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Itriyeva K. Premenstrual syndrome and premenstrual dysphoric disorder in adolescents. Curr Probl Pediatr Adolesc Health Care 2022; 52:101187. [PMID: 35534402 DOI: 10.1016/j.cppeds.2022.101187] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent two premenstrual disorders characterized by physical and psychological symptoms that occur in the luteal phase of the menstrual cycle, prior to the onset of menses, and have a negative impact on the psychosocial functioning of affected individuals. PMS, more common than PMDD, affects 20-40% of menstruating women, with common symptoms including fatigue, irritability, mood swings, depression, abdominal bloating, breast tenderness, acne, changes in appetite and food cravings. PMDD, affecting a smaller percentage of women, is characterized by more severe symptoms and is listed as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While the pathophysiology of these premenstrual disorders remains unclear, it has been hypothesized that sensitivity to hormonal fluctuations during the luteal phase of the menstrual cycle, abnormal serotonergic activity, and aberrations in progesterone and the neurotransmitter gamma aminobutyric acid (GABA) may all play a role in these disorders. Treatment of PMS and PMDD is focused on alleviation of symptoms and improvement of functioning and quality of life for affected individuals. The treatment of severe PMS and PMDD typically requires pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs), oral contraceptive pills (OCPs), gonadotropin-releasing hormone (GnRH) agonists, and non-contraceptive estrogen formulations. Non-pharmacologic treatment with diet, exercise, cognitive behavioral therapy (CBT), certain vitamin and herbal supplements, and acupuncture may additionally be effective for some individuals.
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Affiliation(s)
- Khalida Itriyeva
- Division of Adolescent Medicine, Cohen Children's Medical Center Northwell Health, New Hyde Park, NY, United States; Donald and Barbara Zucker School of Medicine at Hofstra / Northwell, Hempstead, NY, United States.
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Kamat SV, Nimbalkar A, Phatak AG, Nimbalkar SM. Premenstrual syndrome in Anand District, Gujarat: A cross-sectional survey. J Family Med Prim Care 2019; 8:640-647. [PMID: 30984687 PMCID: PMC6436252 DOI: 10.4103/jfmpc.jfmpc_302_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim of Study: We assessed the prevalence and severity of premenstrual syndrome (PMS) in adolescents and identified probable associations of PMS and premenstrual dysphoric disorder (PMDD) with age, locality, food habits, obesity, stress, genetic influence, menorrhagia and dysmenorrhoea. Methods: Cross-sectional study in schools of Anand District in State of Gujarat, India. We conducted the study in 1702 girls in the age group of 8–23 years who had achieved menarche. Main Outcome Measures: Prevalence of PMS and PMDD using the self-administered Premenstrual Symptoms Screening Tool for Adolescents (PSST-A). Results: The prevalence of moderate to severe PMS was 19.3% and PMDD was 4.6%. Almost all (94.8%) girls had at least one PMS symptom with 65.7% having moderate to severe symptoms. We found dysmenorrhoea in 71.2% girls and menorrhagia in 15.2%. Physical symptoms were reported by 53.5%, disruption of daily activities by 41.7%, while 25.1% had to miss school/college. Majority (81.3%) felt that PMS was a normal part of menstruation and 53.0% reported moderate to severe stress. Multivariate logistic regression model revealed older age, dysmenorrhoea, menorrhagia, high levels of stress and PMS in mother to be significantly associated with PMS. In addition to these, lower age at menarche and junk food significantly contributed to PMDD. Conclusion: Prevalence of moderate to severe PMS and PMDD in this population falls within the range reported elsewhere. PMS/PMDD affects the lives of many, significantly reducing their efficiency and worsening the quality of life.
