression of premenstrual disorder (PMD). Methods: We surveyed 414 women aged 22-48 who were experiencing the menstrual cycle but not using hormonal contraception. There were two physically active groups, runners (N = 215) and Argentine tango dancers (N = 94), and there was one group not undertaking any physical activity-the control group (N = 104). The research was conducted using the researchers' own questionnaire. Results: The number of days of PMD symptoms in the tango vs. runner vs. control groups are as follows: pre-bleeding (mean: 4.14 vs. 4.86 vs. 4.85; p = 0.024), after the onset of bleeding (mean: 1.76 vs. 2.39 vs. 2.16; p = 0.001), and in total (mean: 5.94 vs. 7.25 vs. 7.01; p < 0.001). The regression analysis results without grouping results are as follows: the number of days of symptoms before bleeding and menarche (B: -0.16; 95% CIs: from -0.29 to -0.04; p = 0.011), the total duration of symptoms and menarche (B: -0.17; 95% CIs: from -0.32 to -0.01; p = 0.036), lower abdominal pain and age (B: -0.05; 95% CIs: 0.92-0.98; p = 0.002), diarrhoea (B: -0.08; 95% CIs: 0.88-0.97; p < 0.001), tearfulness, depressive states and age (B: -0.06; 95% CIs: 0.91-0.97; p < 0.001), skin problems and age (B: -0.05; 95% CIs: 0.92-0.98; p = 0.004), joint pain and age (B: -0.09; 95% CIs: 0.86-0.96; p = 0.001), pain in the lumbar spine (B: -0.06, 95% CIs: 0.91-0.98; p = 0.001), water retention and BMI (B: 0.09; 95% CIs: 0.92-0.98; p = 0.007), and water retention and menarche (B: -0.19; 95% CIs: 0.73-0.94; p = 0.003). Information: generally there is one regression model, we have several here, we have a bit the description. Conclusions: Physical activity such as dancing (tango) shortens the duration of PMD symptoms but does not completely eliminate them. Running does not have as beneficial an effect on symptom relief as dancing. Current age, age when menstruation began (menarche), and BMI were revealed to be important factors influencing the symptoms of premenstrual disorders.

Physical and Psychological Symptoms Associated With Premenstrual Syndrome and Their Impact on the Daily Routine of Women in a Low Socioeconomic Status Locality

Introduction

The constellation of the physical and psychological symptoms that appear several days before menstrual period is regarded as the premenstrual syndrome (PMS). The current study evaluated the symptoms associated with PMS and their impact on the day-to-day activities of women.

Methodology

An observational cross-sectional study was conducted at a squatter settlement in Karachi, Pakistan, from January 2019 to February 2020. Amenorrheic, pregnant women, and women who were on birth control at the time of data collection were excluded from the study. The demographics, symptoms of PMS experienced by the participants, and the impact of PMS symptoms on the daily lives of women were recorded. Statistical Package for the Social Sciences v.25 (IBM Corp., Armonk, NY) was used for data analysis. 

Results

The mean age ± standard deviation of 23.93 years ± 9.41 years was recorded. As many as 213 (63%) women reported dysmenorrhea, followed by fatigue in 108 (32%), bloating in 64 (18.9%), and back pain in 45 (13.3%) women. Irritability and anxiety were experienced by 134 (39.6%) and 117 (34.6%) women, respectively. When asked about their attitude and perception towards menstruation, more than four-fifth respondents confessed that they feel impure when they are experiencing their monthly period. About 38 women (11.2%) believed that menstruation is God’s way of punishing the womankind. For the question, “Do you feel that your normal routine is significantly disturbed during your period?”, 40% responded in affirmation.

Conclusion

The findings of the current study reflected a generally negative attitude towards menstruation, which significantly affected the routine lives of women in our setting. The study further concluded that dysmenorrhea, fatigue, irritability, and anxiety were the most common symptoms of PMS experienced by women.

