Perimenstrual symptoms and health-seeking behavior

Effects of Yoga for Coping with Premenstrual Symptoms in Taiwan-A Cluster Randomized Study

Home-based yoga practice has not been approved as a method for alleviating premenstrual symptoms in Taiwan. This study was a cluster randomized trial. A total of 128 women self-reporting at least one premenstrual symptom were enrolled in the study, of which there were 65 participants in the experimental group and 63 participants in the control group. Women in the yoga group were provided with a yoga DVD program (30 min) to practice for three menstrual months, at least three times a week. All participants were given the Daily Record of Severity of Problems (DRSP) form to measure premenstrual symptoms. After the yoga exercise intervention, the yoga group had statistically significantly fewer and/or less severe premenstrual depressive symptoms, physical symptoms, and anger/irritability. Other disturbances and the impairment of daily routine, hobbies/social activities, and relationships also occurred significantly less often in the yoga group. The study found that yoga is useful to relieve premenstrual symptoms. Moreover, home-based yoga practice is more pertinent in the pandemic era. The strengths and drawbacks of the study are discussed and further study is recommended.

Beliefs About Dysmenorrhea and Their Relationship to Self-Management

Dysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care-seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management. © 2016 Wiley Periodicals, Inc.

It’s not all bad: Women’s construction and lived experience of positive premenstrual change

Although premenstrual change is invariably pathologized and described as PMS or PMDD, there is evidence that many women experience premenstrual changes positively. This suggests that premenstrual change is both a lived experience and social construction, which is not inevitably positioned as debilitating or distressing. However, previous research has provided little insight into how and why women construct premenstrual change as positive. Accordingly, the present study used a critical realist epistemology and a material-discursive-intrapsychic model to explore women’s construction and lived experience of positive premenstrual change. Drawing on focus groups with 47 women, explanations for positive premenstrual experiences included: ‘positive emotional outcomes’, ‘releasing tension’, ‘increased attractiveness’, ‘legitimacy of self-care’ and ‘indication of menstruation’. Findings not only reinforce reports from previous research that many women experience positive premenstrual changes, but also challenge bio-medical conceptualizations of premenstrual change as inherently negative, with accounts of relational negotiation emphasizing the context-dependent nature of premenstrual change.

Prevalence and severity of menstrual symptoms among institutionalised women with an intellectual disability

BACKGROUND

Perimenstrual syndrome (PMS) among women with an intellectual disability (ID) has not been investigated in Taiwan. This study explores the prevalence/severity of PMS experienced by women with ID who are institutionalised.

METHOD

Ninety two female residents aged 15 to 54 at six public institutions completed a structured interview between June and November 2006, together with the Moos Menstrual Distress Questionnaire (MMDQ).

RESULTS

Strong significant differences were detected between the participants' physical, emotional, behavioural, and psychological changes during the perimenstrual and remainder phases in all domains other than Arousal. Cramps, hot flushes, affection, orderliness, excitement, and bursts of energy/activity were most prevalent during the perimenstruum (>50%). The participants' unique characteristics and cultural context were associated with the various domains of the PMS.

CONCLUSIONS

Special attention should be paid in future to ascertain whether these experiences and perceptions of PMS are common among all women with ID.

Health seeking related to ovarian cancer

Critical review of general health-seeking models showed a need for expansion to include the early and atypical symptom period associated with ovarian cancer and the role of self and primary care in the diagnostic process. Data from family functioning research showed that in the self-care phase, the initial gastrointestinal symptoms were unrecognized as serious, given common sense labels, and self-managed. When primary care provider care was sought, misdiagnoses occurred three fourth of the time. Diagnostic delays occurred in these 2 phases of care. An expansion of a model of health seeking links personal and family risks and adds early symptom data may be obtained through monthly self-monitoring by women using a symptom checklist. Organization of risks and symptom information assists in interpretation of disparate streams of data and gives a recommended outcome: high personal risk level + high family risk level + high early and persistent symptoms presence = high need for a prompt gynecological evaluation. The restructured health-seeking process requires women be taught how to monitor their ovarian health. Nurses and primary care providers need frequent continuing education updates and the health media need current and accurate information about this malignancy.