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Affiliation(s)
- Shruti V Kamat
- Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Archana Nimbalkar
- Department of Physiology, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Ajay G Phatak
- Department of Physiology, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Somashekhar M Nimbalkar
- Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.,Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
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Ozcan H, Oral E, Gulec M, Turkez H, Gulec TC, Ustundag MF, Aydinoglu U, Yucel A. Total oxidant–antioxidant and paraoxonase-1 levels in premenstrual dysphoric disorder: a follow-up study. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1326735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Halil Ozcan
- Department of Psychiatry, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Elif Oral
- Department of Psychiatry, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Mustafa Gulec
- Department of Psychiatry, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - Hasan Turkez
- Department of Molecular Biology and Genetics, School of Science, Erzurum Technical University, Erzurum, Turkey
| | - Tezay Cakin Gulec
- Department of Neurology, Turkan Ozilhan Bornova State Hospital, Izmir, Turkey
| | | | - Unsal Aydinoglu
- Department of Psychiatry, Kastamonu Dr. Munif Islamoglu State Hospital, Kastamonu, Turkey
| | - Atakan Yucel
- Department of Psychiatry, School of Medicine, Ataturk University, Erzurum, Turkey
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Uran P, Yürümez E, Aysev A, Kılıç BG. Premenstrual syndrome health-related quality of life and psychiatric comorbidity in a clinical adolescent sample: a cross-sectional study. Int J Psychiatry Clin Pract 2017; 21:36-40. [PMID: 27669573 DOI: 10.1080/13651501.2016.1235710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Adolescents who were admitted to the child and adolescent psychiatry clinic were compared with respect to the premenstrual symptom severity, psychiatric comorbidities and health related quality of life (HRQoL). METHODS The research group was identified using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Premenstrual Assessment Form. They completed the Pediatric Quality of Life Inventory (The PedsQL). RESULTS There were 55 adolescents who were eligible for the study and 89% of participants were diagnosed with at least one psychiatric disorder. The most common psychiatric diagnoses among the diagnosed cases were anxiety and major depressive disorders. Of all of the cases, 78.2% were diagnosed with premenstrual syndrome (PMS) and among those cases, 46.5% had mild, 34.8% had moderate and 18.6% had severe PMS. Most common PMS symptom was anger/irritability. HRQoL in the group with PMS was significantly lower than that of the adolescents without PMS. Moreover, HRQoL of adolescents with PMS was found to deteriorate with the increasing severity of PMS. CONCLUSIONS This study is of great importance since it demonstrated that PMS frequency is very high in a clinical adolescent population and negatively affects their HRQoL as similar to non-clinical adolescent population studies.
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Affiliation(s)
- Pınar Uran
- a Child and Adolescent Psychiatry Department , Ankara University School of Medicine , Ankara , Turkey
| | - Esra Yürümez
- b Child and Adolescent Psychiatry Department , Ufuk University School of Medicine , Ankara , Turkey
| | - Ayla Aysev
- a Child and Adolescent Psychiatry Department , Ankara University School of Medicine , Ankara , Turkey
| | - Birim Günay Kılıç
- a Child and Adolescent Psychiatry Department , Ankara University School of Medicine , Ankara , Turkey
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Raval CM, Panchal BN, Tiwari DS, Vala AU, Bhatt RB. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian J Psychiatry 2016; 58:164-70. [PMID: 27385849 PMCID: PMC4919960 DOI: 10.4103/0019-5545.183796] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by mood changes, anxiety, and somatic symptoms experienced during the specific time of menstrual cycle. Prevalence data of PMS and PMDD is sparse among college girls in India. AIMS The aim of this study is to study the prevalence of PMS and PMDD among college students of Bhavnagar (Gujarat), its associated demographic and menstrual factors, to rank common symptoms and compare premenstrual symptom screening tool (PSST) with Structured Clinical Interview for DSM-IV-TR defined PMDD (SCID-PMDD) for sensitivity and specificity. MATERIALS AND METHODS A cross-sectional survey was done in five colleges of Bhavnagar. Of 529 subjects approached, 489 college girls were finally analyzed for sociodemographic data, menstrual history, and PSST. SCID-PMDD was applied among those who were positive on PSST and 20% of those who were negative. The data were analyzed using OpenEpi Version 2. Chi-square test was done for qualitative variables and analysis of variance for quantitative variables. Sensitivity, specificity, and predictive values were calculated for PSST. RESULTS The prevalence of PMS was 18.4%. Moderate to severe PMS was 14.7% and PMDD was 3.7% according to DSM IV-TR and 91% according to International Classification of Diseases, 10(th) edition criteria. The symptoms commonly reported were "fatigue/lack of energy," "decrease interest in work," and "anger/irritability." The most common functional impairment item was "school/work efficiency and productivity." PSST has 90.9% sensitivity, 57.01% specificity, and 97.01% predictive value of negative test. CONCLUSION Prevalence of PMS among college students is similar to other studies from Asia. PSST is a useful screening tool for PMS, and it should be confirmed by more specific tool as by SCID-PMDD. Routine screening with PSST can identify college girls who can improve with treatment.
