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Taim BC, Ó Catháin C, Renard M, Elliott-Sale KJ, Madigan S, Ní Chéilleachair N. The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review. Sports Med 2023; 53:1963-1984. [PMID: 37389782 DOI: 10.1007/s40279-023-01871-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Menstrual cycle (MC) disorders and MC-related symptoms can have debilitating effects on the health and performance of female athletes. As the participation of women in sports continues to increase, understanding the prevalence of a range of MC disorders and MC-related symptoms may guide preventive strategies to protect the health and optimise the performance of female athletes. OBJECTIVE To examine the prevalence of MC disorders and MC-related symptoms among female athletes who are not using hormonal contraceptives and evaluate the assessment methods used to identify MC disorders and MC-related symptoms. METHODS This systematic review was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Six databases were searched until September 2022 for all original research that reported the prevalence of MC disorders and/or MC-related symptoms in athletes not using hormonal contraceptives, which included the definitions of the MC disorders examined, and the assessment methods used. MC disorders included amenorrhoea, anovulation, dysmenorrhoea, heavy menstrual bleeding (HMB), luteal phase deficiency (LPD), oligomenorrhoea, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). MC-related symptoms included any affective and physical symptoms related to the MC that do not cause significant personal, interpersonal or functional impairment. The prevalence data across eligible studies were combined, and all studies were qualitatively synthesised to evaluate the assessment methods and tools used to identify MC disorders and MC-related symptoms. The methodological quality of studies was assessed using a modified Downs and Black checklist. RESULTS Sixty studies involving 6380 athletes were included. A wide range of prevalence was observed for all types of MC disorders, with a dearth of data on anovulation and LPD. Based on pooled data, dysmenorrhoea (32.3%; range 7.8-85.6%) was the most prevalent MC disorder. Studies reporting MC-related symptoms mostly examined the premenstrual and menstruation phases, where affective symptoms appeared more prevalent than physical symptoms. A larger proportion of athletes reported symptoms during the initial days of menstruation compared with the premenstrual phase. MC disorders and MC-related symptoms were retrospectively assessed using self-report methods in 90.0% of studies. Most studies (76.7%) in this review were graded as moderate quality. DISCUSSION MC disorders and MC-related symptoms are commonplace among female athletes, warranting further research examining their impact on performance and preventive/management strategies to optimise athlete health. To increase the quality of future studies, researchers should adopt standardised definitions of MC disorders and assessment methods such as a combination of calendar counting, urinary ovulation tests and a mid-luteal phase serum progesterone measurement when assessing menstrual function. Similarly, standardised diagnostic criteria should be used when examining MC disorders such as HMB, PMS and PMDD. Practically, implementing prospective cycle monitoring that includes ovulation testing, mid-luteal blood sampling (where feasible) and symptom logging throughout the MC could support athletes and practitioners to promptly identify and manage MC disorders and/or MC-related symptoms. TRIAL REGISTRATION This review has been registered in the PROSPERO database (CRD42021268757).
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Affiliation(s)
- Bernadette Cherianne Taim
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
| | - Ciarán Ó Catháin
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Michèle Renard
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Kirsty Jayne Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, 99 Oxford Road, M1 7EL, Manchester, UK
| | - Sharon Madigan
- Sport Ireland Institute, Dublin, Ireland
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Niamh Ní Chéilleachair
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
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Bougault V, Schiano-Lomoriello S, Castanier C, Buisson C, Ericsson M, Teulier C, Collomp K. Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms. Front Physiol 2023; 14:1185343. [PMID: 37265844 PMCID: PMC10230043 DOI: 10.3389/fphys.2023.1185343] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.