Prevalence and clinical picture of premenstrual syndrome in females from Bulgaria

BACKGROUND

Premenstrual syndrome (PMS) and its more severe form premenstrual dysphoric disorder (PMDD) are highly prevalent conditions, but there seems to be ethnic and cultural variances in their distribution.

AIMS

To explore the prevalence of PMS/PMDD and their typical clinical features in a Bulgarian population.

MATERIALS AND METHODS

This investigation was designed and executed as a cross-sectional descriptive study. Three hundred and five conveniently recruited females with no psychiatric history filled in a self-evaluation questionnaire based on DSM-IV tapping on different symptoms of PMS. The prevalence of the conditions was calculated.

RESULTS

32.1% (N = 98) of the tested females (mean age 31.04 ± 6.31) suffered from PMS and 3.3% (N = 10) were diagnosed with PMDD. The leading symptoms in the sample were irritability, fatigue and changes in appetite, depressed mood, mood swings, and anxiety, and abdominal bloating, breast tension and tenderness. Most of the symptoms were moderately severe. Mild and moderate cases of PMS were near equally distributed and more frequent than severe ones.

CONCLUSION

PMS is a common condition which is usually mildly expressed, but severe cases are not an exception. The clinical picture is dominated by almost equally distributed psychological and somatic symptoms.

Regular physical exercise, sedentarism and characteristics of dismenorrhea and premenstrual syndrome

Abstract Introduction: Among the menstrual disorders of the female reproductive period, Premenstrual Syndrome (PMS) and Dysmenorrhea are the most prevalent. The intensity of the signs and symptoms in each of these conditions may compromise the physical, psychological and social well-being of the woman at the stage of the menstrual cycle. Objective: To compare the signs and symptoms of menstrual disorders in women who practice regular exercise or not. Methods: A cross-sectional study carried out on women who practice exercises regularly and sedentary women. The IPAQ questionnaires and the evaluation of signs and symptoms of dysmenorrhea and PMS were applied to non-sedentary and sedentary students from the Federal University of Sergipe, Campus Lagarto. Results: Both groups had similar data for mean age and the mean Body Mass Index (BMI), therefore, passive of comparison. The prevalence of dysmenorrhea was significantly higher among sedentary women, 82% in the sedentary group and 46% in the non-sedentary group (p < 0.001), as well as some negative impacts on the psychological, social and physical state of both PMS and dysmenorrhea. Conclusion: The prevalence of signs and symptoms of dysmenorrhea was significantly higher in the Sedentary Group. Analyzing the behavior of PMS in relation to the practice of physical exercises, it was observed that the signs and symptoms of depressed mood, fatigue, difficulty to concentrate, lack of interest in social and home activities were more significant in the Sedentary Group.

Carbohydrate and fiber intake and the risk of premenstrual syndrome

BACKGROUND/OBJECTIVES

Women with premenstrual syndrome (PMS) are encouraged to reduce sugar and increase fiber intake to reduce symptoms. However, research supporting these recommendations is limited, and their role in PMS development is unclear. This study examines the relation between carbohydrate and fiber intake and the risk of PMS nested within the prospective Nurses' Health Study II cohort.

SUBJECTS/METHODS

Carbohydrate and fiber intake were assessed at baseline and three additional times during follow up by food frequency questionnaire. Incident cases of PMS were identified by self-reported PMS diagnosis during 14 years of follow up and validated by supplemental questionnaire (n = 1234). Women were classified as controls if they did not report PMS diagnosis during follow up and confirmed minimal or no premenstrual symptoms (n = 2426). We estimated relative risks (RR) and 95% confidence intervals (CI) using multivariable logistic regression.

RESULTS

Total carbohydrate intake 2-4 years before reference year was not associated with PMS development (RR quintile 5 versus 1 = 0.99; 95% CI = 0.74-1.33). Intakes of specific carbohydrates or fibers were not associated with PMS development, except maltose. Adjusting for body mass index, smoking, and other factors, women with the highest maltose intake (median = 3.0 g/day) had a RR of 1.45 (95% CI = 1.11-1.88) compared to those with the lowest intake (median = 1.2 g/day).