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Affiliation(s)
- Chintan Madhusudan Raval
- Department of Psychiatry, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
| | - Bharat Navinchandra Panchal
- Department of Psychiatry, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
| | - Deepak Sachidanand Tiwari
- Department of Psychiatry, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
| | - Ashok Ukabhai Vala
- Department of Psychiatry, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
| | - Renish Bhupendrabhai Bhatt
- Department of Psychiatry, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India
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Abstract
Menstrual suppression--the use of hormones to delay or eliminate menses--is often used in adolescents to manage conditions associated with the menstrual cycle and to accommodate lifestyle preferences. Reducing the frequency of menstrual bleeding does not cause any known physiologic harm and has potential short-term and long-term advantages. Different methods used for menstrual suppression, however, have associated risks and side effects that need to be weighed against the benefits of controlling menses. This article reviews the advantages and disadvantages of menstrual suppression and the different methods available for adolescents.
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Oral E, Kirkan TS, Yildirim A, Kotan Z, Cansever Z, Ozcan H, Aliyev E, Gulec M. Serum brain-derived neurotrophic factor differences between the luteal and follicular phases in premenstrual dysphoric disorder. Gen Hosp Psychiatry 2015; 37:266-72. [PMID: 25799087 DOI: 10.1016/j.genhosppsych.2015.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 01/30/2015] [Accepted: 03/05/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We hypothesized that comparison of the serum brain-derived neurotrophic factor (BDNF) levels between women with premenstrual dysphoric disorder (PMDD) and women without PMDD in the luteal and follicular phases of their menstrual cycles would reflect the altered neuromodulator responses that compensate the underlying pathogenesis in PMDD. METHOD Twenty-nine participants without PMDD and 20 with PMDD were enrolled in the study. The serum BDNF, estrogen and progesterone levels were assessed at the follicular and luteal phases in their two consecutive menstrual cycles. RESULTS Participants with PMDD had significantly higher luteal serum BDNF levels than the control subjects. The serum BDNF levels were significantly higher in the luteal phase than in the follicular phase in women with PMDD. The difference in the serum BDNF levels between the luteal and follicular phases were significantly higher in the PMDD patients than in the control. CONCLUSIONS The higher serum BDNF levels in the luteal phase in the PMDD patients may reflect compensatory process that results in subsequent improvement of the PMDD-associated depressive symptoms in the follicular phase. The higher difference in the serum BDNF levels between the phases in PMDD patients may reflect an altered neuromodulator response.
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Affiliation(s)
- Elif Oral
- Department of Psychiatry, Medical Faculty, Ataturk University, Erzurum, Turkey.
| | - Tulay Sati Kirkan
- Department of Psychiatry, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Abdulkadir Yildirim
- Department of Biochemistry, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Zerrin Kotan
- Department of Biochemistry, Pharmacy Faculty, Ataturk University, Erzurum, Turkey
| | - Zeliha Cansever
- Department of Medical Education, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Halil Ozcan
- Department of Psychiatry, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Elvin Aliyev
- Department of Biochemistry, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Mustafa Gulec
- Department of Psychiatry, Medical Faculty, Katip Celebi University, İzmir, Turkey
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Naheed B, Uthman OA, O'Mahony F, Kuiper JH, O'Brien PMS. Gonadotropin-releasing hormone (GnRH) analogues for premenstrual syndrome (PMS). Hippokratia 2014. [DOI: 10.1002/14651858.cd011330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bushra Naheed
- Keele University; Institute for Science and Technology in Medicine; Thornburrow Drive, Hartshill Stoke-on-Trent UK ST4 7QB UK
| | - Olalekan A Uthman
- Division of Health Sciences, Warwick Medical School, The University of Warwick; Warwick Centre for Applied Health Research and Delivery (WCAHRD); Warwick UK
| | - Fidelma O'Mahony
- University Hospital of North Staffordshire; Academic Unit of Obstetrics and Gynaecology; Newcastle Road Stoke-on-Trent UK ST4 6QG
| | - Jan Herman Kuiper