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Affiliation(s)
| | - Sandrine Schiano-Lomoriello
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health Research Group, Orléans, France
| | - Carole Castanier
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
| | - Corinne Buisson
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
| | - Magnus Ericsson
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
| | - Caroline Teulier
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
| | - Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health Research Group, Orléans, France
- Laboratoire Anti-Dopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
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Chen Z, Imai K, Zhou X. The relationship between physical activity and premenstrual syndrome in senior high school students: a prospective study. Sci Rep 2023; 13:5881. [PMID: 37041217 PMCID: PMC10090091 DOI: 10.1038/s41598-023-32357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/26/2023] [Indexed: 04/13/2023] Open
Abstract
Reproductive-aged women experience somatic and affective symptoms of premenstrual syndrome (PMS) which affect their daily life and work, but there are limited tracking data on senior high school-age female students. To investigate the characteristics and incidence of PMS, and to detect the relationship between physical exercise participation and PMS in female students of senior high school. A prospective study was conducted among senior high school female students aged 14-16 years. The participant was asked to finish two questionnaires. One questionnaire collected information about demographic data and PMS symptoms which were recorded on a daily calendar named Daily Record of Severity of Problems (DRSP) per day. Another questionnaire was physical exercises participation questionnaire, collecting times of physical education (PE) class participation, exercise times, exercise type participation in morning exercise and recess exercise, times of morning exercise, times of recess exercise per week, recess exercise time, and autonomous exercise participation of students. The data were prospectively recorded for three consecutive months. Odds ratio (OR) with 95% confidence intervals (CI) was performed for results of the multivariate logistic regression analysis model. A total of 233 participants completed the prospective study, 78 (33.5%) participants experienced PMS. The incidence of the participants with mild PMS was 20.2% while moderate PMS was 11.6% and severe PMS was 1.7%. The most common somatic symptom was fatigue while the most common affective symptom was cannot concentrate. Participants with PE classes less than 2 times per week were 4.43 times (OR 4.43, 95% CI 1.18-16.6, p < 0.05) more possible to experience PMS than those with 2 times PE classes per week. PMS is a frequent phenomenon in senior high school female students. Female students with 2 times PE classes per week show a lower incidence of PMS. This study encouraged senior high school-age females to take more physical exercises per week and could be helpful to create a no-pharmacology coping strategy.
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Affiliation(s)
- Zhuo Chen
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, 153-8902, Japan
| | - Kazuhiro Imai
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, 153-8902, Japan.
| | - Xiao Zhou
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, 153-8902, Japan
- School of Physical Education of Huazhong University of Science and Technology, Wuhan, China
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Pallante PI, Vega AC, Escobar A, Hackney AC, Rubin DA. Micronutrient intake and premenstrual syndrome in female collegiate athletes. J Sports Med Phys Fitness 2023; 63:444-451. [PMID: 36861879 DOI: 10.23736/s0022-4707.22.13829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND In non-athletic populations micronutrient consumption is associated with premenstrual syndrome (PMS). PMS can be a debilitating condition for female athletes as it may affect their performance and training. This study investigated potential differences in select micronutrients' intake in female athletes with or without PMS. METHODS Participants were thirty NCAA Division I eumenorrheic female athletes ages 18-22 years not using oral contraceptives. Participants were classified with or without PMS using the Premenstrual Symptoms Screen tool. Participants completed dietary logs (two weekdays and one weekend day) one week before their projected menstruation. Logs were analyzed for caloric, macronutrient, food sources, and vitamin D, Mg, and Zn intake. Non-parametric independent T-Tests determined differences in the median and Mann-Whitney U tests determined differences in the distribution between groups. RESULTS 23% of the 30 athletes showed PMS. There were no significant (P>0.22) for all comparisons) differences between groups for daily kilocalories (2150 vs. 2142 kcals), carbohydrates (278 vs. 271g), protein (90 vs. 100.2g), fats (77 vs. 77.2g), grains (224.0 vs. 182.6g), dairy (172.4 vs. 161.0g). vegetables (95.3 vs. 263.1g), or fruits (204.1 vs. 156.5g). A statistical trend (P=0.08) indicated differences in vitamin D intake (39.4 vs. 66.0 IU), but not for Mg (205.0 vs. 173.0 mg), or Zn (11.0 vs. 7.0mg) between groups. CONCLUSIONS No association was found between Mg, and Zn intake and PMS. However, lower vitamin D intake tended to be associated with presenting PMS in female athletes. Further studies should include vitamin D status to clarify this potential association.
