Effect of exercise on symptoms of premenstrual syndrome in low and middle-income countries: a protocol for systematic review and meta-analysis

The Effect of Physical Activity on Premenstrual Syndrome: A Systematic Review

Background

Physical, emotional, and behavioural symptoms that can significantly impact daily life are the hallmarks of premenstrual syndrome (PMS), a common illness affecting women of reproductive age. There are many different ways to manage PMS, and there is mounting evidence that physical activity may be helpful in reducing symptoms. With an emphasis on different exercise modalities such as weight training, yoga, and aerobic activity, this systematic review attempts to investigate how physical activity affects the management of PMS symptoms.

Summary

A systematic review of studies published between 2009 and 2023 was conducted, adhering to PRISMA guidelines. Articles from PubMed, Embase, and the Cochrane Library were evaluated based on inclusion criteria focusing on the effects of physical activity on PMS symptoms. The findings indicate that regular participation in exercises such as weight training, yoga, and aerobic activities significantly reduces fatigue, improves mood regulation, and alleviates physical discomfort associated with PMS. These results highlight the benefits of exercise as an effective, non-pharmacological intervention for managing PMS symptoms.

Key Messages

Incorporating regular physical activity into daily routines can serve as a practical and sustainable approach to managing PMS symptoms. Women suffering from PMS can experience improved physical and psychological well-being through diverse forms of exercise, including yoga and aerobic workouts. This underscores the role of exercise as a holistic and accessible intervention for enhancing women's health.

The effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome: a single-blind, randomized controlled trial

BACKGROUND

Premenstrual syndrome affects many women in their reproductive years and often disrupts their social connections and work. This study aimed to compare the effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome.

METHODS

In this four-group parallel clinical trial with blinded data analysis, 120 eligible students who experienced premenstrual syndrome were recruited based on inclusion/exclusion criteria and randomly allocated to four groups (n = 30) including three experiment groups as positive psychology, physical activity, and positive psychology, physical activity, and control group, using a simple randomization method. All four groups completed premenstrual syndrome screening and the DASS-21 questionnaire before the intervention. Then, the positive psychology intervention group received eight sessions of 70-90 min weekly intervention, the second group received eight weeks of aerobic physical activity intervention, and the third group received positive psychology and physical activity intervention for eight weeks. The control group did not receive any interventions. The DASS-21 was completed immediately after the intervention and two months later by all four groups. In this study, the participants and investigators were not blinded; however, the analysts were. The recruitment process took place from September 2018 to March 2019. One hundred twenty participants fulfilled the study. The Data were collected and analyzed using SPSS (v18).

RESULTS

Before and immediately after the intervention, there was no statistically significant difference in depression, anxiety, and stress mean scores among the positive psychology, physical activity, positive psychology, and physical activity and control groups (p ≥ 0.05). However, two months after the intervention, a significant difference was observed between the four groups so there was a difference between the scores of the three intervention groups and the control group (p < 0.05). There was no significant difference between positive psychology, and physical activity groups. No significant adverse events or side effects were observed.

CONCLUSION

Our findings supported the use of aerobic physical activity and educational interventions based on positive psychology as non-pharmacologic interventions to reduce anxiety, depression, and stress. This research should be replicated in different settings.

TRIAL REGISTRATION CLINICAL TRIALS

Iranian Registry of Clinical Trials; https://irct.behdasht.gov.ir/trial/32363 (IRCT20130812014333N97), registered (11/08/2018).

Do contrasting socio-ecological conditions bring difference in premenstrual syndrome and its concomitants? A sedente-migrant comparative study from Eastern India

OBJECTIVES

We asked in our research whether the premenstrual syndrome (PMS) and its concomitants, differ between "sedente" and "migrant" populations hailing from the same ethnic group, owing to their living in contrasting socio-ecological conditions.

METHODS

A total of 501 Oraon adolescents (sedente: 200, migrant: 301) were studied. Data on PMS was reported retrospectively using a list of 29 standard symptoms. Principal component analysis (PCA) was applied on PMS. PCA, which resulted in six principal components (PC1 to PC6) were loaded with "behavioral and cognitive," "negative mood," "pain and fluid retention," "vestibular and breast tenderness," and "fatigue," and/or "gastrointestinal" symptoms. Step-wise hierarchical regression was applied using migration status (step 1), socio-demographic (step 2), menstrual (step 3), and nutritional and lifestyle variables (step 4) as concomitants for each principal component.

RESULTS

Significantly, a greater number of migrants reported PMS but of milder intensity, unlike the sedentes. Significant sedente-migrant differences were found in the concomitants for PMS. Multivariate analyses showed differential socio-demographic (occupational, educational and wealth status, religion), nutritional (dietary carbohydrate protein and fat, tea intake, body mass index, percent body fat, waist hip ratio, fat mass index), menstrual (age at menarche, cycle length, dysmenorrhoea) and anemic status of the sedentes and the migrants were significantly associated with PMS.

CONCLUSIONS

Sedente and migrant participants, despite hailing from the same ethnic group, sharply differed in the prevalence of PMS and its concomitants owing to their living in contrasting socio-ecological conditions.

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.

Evaluation of the effectiveness of yoga in management of premenstrual syndrome: a systematic review and meta-analysis

Aim: The management of Premenstrual Syndrome (PMS) is still evolving due to the modest effect sizes of the available treatment modalities. Yoga as therapeutic intervention in PMS has been gathering interest amongst researchers. The current manuscript reviews the evidence surrounding yoga in PMS.Methods: This manuscript was a systematic review and meta-analysis evaluating the effectiveness of yoga on the total scores and sub-domains of PMS after studies were identified using a pre-defined selection criterion after a search in PubMed, Google Scholar, Scopus and Web of Science. Both quantitative and qualitative analysis of the accumulated data was performed. Overall, 14 studies were identified for the review, 11 of which were used for the purpose of quantitative analysis.Results: The studies were heterogenous in terms of the design, yoga regimes, nature of interventions and tools used for outcome measures. It was found that yoga was beneficial in the management of PMS. This benefit was also seen when all the sub-domains of PMS were individually examined except physical sub-domain.Conclusion: Though there were certain limitations in our review like heterogeneity in studies, possibility of publication bias and restrictive selection criterion; it supported that yoga can be beneficial in patients with PMS.