- Keele University; Institute for Science and Technology in Medicine; Thornburrow Drive, Hartshill Stoke-on-Trent UK ST4 7QB UK
| | - Patrick Michael Shaughn O'Brien
- Keele University Medical School; Academic Department of Obstetrics and Gynaecology; North Staffordshire Hospital, City General Hospital Newcastle Road Stoke-on-Trent Staffordshire UK ST4 6QG
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Yang J, Joe SH, Lee MS, Kim SH, Jung IK. Survey of premenstrual symptom severity and impairment in Korean adolescents: premenstrual dysphoric disorder, subthreshold premenstrual dysphoric disorder and premenstrual syndrome. Asia Pac Psychiatry 2014; 6:135-44. [PMID: 23857722 DOI: 10.1111/appy.12024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 10/28/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aims of the study were to examine the prevalence of premenstrual dysphoric disorder (PMDD), subthreshold PMDD and premenstrual syndrome (PMS) among adolescents, and to assess the nature of symptoms and the impact on daily life functions, especially for PMDD and subthreshold PMDD. METHODS A cross-sectional survey was conducted among adolescents from an urban area. Participants included 984 girls divided into the following four groups, using a premenstrual symptoms screening tool: PMDD, subthreshold PMDD, moderate/severe PMS and no/mild PMS. An Adolescent Mental Problem Questionnaire, Center for Epidemiological Studies-Depression Scale, revised Children's Manifest Anxiety Scale, and a menstrual information questionnaire were also used. RESULTS Sixty-three (6.76%) of the subjects met the criteria for PMDD and 58 (6.2%) were subthreshold PMDD. The subthreshold PMDD group included 79.3% who met the symptom criteria for PMDD, but their impairment was moderate, and 21.7% who were falling short by the number of symptoms for PMDD diagnosis, though reporting severe impairment. The symptom intensity and frequency of the subthreshold PMDD subjects were similar to those in subjects with PMDD. In these two groups, 69% had moderate to severe physical symptoms. Psychiatric problems, including depression and anxiety, were higher in the PMDD and subthreshold PMDD groups than in the moderate/severe PMS and no/mild PMS group. DISCUSSION In total, 20% of adolescents reported suffering from distressing premenstrual symptoms, and girls with PMDD and subthreshold PMDD were very similar in their symptom severity and characteristics. Prospective daily charting is needed to confirm the accurate diagnosis and management of PMDD.
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Affiliation(s)
- Jaewon Yang
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea; Korea University Research Institute of Mental Health, Seoul, Korea
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Luteal serum BDNF and HSP70 levels in women with premenstrual dysphoric disorder. Eur Arch Psychiatry Clin Neurosci 2013; 263:685-93. [PMID: 23455589 DOI: 10.1007/s00406-013-0398-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 02/19/2013] [Indexed: 12/16/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome characterized by psychological and somatic symptoms commencing in the luteal phase of the menstrual cycle and concludes with menstrual bleeding. PMDD affects 3-8 % of premenopausal women and represents a significant public health problem especially in young women. Decreased brain-derived neurotrophic factor (BDNF) levels are associated with several mental disorders. Heat-shock protein-70 (HSP70) is an important member of the molecular chaperone system, which provides a molecular defense against proteotoxic stress. We hypothesized that there would be changed levels of BDNF and HSP70 in women with PMDD compared with non-symptomatic women, reflecting impaired and/or activated stress-related responses involved in the underlying pathogenesis of PMDD. Female medical students were screened, and 24 women without premenstrual symptoms and 25 women with PMDD were enrolled in the study. Psychiatric evaluation and the Daily Record of Severity of Problems-Short Form were used for two consecutive menstrual cycles to diagnose PMDD. Serum BDNF and HSP70 levels were assessed in the third luteal phase. Participants with PMDD had significantly higher serum BDNF and HSP70 levels compared with controls, and there was a significant positive correlation between serum BDNF and HSP70 levels. Increased HSP70 levels may reflect cellular distress in PMDD. Increased serum BDNF levels in the luteal phase in subjects with PMDD may reflect a compensation process, which results in subsequent improvement of PMDD-associated depressive symptoms in the follicular phase. Thus, increased serum BDNF levels may be indicative of a compensating capacity in PMDD.