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Affiliation(s)
- Paloma I Pallante
- Department of Kinesiology, California State University Fullerton, Fullerton, CA, USA
| | - Alexa C Vega
- Department of Kinesiology, California State University Fullerton, Fullerton, CA, USA
| | - Alexandra Escobar
- Department of Kinesiology, California State University Fullerton, Fullerton, CA, USA
| | - Anthony C Hackney
- Department of Exercise and Sport Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniela A Rubin
- Department of Kinesiology, California State University Fullerton, Fullerton, CA, USA -
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Takeda T. Premenstrual disorders: Premenstrual syndrome and premenstrual dysphoric disorder. J Obstet Gynaecol Res 2023; 49:510-518. [PMID: 36317488 DOI: 10.1111/jog.15484] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 02/10/2023]
Abstract
Recently, the term premenstrual disorders (PMDs), which includes premenstrual syndrome and premenstrual dysphoric disorder as a continuum, has been proposed. Although the precise etiology of PMDs remains unknown, the involvement of hormonal fluctuations is clear. The brain transmitters, serotonin and γ-amino butyric acid, also seem to be involved. Serotonin reuptake inhibitors and oral contraceptives are the current mainstay of treatment, but these are insufficient. Even the currently used prospective two-period symptom diary is not widely used in actual clinical practice, creating a major problem of discrepancy between research and clinical practice. In this review, I would like to outline the latest information and problems in the etiology, diagnosis, and treatment of PMDs, with an emphasis on promising new therapies.
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Affiliation(s)
- Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan
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Takabayashi-Ebina A, Higuchi T, Yokoyama M, Oishi M, Yokoyama Y. Survey on the Awareness of Menstruation and Menstruation-Related Problems in Athletes among Public High School Physical Education Teachers. JMA J 2023; 6:55-62. [PMID: 36793524 PMCID: PMC9908377 DOI: 10.31662/jmaj.2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 09/05/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction In recent years, the activities of female athletes have attracted increasing attention, especially regarding the effect of menstruation on athletic performance. Nevertheless, there are no surveys of these practices among coaches who train non-top-level athletes for general competition. This study aimed to investigate how high school physical education teachers approach the issue of menstruation and the awareness of menstruation-related problems. Methods This was a questionnaire-based cross-sectional study. The participants were 225 health and physical education teachers from 50 public high schools in the Aomori Prefecture. Participants were asked to answer a questionnaire regarding whether they talk to their female athletes about menstruation, keep track of their menstrual status, or make adjustments for menstruating students. Additionally, we asked for their views on painkiller use and their knowledge of menstruation. Results The participants included 183 men (81.3%) and 42 women (18.7%); data from 221 participants were analyzed after four teachers were excluded. Teachers of female athletes who communicated with students regarding their menstrual conditions and physical changes were predominantly female (p < 0.01). Regarding the use of painkillers for menstrual pain, more than 70% of respondents said that they recommended their active use. Few respondents reported that they would adjust a game because of athletes with menstrual problems. More than 90% of the respondents knew that there was a change in performance due to the menstrual cycle, and 57% of the respondents understood the relationship between amenorrhea and osteoporosis. Conclusions Menstruation-related problems are not only issues for top athletes but also important for general competition level athletes. Hence, even in high school clubs, teachers should be educated on how to deal with menstruation-related problems to prevent withdrawal from sports, maximize athletes' abilities, prevent future diseases, and preserve fertility.
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Affiliation(s)
- Anna Takabayashi-Ebina
- Department of Obstetrics and Gynecology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Tsuyoshi Higuchi
- Department of Nursing Science, Hirosaki University, Graduate School of Health Sciences, Hirosaki, Japan
| | - Minako Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Maika Oishi
- Department of Obstetrics and Gynecology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
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Foster JA, Baker GB, Dursun SM. The Relationship Between the Gut Microbiome-Immune System-Brain Axis and Major Depressive Disorder. Front Neurol 2021; 12:721126. [PMID: 34650506 PMCID: PMC8508781 DOI: 10.3389/fneur.2021.721126] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/24/2021] [Indexed: 12/17/2022] Open
Abstract
Major depressive disorder (MDD) is a prominent cause of disability worldwide. Current antidepressant drugs produce full remission in only about one-third of MDD patients and there are no biomarkers to guide physicians in selecting the best treatment for individuals. There is an urgency to learn more about the etiology of MDD and to identify new targets that will lead to improved therapy and hopefully aid in predicting and preventing MDD. There has been extensive interest in the roles of the immune system and the gut microbiome in MDD and in how these systems interact. Gut microbes can contribute to the nature of immune responses, and a chronic inflammatory state may lead to increased responsiveness to stress and to development of MDD. The gut microbiome-immune system-brain axis is bidirectional, is sensitive to stress and is important in development of stress-related disorders such as MDD. Communication between the gut and brain involves the enteric nervous system (ENS), the autonomic nervous system (ANS), neuroendocrine signaling systems and the immune system, and all of these can interact with the gut microbiota. Preclinical studies and preliminary clinical investigations have reported improved mood with administration of probiotics and prebiotics, but large, carefully controlled clinical trials are now necessary to evaluate their effectiveness in treating MDD. The roles that several gut microbe-derived molecules such as neurotransmitters, short chain fatty acids and tryptophan play in MDD are reviewed briefly. Challenges and potential future directions associated with studying this important axis as it relates to MDD are discussed.