CONCLUSIONS

Overall, carbohydrate and fiber consumption was not associated with risk of PMS. As this is the first study to suggest that maltose may be associated with PMS development, further replication is needed.

Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature

Background

Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context.

Methods

We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity.

Results

We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so.

Conclusions

Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5472-z) contains supplementary material, which is available to authorized users.

Premenstrual Syndrome: Existence, Knowledge, and Attitude Among Female University Students in Karachi

Objective

The aim of this study was to investigate the existence, knowledge, and the attitude of female students towards premenstrual syndrome (PMS).

Methods

This cross-sectional study was conducted in three universities in Karachi, Pakistan. A total of 448 female students participated in the study. The clinical criterion of American College of Obstetricians and Gynecologists (ACOG) for PMS was used to assess the prevalence of PMS in the participants. The questionnaire was set in four parts, one each to assess the knowledge, the attitude, and practices regarding PMS and one to assess the gap between self-perceived PMS and actual PMS. Data were analyzed descriptively using the Statistical Package for the Social Sciences (SPSS), version 20 (IBM SPSS Statistics, Armonk, NY).

Results

The majority (96.4%) of female students were aware of PMS, while only 19% females knew about premenstrual dysphoric disorder. The self-reported prevalence of PMS was 79.5% and the prevalence using the ACOG criteria was 23.9%. Common symptoms were irritability, angry outbursts, depression, breast tenderness, and gastrointestinal problems. More than half (60.4%) of the participants reported PMS disturbed their normal routine, while 81.5% reported stress exacerbated their symptoms. The majority (77.5%) of women believed PMS was a significant issue to be discussed but 49.4% did not take treatment for their PMS.

Conclusion

There is a significant impact of PMS in the lives of Pakistani women, and it is a common problem all over the globe. Despite the growing awareness, there remains a considerable deficiency of knowledge about the necessity to consult a doctor or seek treatment for their symptoms.

MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women

Context

About 10% of Japanese female athletes are afflicted by menstrually-related edema, mainly in the lower limbs, and, with few studies on this problem, the effect on performance remains unclear.

Objective

To quantitatively evaluate fluid retention in the calf in female students over their menstrual cycle using magnetic resonance imaging (MRI) and to determine the relationship of MRI changes and athletic performance.

Design

The menstrual cycle was divided into 5 phases: menstrual, follicular, ovulatory, early luteal, and late luteal with sampling done in either morning (AM) or afternoon (PM) sessions. At each phase, MRI of the calf (7:00–8:00, 14:00–16:00), body composition and hormones (7:00–8:00), and athletic performance (14:00–16:00) were evaluated.

Participants

13 adult healthy Japanese female students with eumenorrhea.

Results

Estradiol levels decreased significantly in the menstrual phase and the follicular phase compared to the early luteal phase (P = 0.001, P = 0.024 respectively). Menstrual phase estradiol levels were significantly lower compared to the ovulatory phase (P = 0.015), and the late luteal phase (P = 0.003). Progesterone levels decreased significantly in the menstrual phase and the follicular phase compared to the ovulatory phase (P = 0.012, P = 0.009 respectively), the early luteal phase (both P = 0.007), and the late luteal phase (P = 0.028, P = 0.029 respectively), and it along with a significant decrease in the ovulatory phase compared to the early luteal phase (P = 0.010). AM T2 signals were significantly lower in the menstrual phase compared to the ovulatory phase (P = 0.043) but not other phases. PM T2 signals increased significantly in the menstrual phase compared to the follicular phase (P = 0.003), ovulatory phase (P = 0.009), and the late luteal phase (P = 0.032), and the difference between the AM and PM values increased significantly in the menstrual phase compared to the other 4 phases (P<0.01). A negative correlation between fluid retention and agility was observed.