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Menstrual suppression in the adolescent. J Pediatr Adolesc Gynecol 2013; 26:132-7. [PMID: 23158755 DOI: 10.1016/j.jpag.2012.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 08/06/2012] [Accepted: 08/07/2012] [Indexed: 11/23/2022]
Abstract
Menstrual suppression, the use of contraceptive methods to eliminate or decrease the frequency of menses, is often prescribed for adolescents to treat menstrual disorders or to accommodate patient preference. For young women using hormonal contraceptives, there is no medical indication for menstruation to occur monthly, and various hormonal contraceptives can be used to decrease the frequency of menstruation with different side effect profiles and rates of amenorrhea. This article reviews the different modalities for menstrual suppression, common conditions in adolescents which may improve with menstrual suppression, and strategies for managing common side effects.
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Matsumoto T, Asakura H, Hayashi T. Biopsychosocial aspects of premenstrual syndrome and premenstrual dysphoric disorder. Gynecol Endocrinol 2013; 29:67-73. [PMID: 22809066 DOI: 10.3109/09513590.2012.705383] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A majority of women in their reproductive years experience a variety of symptoms premenstrually that can alter behavior and well-being and affect family, friends, and working relationships. Notwithstanding its prevalence, however, research has not yet clarified this inscrutable condition, commonly known as premenstrual syndrome (PMS) or more severe PMS, premenstrual dysphoric disorder (PMDD). This comprehensive review discusses the diagnosis, epidemiology, symptoms, etiology, and the complex web of biopsychosocial factors that attends PMS.
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Affiliation(s)
- Tamaki Matsumoto
- Department of Education, Faculty of Education, Shitennoji University, Osaka, Japan.
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Effects of Perimenstrual Complaints on Sexuality and Disability and Coping Strategies of University Students. SEXUALITY AND DISABILITY 2012. [DOI: 10.1007/s11195-012-9264-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leminen H, Heliövaara-Peippo S, Halmesmäki K, Teperi J, Grenman S, Kivelä A, Tuppurainen M, Paavonen J, Hurskainen R. The effect of hysterectomy or levonorgestrel-releasing intrauterine system on premenstrual symptoms in women treated for menorrhagia: secondary analysis of a randomized controlled trial. Acta Obstet Gynecol Scand 2012; 91:318-25. [PMID: 22168810 DOI: 10.1111/j.1600-0412.2011.01340.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on premenstrual symptoms in women treated for menorrhagia. DESIGN Secondary analysis of a randomized controlled trial. SETTING Five university hospitals in Finland. SAMPLE A cohort of 236 women, aged 35-49 years (mean 43 years) referred for menorrhagia between 1994 and 1997. Women were not diagnosed with premenstrual syndrome. METHODS Women were randomized to treatment by hysterectomy (n=117) or LNG-IUS (n=119). Analyses were performed using the intention-to-treat and actual treatment principles. Women using estrogen therapy and women who underwent bilateral salpingo-oophorectomy were excluded from the analyses. MAIN OUTCOME MEASURES The occurrence of premenstrual symptoms evaluated by questionnaires at baseline and at follow-up visits six and 12 months after the treatment and five years after the randomization. RESULTS Premenstrual symptoms decreased significantly in both groups by six months (p≤0.028) without significant differences between the groups, except that in the LNG-IUS group the decrease of breast tenderness was seen first by 12 months (p=0.048). Even though 42% of the women assigned to treatment with LNG-IUS were hysterectomized during the follow-up period, the results of intention-to-treat and actual treatment analyses were comparable. CONCLUSIONS Both hysterectomy and LNG-IUS seem to alleviate premenstrual symptoms of women treated for menorrhagia, while the effect of these treatments on premenstrual syndrome remains unsettled.
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Affiliation(s)
- Henri Leminen
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Finland.
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Delara M, Ghofranipour F, Azadfallah P, Tavafian SS, Kazemnejad A, Montazeri A. Health related quality of life among adolescents with premenstrual disorders: a cross sectional study. Health Qual Life Outcomes 2012; 10:1. [PMID: 22208808 PMCID: PMC3281794 DOI: 10.1186/1477-7525-10-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 01/01/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Premenstrual disorders usually refer to premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study was designed to evaluate health-related quality of life (HRQOL) in a sample of Iranian adolescents with premenstrual disorders. METHODS This was a cross sectional study. A sample of adolescent schoolgirls aged between 14 and 19 years were included in the study. Premenstrual disorders were indicated according to the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Health-related quality of life was measured using the Short Form Health Survey (SF-36). The data were analyzed in a descriptive fashion and were compared among subgroups of the study sample. RESULTS In all 602 female students were studied. All students reported at least one premenstrual symptom. Of these, 224 (37.2%) met the diagnostic criteria for premenstrual dysphoric disorder (PMDD). Comparing the SF-36 scores between female students with and without PMDD, it was found that there were significant differences between these two groups in all measures (P < 0.001) except for physical functioning (P = 0.274). These differences were more evident on role emotional, role physical, social functioning and bodily pain. CONCLUSION The study findings affirm the fact that adolescents with premenstrual disorders suffer from poor health-related quality of life. In order to improve quality of life in female adolescents appropriate support should be provided for this population especially for those who suffer from more severe premenstrual disorders.