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Affiliation(s)
- Jane A. Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Glen B. Baker
- Department of Psychiatry and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Serdar M. Dursun
- Department of Psychiatry and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Witkoś J, Hartman-Petrycka M. The Influence of Running and Dancing on the Occurrence and Progression of Premenstrual Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7946. [PMID: 34360242 PMCID: PMC8345691 DOI: 10.3390/ijerph18157946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, G. Herlinga-Grudzińskiego Street 1, 30-705 Kraków, Poland
| | - Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland, Kasztanowa Street 3, 41-200 Sosnowiec, Poland;
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Takeda T, Yoshimi K, Imoto Y, Shiina M. Associations between sleep habits and interference of premenstrual symptoms in athletic performance in Japanese adolescent athletes: a cohort study over a 2-year period. Gynecol Endocrinol 2020; 36:885-889. [PMID: 32124639 DOI: 10.1080/09513590.2020.1734787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Premenstrual symptoms are common problems among female high-school and college athletes. This prospective study investigated associations between sleep habits and interference of premenstrual symptoms in athletic performance among Japanese adolescent athletes. A school-based survey on menstruation and school life was conducted among 623 female high-school students in 2015 and 2016, and data from the two surveys were connected. In total, 262 students completed the questionnaire in both years. We recruited 108 of those students who were athletes with regular menstrual cycles. Participants completed a questionnaire about their premenstrual symptoms and lifestyle habits. The prevalence of short sleep duration (<8 h) was high (95.4%). The difference in premenstrual symptom severity in individual students between the first and second years was not significant (p > .05). Premenstrual symptoms were less associated with disturbance in 'athletic performance in training or competition' in the second year than the first. 'Longer sleeping time' in the first year was associated with lower risk of increased interference of premenstrual symptoms in athletic performance in the second year (odds ratio 0.982, 95% confidence interval: 0.970-0.994). Shorter sleep duration may therefore have an effect on premenstrual symptoms' interference with athletic performance among Japanese adolescents.
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Affiliation(s)
- Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Kana Yoshimi
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Yoko Imoto
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Masami Shiina
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
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Yamada K, Kubota Y, Paré C, Takeda T. Internet addiction belief, but not Internet use time, is independently associated with menstrual pain severity and interference to social life among adolescents: a cross-sectional study. Br J Pain 2020; 15:302-311. [PMID: 34381613 DOI: 10.1177/2049463720959377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Problematic Internet use is a serious health issue for modern adolescents who have developed and matured in a global Internet environment. This study aimed to examine whether Internet use time and Internet addiction beliefs were independently associated with menstrual pain severity and its interference among Japanese adolescents. Methods We recruited 1166 adolescents at two high schools to complete questionnaires on Internet use and menstrual pain. The explanatory variable was self-reported average Internet use time per day and Internet addiction beliefs ('none' (reference) 'somewhat', 'moderate' and 'severe'). The outcome variables were moderate-to-severe menstrual pain and interference. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for moderate-to-severe menstrual pain and interference. Adjustment variables were age, body mass index, belonging to a community or school sports club, sleep duration and Internet addiction beliefs/Internet use time. Results Internet addiction belief, but not Internet use time, was independently associated with menstrual pain severity and interference to social life in a dose-response manner. ORs (95% CIs) of moderate-to-severe menstrual pain for slight, moderate and severe Internet addition beliefs were 1.43 (1.02-1.99), 1.89 (1.31-2.74) and 1.88 (1.10-3.23), respectively. ORs of moderate-to-severe disability due to menstrual pain for slight, moderate and severe Internet addition beliefs were 1.25 (0.75-1.82), 1.72 (1.01-2.92) and 2.21 (1.11-4.40), respectively, after adjusting for average Internet use time. Conclusion Internet addiction belief was associated with higher prevalence of moderate-to-severe menstrual pain among adolescents, beyond the variance accounted for by Internet use time.