Conclusion

In female students fluid retention during the menstrual phase could be a factor that influences athletic agility.

PMS: diagnosis, aetiology, assessment and management

This article reviews our understanding of the epidemiology and aetiology of premenstrual syndrome and premenstrual dysphoric disorder, and its assessment and management. It also addresses the concerns of the feminist community and the views of women themselves about this condition and its management. Service provision in the UK for women with these problems is unfocused and greatly varying, and they might be better assessed and treated by psychiatrists.

Recreational Physical Activity and Premenstrual Syndrome in Young Adult Women: A Cross-Sectional Study

Introduction

It is estimated that up to 75% of premenopausal women experience at least one premenstrual symptom and 8–20% meet clinical criteria for premenstrual syndrome. Premenstrual syndrome substantially reduces quality of life for many women of reproductive age, with pharmaceutical treatments having limited efficacy and substantial side effects. Physical activity has been recommended as a method of reducing menstrual symptom severity. However, this recommendation is based on relatively little evidence, and the relationship between physical activity, premenstrual symptoms, and premenstrual syndrome remains unclear.

Methods

We evaluated the relationship between physical activity and premenstrual syndrome and premenstrual symptoms among 414 women aged 18–31. Usual premenstrual symptom experience was assessed with a modified version of the Calendar of Premenstrual Experiences. Total, physical, and affective premenstrual symptom scores were calculated for all participants. Eighty women met criteria for moderate-to-severe premenstrual syndrome, while 89 met control criteria. Physical activity, along with dietary and lifestyle factors, was assessed by self-report.

Results

Physical activity was not significantly associated with total, affective, or physical premenstrual symptom score. Compared to the women with the lowest activity, women in tertiles 2 and 3 of activity, classified as metabolic equivalent task hours, had prevalence odds ratios for premenstrual syndrome of 1.5 (95% CI: 0.6–3.7) and 0.9 (95% CI: 0.4–2.4), respectively (p-value for trend = 0.85).

Conclusions

We found no association between physical activity and either premenstrual symptom scores or the prevalence of premenstrual syndrome.

A prospective study of caffeine and coffee intake and premenstrual syndrome

BACKGROUND

Clinically significant premenstrual syndrome (PMS) affects 15-20% of premenopausal women, substantially reducing quality of life. Women with PMS often are counseled to minimize caffeine intake, although only limited evidence supports this recommendation.

OBJECTIVE

We evaluated the association between total caffeine, coffee, and tea intake and the development of PMS in a case-control study nested within the prospective Nurses' Health Study II.

DESIGN

All participants were free from PMS at baseline (1991). PMS cases reported a new clinician-made diagnosis of PMS on biennial questionnaires between 1993 and 2005, and then confirmed symptom timing and moderate-to-severe impact and severity of symptoms with the use of a retrospective questionnaire (n = 1234). Controls did not report PMS and confirmed experiencing no symptoms or few mild symptoms with limited personal impact (n = 2426). Caffeine, coffee, and tea intake was measured by food-frequency questionnaires every 4 y, and data on smoking, body weight, and other factors were updated every 2-4 y. Logistic regression was used to evaluate the associations of total caffeine intake and frequency of coffee and tea consumption with PMS.

RESULTS

After adjustment for age, smoking, and other factors, total caffeine intake was not associated with PMS. The OR comparing women with the highest (quintile median = 543 mg/d) to the lowest (quintile median = 18 mg/d) caffeine intake was 0.79 (95% CI: 0.61, 1.04; P-trend = 0.31). High caffeinated coffee intake also was not associated with risk of PMS or specific symptoms, including breast tenderness (OR for ≥4 cups/d compared with <1/mo: 0.73; 95% CI: 0.48, 1.12; P-trend = 0.44).

CONCLUSIONS

Our findings suggest that caffeine intake is not associated with PMS, and that current recommendations for women to reduce caffeine intake may not help prevent the development of PMS.