The relationship between menstrual attitudes and menstrual symptoms among Taiwanese women

AIM OF THE STUDY

This study explored characteristics of the menstrual cycle including duration, prevalence and severity of symptoms and examined the relationship of these characteristics with attitudes toward menstruation.

BACKGROUND

Conceptualization of menstrual phenomena and attitudes toward menstruation may vary among cultures. While data about menstrual health among American women are widely available, there are little data concerning menstrual health in Taiwanese women.

DESIGN/METHODS

A total of 30 healthy women with a mean age of 24.4 years participated in the study and made daily records of symptoms over a 90-day period with the Woods Daily Health Diary (WDHD). They then retrospectively completed the Moos Menstrual Distress Questionnaire (MMDQ) and the Menstrual Attitudes Questionnaire (MAQ).

RESULTS

The mean age of menarche of these women was 13 years, their mean cycle duration was 5.8 days and the cycle length was 31.1 days. The mean scores of five subscales for MAQ ranged from 2.19 to 3.28. Forty-six percent of the surveyed Taiwanese women agreed that the onset of menstruation can be predicted and anticipated, and 78% of these women agreed that menstruation was a natural event.

CONCLUSIONS

Menstrual attitudes in Taiwanese women are multidimensional, and that significant cross-cultural differences are present. Attitudes toward menstruation in Taiwanese women are related to their physical, cognitive, behavioural and psychological changes in the premenstrual and menstrual phases.

Medical care-seeking for menstrual symptoms

Fifty-six female undergraduates completed questionnaires regarding their menstrual symptoms, social learning experiences, and illness representations. The results showed that, compared to non-care-seekers, participants who had sought medical care for their menstrual symptoms reported more symptoms that had been problematic since menarche. Consistent with previous research, care-seekers reported more reinforcement for adolescent menstrual illness behaviours than non-care-seekers. Care-seekers also reported their symptoms as more serious and more difficult to ignore. The perceived seriousness and severity of symptoms were both correlated with reinforcement for adolescent menstrual symptoms. Lay referral was also a reported factor in care-seekers. The results of the present data are discussed with respect to previous research on care-seeking for menstrual and other symptoms.

Women's perceptions of phenomena they label premenstrual tension: normal experiences reflecting ordinary behaviour

Remarkably little empirical knowledge exists about premenstrual tension (PMT), a construct that has been studied intensively during the last 30 years. Practically nothing is known about the perceptions women have about PMT. The purpose of this study is to describe the perceptions healthy women have about PMT. Seventeen women, who had 4 years earlier participated in a concurrent diary study assessing the prevalence of PMT, were interviewed. The interviews were analysed by means of a qualitative content analysis. Four main categories describing the women's perceptions were formed: (1) individual experiences of phenomena referred to as PMT; (2) phenomena referred to as PMT reflect ordinary experiences in healthy women; (3) biopsychosocial explaining of phenomena referred to as PMT; (4) internal and external resources used to manage the variability of phenomena referred to as PMT. The content of these categories reflects the participants' perceptions of PMT as the common, normal and very variable experiences which women handle by the use of management strategies commonly used in contemporary society to deal with life in general. Experiences of women differ with respect to what they experience and the timing and persistence of those experiences. This the participants explain from a biopsychosocial perspective. It is suggested that women have adapted a medical term, PMT, to describe what they consider normal female phenomena.