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Affiliation(s)
- Mahin Delara
- Depratment of Health Education, Medical School, Tarbiat Modares University, Tehran, Iran
| | - Fazlollah Ghofranipour
- Depratment of Health Education, Medical School, Tarbiat Modares University, Tehran, Iran
| | - Parviz Azadfallah
- Depratment of Health Education, Medical School, Tarbiat Modares University, Tehran, Iran
| | | | | | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Henderson EM, Rosser BA, Keogh E, Eccleston C. Internet Sites Offering Adolescents Help With Headache, Abdominal Pain, and Dysmenorrhoea: A Description of Content, Quality, and Peer Interactions. J Pediatr Psychol 2011; 37:262-71. [DOI: 10.1093/jpepsy/jsr100] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Drosdzol A, Nowosielski K, Skrzypulec V, Plinta R. Premenstrual disorders in Polish adolescent girls: Prevalence and risk factors. J Obstet Gynaecol Res 2011; 37:1216-21. [DOI: 10.1111/j.1447-0756.2010.01505.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Steiner M, Peer M, Palova E, Freeman EW, Macdougall M, Soares CN. The Premenstrual Symptoms Screening Tool revised for adolescents (PSST-A): prevalence of severe PMS and premenstrual dysphoric disorder in adolescents. Arch Womens Ment Health 2011; 14:77-81. [PMID: 21271266 DOI: 10.1007/s00737-010-0202-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 12/12/2010] [Indexed: 10/18/2022]
Abstract
The Premenstrual Symptoms Screening Tool was modified for use in adolescents and piloted in 578 girls at three international sites. Nearly one third (29.6%) reported experiencing severe PMS or PMDD, with irritability being the most commonly reported symptom. Rates of menstrual-related pain were high, particularly in those with severe PMS or PMDD. Severe PMS and PMDD present with similar rates and symptoms in adolescents as in adults, and the Premenstrual Symptoms Screening Tool modified for adolescents is a fast, reliable tool to screen for these syndromes in adolescents.
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Affiliation(s)
- Meir Steiner
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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Harvey AT, Hitchcock CL, Prior JC. Ovulation disturbances and mood across the menstrual cycles of healthy women. J Psychosom Obstet Gynaecol 2009; 30:207-14. [PMID: 19842789 DOI: 10.3109/01674820903276438] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We examined the cyclicity of negative mood relative to ovulation and ovulation disturbances in Menstrual Cycle Diary(c) data collected daily during a 1-year study of ovulation, exercise, and bone change. A validated quantitative basal temperature-based methodology was used to determine the onset of the luteal phase. 'Feeling depressed', 'feeling anxious', and 'feeling angry/frustrated' were scored on a scale of 0 (absent) to 4 (very intense). Mood scores were examined over two 15-day intervals centered on either ovulation/midpoint, or on the onset of flow. Data were available from 765 cycles of 62 healthy and initially ovulatory women with a mean age of 33.9 +/- 5.4 years. Of 739 cycles that could be classified, 532 (72%) were normally ovulatory, 185 (25%) were ovulatory with a short (<10 day) luteal phase, and 22 (3%) were anovulatory. Minor cyclic mood changes were present in both ovulatory and anovulatory menstrual cycles. In anovulatory cycles, mood tended to be more variable but less negative, with a time course that differed from that in ovulatory cycles. Mood scores did not differ based on luteal phase length or with hormone levels. Patterns and mechanisms of mood change in very symptomatic women appear to be essentially amplifications of normal experiences.
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Affiliation(s)
- Anne T Harvey
- Via Christi Research, Via Christi Regional Medical Center, Wichita, Kansas 67218, USA.
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