The relationship between food frequency and menstrual distress in high school females

Background:

Nutrition pattern is one of the important factors predicting menstrual distress, which varies among different cultures and countries. The purpose of this study is to determine the relationship between food frequency and menstrual distress in high school girls from Mashhad.

Materials and Methods:

This cross-sectional study was conducted in 2012 using a two-stage sampling method on 407 high school female students from Mashhad who met the inclusion criteria. Subjects completed questionnaires of demographic characteristics, food frequency, and Menstrual Distress Questionnaire (MDQ) during three phases of the menstrual cycle (a week before bleeding, during menstrual bleeding period, and a week after menstruation). The collected data were analyzed by statistical tests such as Pearson correlation coefficient test, independent Student's t-test, and one-way analysis of variance (ANOVA).

Results:

Results showed that 87.7% of the students were at moderate economic status, 82.2% were exposed to cigarette smoke, 94.8% had mothers without university education, and 9.4% had working mothers. About 71% of the students reported minor pre-menstruation distress, 81% reported minor distress during bleeding, and 39% reported minor post-menstruation distress. In addition, the mean (SD) values for sweet–fatty foods, salty–fatty foods, fast foods, and caffeine were 3.6, 3.3, 1.3, and 10.2 per week, respectively. In addition, Pearson correlation coefficient test showed no significant correlation between total menstruation distress and food frequency (P > 0.05).

Conclusions:

With regard to the inappropriate food frequency and high intensity of menstrual distress among high school students and as health care and educational efforts for prevention and health promotion in society are among the duties of health workers, the results of this study can help the officials involved in education to emphasize on nutrition and the menstrual health of students.

Premenstrual dysphoric disorder in medical students residing in hostel and its association with lifestyle factors

CONTEXT

There is scant research on premenstrual syndrome (PMS) and its more severe counterpart, premenstrual dysphoric disorder (PMDD) in Indian females. This study aimed to evaluate symptoms of PMS in medical students and to find the association of sociodemographic variables and lifestyle factors with PMDD.

SUBJECTS AND METHODS

A total of 179 medical students residing in the hostel of an Indian medical college and its affiliated teaching hospital were approached, of which 100 (55.8%) returned the completed questionnaires. Data related to lifestyle factors was collected. Self-screening quiz for Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision PMDD and Shortened Premenstrual Assessment Form were used for diagnosis of PMDD and detection of symptomatology, respectively.

RESULTS

PMDD was present in 37% of the respondents. It was found at a higher rate in older and postgraduate students. PMDD was significantly associated with lifestyle factors, namely, sleep, physical activity, total tea/coffee intake, and change in tea/coffee and food intake under stress. The most common physical and psychological symptoms were body ache/joint pain and feeling depressed/blue, respectively.

CONCLUSIONS

PMDD is fairly common in Indian medical students residing in hostel although cultural factors may influence symptom expression. This study suggests that PMDD is associated with lifestyle factors in young, professional, urban women. Modification in lifestyle may thus be an important approach for management of PMS/PMDD. Prospective studies with larger representative samples are needed to validate these findings.

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

OBJECTIVES

A marked increased in food intake in the late-luteal phase is a characteristic symptom of premenstrual dysphoric disorder (PMDD). The aim of the study was to evaluate the leptin level, caloric intake, and eating behaviors of women with PMDD across the menstrual cycle among normal-weight and overweight subjects, respectively.

METHODS

A total of 62 women with PMDD and 69 controls were recruited following psychiatric interviewing and underwent prospective investigation. The leptin level, caloric intake, and three factors related to eating behavior were assessed in both the late-luteal and follicular phases.