Premenstrual symptoms: delineating symptom clusters

The purposes of this study were to (1) identify the clusters of symptoms women experience during the premenstruum, (2) assess the reliability of the symptom clusters as reported by a population-based sample and a sample of women with three perimenstrual symptom patterns, (3) compare the levels of severity for the symptom clusters across menstrual cycle phases and by symptom patterns (e.g., premenstrual syndrome [PMS] vs. low severity), and (4) estimate the stability of the symptom cluster rankings across three menstrual cycle phases. Data from a cross-sectional population-based sample and a comparative sample of women screened for low-severity (LS), PMS, and premenstrual magnification (PMM) symptom patterns were analyzed using factor analysis, correlation coefficients, multivariate analysis of variance, and reliability and stability coefficients. Four symptom clusters accounted for >40% of the variance: turmoil, fluid retention, somatic symptoms, and arousal symptoms. Alpha (alpha) levels were >.70 for turmoil and fluid retention. None of the symptom clusters had correlations with other factors that exceeded a levels for sample 2. Symptom cluster scores varied by cycle phase and group (LS, PMS, PMM). Arousal and somatic symptoms were the most stable of the symptom clusters across cycle phases, and fluid retention and turmoil symptoms were less stable.

Positively reframing perceptions of the menstrual cycle among women with premenstrual syndrome

OBJECTIVE

To positively reframe perceptions of menstrual cycle experiences to diminish reports of negative perimenstrual symptoms among women with premenstrual syndrome (PMS).

DESIGN/SAMPLE

A longitudinal quasi-experimental research design; data were collected on 28 women.

SETTING

Treatment sessions were conducted in a university classroom in the northeastern United States.

INTERVENTION

The intervention consisted of a health promotion program that provided social support and a psychoeducational intervention with a positive reframing psychotherapeutic maneuver.

MAIN OUTCOME MEASURES

To describe (a) perceptions of biologic, psychologic, and social outcomes related to perimenstrual changes and (b) compare biologic, psychologic, and social outcomes of women participating in a health promotion intervention with women not participating.

RESULTS

Negative perimenstrual symptom reports decreased for women in the experimental group. In addition, the participants' personal resources increased significantly.

CONCLUSIONS

Participation in a peer support group that provides women with information on positive concomitants of the menstrual cycle can benefit women with PMS.

Premenstrual symptomatology: role of prior knowledge about premenstrual syndrome

OBJECTIVE

Most women have some premenstrual symptoms that may be influenced by diverse environmental factors. The aim of this study was to determine the influence of knowledge about premenstrual syndrome (PMS) in the reports of women and their symptoms.

METHOD

We studied 86 healthy Mexican women whose highest level of education was sixth grade. Participants were assigned to one of two groups. The experimental group watched a videotape describing PMS and its negative consequences in daily life. The control group watched a videotape describing the menstrual cycle. The Menstrual Distress Questionnaire was administered to all women during the first week after menstruation, after which they were shown their designated videotape, and the questionnaire was administered again after the next menstruation.

RESULTS

In the control group, there were no significant differences in premenstrual symptoms reported both before and after the women watched the videotape. However, women in the experimental group reported more severe premenstrual symptoms after watching the videotape.

CONCLUSIONS

These results suggest that after observing the videotape, women's expectancies of negative symptoms in the premenstrual phase increased. Thus, the symptoms reported by these women were enhanced.

Relationships between premenstrual complaints and perimenopausal experiences

This study evaluates whether a history of menstrually-related problems, termed premenstrual complaints (PMCs), is a significant predictive marker for a more symptomatic perimenopausal experience. Two hundred and ninety-one randomly selected urban women, aged between 45 and 55 years were interviewed yearly for three consecutive years to record their individual experiences and changes as they progressed through the menopause transition. Repeated measures were obtained on a range of physical, psychological and social indicators. The experiences of women who reported a self-defined history of premenstrual complaints (n = 104) were compared with those women with no prior premenstrual problems (n = 187) and predictors of perimenopausal symptoms were assessed. Relationships were found between a prior history of both physical and psychological premenstrual complaints and a more symptomatic perimenopause characterised by dysphoria, skeletal, digestive and respiratory symptoms (all ps < 0.05). The more symptomatic women also reported pronounced interpersonal stress (p < 0.001), significant 'hassles', current smoking and low exercise (ps < 0.05). The findings support predictive relationships between a prior history of premenstrual problems and a more problematic menopause transition. The issues of vulnerability and help-seeking behaviors are discussed.