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Affiliation(s)
- Keiko Yamada
- Department of Psychology, McGill University, Montreal, QC, Canada.,Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka, Japan
| | - Catherine Paré
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka-sayama, Osaka, Japan
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Hormonal Contraceptive Use, Menstrual Dysfunctions, and Self-Reported Side Effects in Elite Athletes in Denmark. Int J Sports Physiol Perform 2020; 15:1377-1384. [PMID: 32957078 DOI: 10.1123/ijspp.2019-0636] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/27/2019] [Accepted: 01/09/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To identify the prevalence of hormonal contraceptive (HC) use, menstrual cycle disturbances, and self-perceived physical and emotional symptoms related to the menstrual cycle/pill cycle in elite female athletes. METHODS One hundred eighty-six Danish elite female athletes completed an online questionnaire to assess menstrual status and history, use of HCs, and self-perceived physical and emotional symptoms related to the menstrual cycle or HC use. RESULTS Fifty-seven percent of elite female athletes in Denmark use HC, with 74% using combined HCs and 26% using progestin only. Sixty percent of oral contraceptive users reported having manipulated their menstrual cycle by continuous oral contraceptive use. Forty-nine percent of non-HC users had a regular menstrual cycle, while 51% experienced menstrual disturbances, with 1 athlete being primary amenorrheic and 13 athletes having secondary amenorrhea. Menstrual disturbances were experienced by a larger proportion of endurance athletes (69%) compared with athletes performing power and technical disciplines. In endurance athletes amenorrhea was associated with a higher cardiovascular training volume (P < .001). Negative symptoms related to the menstrual/pill cycle were reported by both HC and non-HC users, whereas positive physical symptoms were experienced more often among the non-HC (14%) versus HC users (2%) (P < .01). Notably, 13% of the athletes reported that negative symptoms sometimes/always caused them to not participate in or complete the scheduled training. CONCLUSION HC use is common among elite athletes, and continuation of HC is used to manipulate the menstrual cycle in relation to sport competitions. HC use does not abolish dysmenorrhea, but it may reduce emotional-related side effects. Menstrual disturbances are frequent in endurance athletes and are associated with cardiovascular training volume.
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Yoshimi K, Shiina M, Takeda T. Lifestyle Factors Associated with Premenstrual Syndrome: A Cross-sectional Study of Japanese High School Students. J Pediatr Adolesc Gynecol 2019; 32:590-595. [PMID: 31518647 DOI: 10.1016/j.jpag.2019.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/29/2019] [Accepted: 09/01/2019] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To investigate the relationships between premenstrual syndrome (PMS) and lifestyle, sleep, and dietary habits among Japanese high school students. DESIGN Cross-sectional study. SETTING Two public high schools in Sendai, the largest city in northeastern Japan. PARTICIPANTS A school-based survey was conducted among 1818 female Japanese high school students in 2015, and 1022 students with regular menstrual cycles (25-38 days) completed the questionnaire. INTERVENTIONS AND MAIN OUTCOME MEASURES Relationships between PMS and lifestyle, sleep, and dietary habits. RESULTS The rates of moderate to severe PMS and premenstrual dysphoric disorder were 9.7% (99/1022) and 2.2% (22/1022), respectively. A total of 121 students (11.9%) were classified as having PMS-the PMS(+) group. Significant differences were observed between the PMS(+) group and those without PMS-the PMS(-) group-in age at menarche (P = .022), menstrual pain (P < .001), hypnagogic disorder (P < .001), long Internet use time (P < .001), eating breakfast (P = .018), chewing well (P = .037), and belonging to a sports club (P = .046). Multivariate analysis revealed that the risk factors for PMS were menstrual pain (odds ratio [OR], 4.74; 95% confidence interval [CI]: 2.83-7.95), hypnagogic disorder (OR, 2.22; 95% CI, 1.47-3.35), stress fracture (OR, 2.19; 95% CI, 1.21-3.98), and Internet use time (OR, 1.003; 95% CI, 1.001-1.005). Belonging to a sports club decreased the risk of PMS (OR, 0.57; 95% CI, 0.35-0.91). CONCLUSION Sleep, dietary habits, belonging to a sports club, and screen time affect PMS among high school students.