RESULTS

The women with PMDD had greater increases in caloric intake, sweet caloric intake, and uncontrolled eating in the late-luteal phase than the controls. Among the normal-weight women, the leptin level was negatively correlated with caloric intake. The normal-weight women with PMDD had a lower leptin level, a lower leptin/body fat percentage (BFP), a higher caloric intake, and higher uncontrolled eating and emotional eating in the late-luteal phase than the normal-weight controls. Their leptin level was correlated negatively with sweet caloric intake. On the other hand, the overweight women with PMDD had a higher leptin level than the normal-weight women with PMDD and no decline was observed in their leptin level in the late-luteal phase. There were no differences in the leptin level between the overweight women with PMDD and the overweight controls. They also had a higher sweet caloric intake and higher uncontrolled eating and emotional eating than the overweight controls.

CONCLUSIONS

A decline in the leptin level is associated with late-luteal overeating among normal-weight women with PMDD. Hyperleptinemia and a high sweet caloric intake of overweight women with PMDD should be monitored and addressed in order to attenuate the risk of leptin resistance. The detailed roles of leptin and other psycho-neuro-endocrinology factors in the mechanism of overeating among women with PMDD should be evaluated in future study.

Relationship of premenstrual syndrome and premenstrual dysphoric disorder with major depression: relevance to clinical practice

BACKGROUND

Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India.

OBJECTIVE

The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression.

MATERIALS AND METHODS

A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4(th) edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale.

RESULTS

Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD.

CONCLUSION

Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.

Characterization of symptoms and edema distribution in premenstrual syndrome

Background

Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized.

Objective

To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period.

Subjects and methods

Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student’s t-test and the test for equality of two proportions (P≤0.05).

Results

Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume.

Conclusion

In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb.

Life Style Factors Associated with Premenstrual Syndrome among El-Minia University Students, Egypt

Aim. To determine the score and frequency of premenstrual syndrome (PMS) among female college students and to detect the possible risk factors of PMS. A trial of life style modification regarding prevention and control of PMS symptoms was carried out using counseling. Materials and Methods. A cross-sectional study was conducted on 253 El-Minia University unmarried female students. A self-administered questionnaire inquiring about symptoms of PMS in the previous three months and risk factors possibly related to it was used. PMS score was calculated. Multiple regression analysis was performed to determine which of several biopsychosocial and dietary factors influenced PMS. Life style modification counseling was done to prevent and control PMS. Results. The study revealed that 80.2% of the participants experienced various degrees of PMS symptoms which were significantly associated with a family history of PMS, physical inactivity, habitual excess consumption of coffee, BMI, frequent consumption of fast food, and smoking, but these factors explained only 52% of the variability in the logistic regression model. Conclusion. We recommend the introduction of a reproductive health component into school and college health education programs and encourage female adolescents and young adults to adopt a healthy behavior.

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.

The phenomenology of premenstrual syndrome in female medical students: a cross sectional study

BACKGROUND

The premenstrual syndrome (PMS) is particularly common in the younger age groups and, therefore represents a significant public health problem in young girls. This study aims to estimate the prevalence, severity, determinants of premenstrual syndrome (PMS) and its impact among the female medical students in Al-Ahsa, Saudi Arabia.

METHODS

This study was performed at the College of Medicine, King Faisal University, Saudi Arabia, from June through December 2009. It included 250 medical students. They filled different questionnaires covering American College of Obstetrics and Gynecology (ACOG) criteria to diagnose PMS, demographic & reproductive factors, physical activity and mental condition. Regression analysis was conducted for all the predictors.

RESULTS

PMS was diagnosed in 35.6% of cases, distributed as 45% mild, 32.6% moderate and 22.4% severe. There were significant trends for older age, rural residence, family income and family history of PMS. The dominant limited activity was concentration in class (48.3%). Limitations of activities were significantly more frequent among severe cases. The prevalence of anxiety and depression was statistically more evident in the PMS group. Regression analysis revealed that, PMS was significantly associated with older age groups, rural residence, lower age at menarche, regularity of menses and family history.

CONCLUSION

PMS is a common problem in young Saudi students in Al Ahsa. Severe PMS was associated with more impairment of daily activities and psychological distress symptoms. Older student age, rural residence, earlier age of menarche, regular cycles and positive family history are possible risk factors for PMS.