Effect of positive reframing and social support on perception of perimenstrual changes among women with premenstrual syndrome

Traditional menstrual cycle research reflects a stereotypical negative bias that does not encompass the complexity of the phenomena. For example, even though the majority of menstrual cycle literature has focused on negative changes during the perimenstruum, some women report positive changes. This article describes a unique intervention aimed at reframing perceptions of menstrual cycle experiences for the purpose of diminishing perimenstrual impairment. The intervention was a health promotion program that provided social support and a positive reframing component for women with premenstrual syndrome (PMS) across four menstrual cycles. Through use of a preexperimental design, data were collected on 18 women. Daily measures included prospective assessment of perceptions of perimenstrual changes (impairment and activation). Retrospective assessments of moods (anxiety and depression), social resources (personal resources and marital satisfaction), and perimenstrual change perceptions were gathered at three time periods--before, during, and after the experimental condition. Data analyses included descriptive and multivariate strategies. Results indicated that, although perimenstrual activation did not increase significantly, impairment did decrease. In addition, there were significant changes from baseline to follow-up on state depression and personal resource variables. Findings from this study underscore the need for further investigation of the wide continuum of women's diverse menstrual cycle experiences.

Daily symptoms and responses in adults: a review

Healthy adults experience a variety of symptoms and health problems each day and the responses to these symptoms and problems vary significantly from doing nothing to consulting professional help. Patterns of daily symptoms for well adults, the symptom experience, and responses to daily symptoms are reviewed. Nurses and other health care professionals must be aware of the dynamic process of symptom identification, monitoring, lay and professional consultation, and decision making to facilitate client's health promotion and disease prevention efforts.

Health care diaries of young women

The purpose of this study was to describe young women's self-care activities related to health maintenance and symptom management. Seventy-six young adult women kept a daily health diary for 3 weeks. They reported a total of 1,213 health maintenance practices. The self-care interventions used to manage symptoms were varied and specific to the reported symptoms. The most frequently reported illness management activity was the use of over-the-counter medications. The self-care measures selected by these young women reflect deliberate approaches to their situations. The findings suggest that nurses in the community should use young adult health promoting and health maintaining behaviors as a basis for designing interventions.

Social pathways to premenstrual symptoms

The purpose of this study was to explore feminine and menstrual socialization, expectations about experiencing symptoms, and the stressful nature of women's lives among women with three perimenstrual symptom patterns. Social learning and stress theory provided a theoretical framework for understanding why some menstruating women experience premenstrual syndrome or premenstrual magnification symptom patterns. Data about socialization, stressful life context, expectations about symptoms, depressed mood, and other health-related and demographic indicators were obtained from an interview. Subsequent daily recordings in a health diary for two or more menstrual cycles provided data with which to classify women's symptoms across the menstrual cycle as a low severity symptom (LS, n = 73), premenstrual syndrome (PMS, n = 36), or premenstrual magnification (PMM, n = 62) pattern. Stepwise discriminant function analysis demonstrated that stressful life context, menstrual socialization, and expectations about symptoms related to menstruation differentiated women with an LS from those with a PMS or PMM symptom pattern. In addition, depressed mood differentiated the three groups.

Arousal and stress response across the menstrual cycle in women with three perimenstrual symptom patterns

The purpose of this study was to compare arousal levels and stress response across menstrual cycle phases in women with three perimenstrual symptom patterns. Women with low symptom severity (LS, N = 28), were compared with those with a premenstrual syndrome (PMS, N = 15) and premenstrual magnification (PMM, N = 19) pattern across postmenses and premenses phases. Each woman was assessed during relaxation and in response to mental task and symptom imaging stressors during a postmenses and premenses day. Results of baseline skin conductance (SCL), electromyogram (EMG), and finger temperature (T) demonstrated arousal premenses in women with the PMS pattern, but not in women with the LS pattern. In addition, women with the PMS pattern experienced increased EMG and SCL response to stressors premenses. Women with the PMM pattern experienced a rise in finger temperature premenses, opposite the pattern of the women with LS or PMS. These results support development of symptom management strategies to reduce arousal and modulate stress response for women with PMS who seek help for their symptoms. In addition, the difference in arousal and stress response observed in women with PMS and PMM support development of different symptom management strategies for these two groups of women.