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Affiliation(s)
- Kana Yoshimi
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Masami Shiina
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan.
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The prevalence of primary dysmenorrhea among students and its association with musculoskeletal and myofascial pain. J Bodyw Mov Ther 2019; 23:785-791. [PMID: 31733762 DOI: 10.1016/j.jbmt.2019.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/05/2019] [Accepted: 05/10/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To examine the association between dysmenorrhea and musculoskeletal pain amongst university students aged 20-35 and the association between dysmenorrhea and the occurrence of MTrPs. METHODS The study comprised two stages: a cross-sectional study evaluated the association between dysmenorrhea and musculoskeletal pain and a case-control study evaluated the association between dysmenorrhea and the occurrence of MTrPs in the abdominal and pelvic area. Initially, questionnaires such as demographics, menstruation characteristics, Numeric Pain Rating Scale (NPRS), measuring the average pain during menstruation and Nordic, were distributed to female students. Twenty subjects who suffered from menstrual pain of >3 on the NPRS (ones with the highest scores) were included in the second stage as cases. An additional 20 who had not suffered from menstrual pain (NPRS ≤3) were considered controls. All 40 subjects underwent an assessment of MTrPs by two examiners blinded to each other's results and to the group allocation of the subjects. RESULTS We found that dysmenorrhea is a very prevalent condition among young female students. Most frequent complaints were: lower abdomen and back pain, tiredness, breast tenderness, mood changes, and an increased appetite. Pain during menstruation indicated a significant positive association with neck, low back, and hip/thigh pain during the last 12 months. The results of the palpitation conclusively showed more active MTrPs in the rectus abdominis, quadratus lumborum and paraspinal muscles in women suffering from pain during menstruation than in those who were not in pain. CONCLUSION Our data provide an initial basis for the inclusion of a myofascial examination when evaluating women with dysmenorrhea.
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Takeda T, Ueno T, Uchiyama S, Shiina M. Premenstrual symptoms interference and equol production status in Japanese collegiate athletes: A cross-sectional study. J Obstet Gynaecol Res 2017; 44:488-494. [PMID: 29226551 PMCID: PMC5873425 DOI: 10.1111/jog.13552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/11/2017] [Indexed: 11/29/2022]
Abstract
Aim Consumption of soy isoflavones reduces the risk of estrogen‐related diseases, such as menopausal symptoms, osteoporosis, and cardiovascular disease. Equol is metabolized from the isoflavone daidzein by intestinal bacteria and has higher bioavailability than other isoflavones. Equol producers are believed to benefit from soybean consumption to a greater extent than non‐producers. Recently, we showed that equol non‐producers were at significant risk of premenstrual syndrome (PMS). Previously, we reported that PMS is a common menstrual problem in female athletes, and almost half of the studied athletes felt a negative effect of premenstrual symptoms on their athletic performance. This study was conducted to evaluate the relation between PMS and equol production status in Japanese collegiate athletes. Methods This was a cross‐sectional, observational study that included 88 Japanese female collegiate athletes. Equol production status was determined using urine samples collected after a soy challenge test. The subjects also completed a questionnaire about their premenstrual symptoms and their competitive career. Results The prevalence of equol producers was 29.5% in Japanese collegiate athletes. The athletic performance of 54.5% of athletes was found to suffer in competition or in practice due to premenstrual symptoms. In multivariate analysis, equol non‐producers (odds ratio, 3.34; 95% confidence interval, 1.03–12.20) and restriction of bodyweight (odds ratio, 4.94; 95% confidence interval, 1.47–20.00) were shown to be significant risk factors for poor athletic performance. Conclusion This study showed a relation between athletic performance and equol production status in Japanese collegiate athletes.
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Affiliation(s)
- Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Tomomi Ueno
- Saga Nutraceuticals Research Institute of Otsuka Pharmaceutical Co., Ltd, Saga, Japan
| | - Shigeto Uchiyama
- Saga Nutraceuticals Research Institute of Otsuka Pharmaceutical Co., Ltd, Saga, Japan
| | - Masami Shiina
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
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