The impact of premenstrual symptoms on activities of daily life in Korean women

OBJECTIVE

To evaluate the impact of premenstrual symptoms on activities of daily life (ADL) of Korean women, and their knowledge and treatment seeking regarding premenstrual syndromes (PMSs).

METHODS

A population-based online survey regarding premenstrual symptoms was conducted in 1000 Korean women aged 15-49 years. Symptoms were classified according to their intensity, persistence each cycle, and impairment of ADL. Women's knowledge of PMSs and physician consultations were assessed.

RESULTS

The approximate prevalence of PMS/premenstrual dysphoric disorder (PMDD) by the WHO's International Classification of Disease (ICD-10), American College of Obstetrics and Gynecology (ACOG), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV[4th edition]) criteria was 98.6, 32.1, and 2.8%, respectively. Among 23 documented symptoms, the most predominant symptoms were joint-muscle-back pain, abdominal pain, and irritability. Physical symptoms were more prevalent than mental symptoms. There was a high correlation between the duration and severity of symptoms. The impact of PMS on ADL and the proportion of women with impaired ADL were significantly associated with the severity of PMS. The proportion of women consulting physicians increased with severity of PMS from 2%, 2.3%, for ICD-10, ACOG PMS to 10.7% for DSM-IV PMDD, respectively. Most of the women (91.5%) had no knowledge regarding terminology pertaining to PMS and PMDD.

CONCLUSION

PMSs occur frequently and have a significant impact on daily life for a proportion of Korean women. However, Korean women have little knowledge about PMSs and only infrequently consult their physicians.

Premenstrual symptoms -- severity, duration and typology: an international cross-sectional study

OBJECTIVES

Determine women's experiences of premenstrual symptoms.

STUDY DESIGN

Cross-sectional survey. Sample In all, 4085 women aged 14-49 years recruited by random telephone digit dialing in France, Germany, Hungary, Italy, Spain, UK, Brazil and Mexico. Main outcome measures Telephone interview checklist of 23 premenstrual symptoms, sociodemographic variables and lifestyle variables.

RESULTS

The most prevalent symptoms were abdominal bloating, cramps or abdominal pain, breast tenderness, irritability and mood swings. Severity of symptoms is directly proportional to duration (R = 0.79). Hierarchical clustering found the following mental and physical domains and a typology: 'Mild' type (40.8%) with minimal symptoms; 'Moderate M' type (28.7%) with moderately severe, mostly mental symptoms; 'Moderate P' type (21.9%) with moderately severe, mostly physical symptoms; and 'Severe' type (8.6%) with severe intensity of both mental and physical symptoms. Multiple stepwise regression found significant effects on symptom duration severity index of age (linear and quadratic effects), current smoking and country.

CONCLUSIONS

Further research is needed on the impact of premenstrual symptoms on quality of life, and whether a brief symptom list could be developed as a valid and reliable tool globally.

Premenstrual syndrome in Thai nurses

OBJECTIVE

To investigate prevalence of premenstrual syndrome (PMS) and its associated factors among Thai nurses.

METHODS

The study was conducted in 423 nurses in a university hospital during October 2005 to March 2006. Prevalence of PMS was determined using a validated Thai version of Premenstrual Symptoms Screening Tool (PSST). Factors associated with PMS were analyzed using Student t-test and Chi-square test.

RESULTS

The prevalence of PMS in Thai nurses was 25.1%. Nurses with younger age, nulligravida, lower income, more coffee consumption, dysmenorrhea, and negative attitude toward menstruation had higher prevalence of PMS. After multiple logistic regression analysis, the significant factors associated with PMS were coffee consumption > 1 cups/day and negative attitude toward menstruation; odds ratios (95% confidence interval) were 2.322 (1.257 to 4.288) and 5.768 (2.096 to 15.872), respectively.

CONCLUSION

According to the Thai PSST, 25.1% of Thai nurses are suffering from PMS. The significant associated factors were more coffee consumption and negative attitude toward menstruation.