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Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024; 25:104574. [PMID: 38788887 PMCID: PMC11347097 DOI: 10.1016/j.jpain.2024.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).
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Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, Indianapolis, Indiana.
| | - Sarah K Rogers
- Department of Psychology, School of Science, Indiana University Purdue University-Indianapolis, Indianapolis, Indiana
| | - Rui Li
- Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Rachel J Hinrichs
- Indiana University Indianapolis, University Library, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Gillen MM, Rosenbaum DL, Winter VR, Bloomer SA. Hormonal contraceptive use and women's well-being: links with body image, eating behavior, and sleep. PSYCHOL HEALTH MED 2024; 29:905-916. [PMID: 37220269 DOI: 10.1080/13548506.2023.2216468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
The goal of the current study was to examine associations between hormonal contraceptive use and indicators of well-being including body image, eating behavior, sleep and energy level. Drawing on a health protection framework, we expected that individuals who use hormonal contraceptives would be more attuned to health and report more positive health attitudes and behaviors on these dimensions. Undergraduate college women (N = 270; M = 19.39 years, SD = 2.43, range 18-39 years) from diverse racial/ethnic and sexual orientation groups completed a survey online. Measures included hormonal contraception use, body image, weight control behavior, breakfast consumption, sleep behavior, and daytime energy level. Nearly 1/3 (30.9%) of the sample reported current hormonal contraceptive use, with most users reporting use of birth control pills (74.7%). Women who used hormonal contraceptives reported significantly higher appearance orientation and body surveillance, lower average energy, more frequent night awakenings, and more naps. Longer duration of hormonal contraceptive use was significantly related to higher body surveillance, and engaging in more unhealthy weight control behavior. Hormonal contraceptive use is not related to indicators of greater well-being. Rather, hormonal contraceptive use is related to greater attention to appearance, lower daytime energy, and some indicators of poorer sleep quality. Clinicians who prescribe hormonal contraceptives should attend to body image, sleep and energy concerns among users.
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Affiliation(s)
- Meghan M Gillen
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | - Diane L Rosenbaum
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | | | - Steven A Bloomer
- Division of Science and Engineering, The Pennsylvania State University, Abington, PA, USA
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Jarosz AC, Noori D, Zeitoun T, Garcia-Bailo B, El-Sohemy A. Variation in the vitamin D receptor gene, plasma 25-hydroxyvitamin D, and risk of premenstrual symptoms. GENES & NUTRITION 2021; 16:15. [PMID: 34551710 PMCID: PMC8459465 DOI: 10.1186/s12263-021-00696-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022]
Abstract
Background Vitamin D status has been associated with the presence and severity of several premenstrual symptoms (PMSx) in some, but not all studies. Inconsistencies among findings may be explained by unaccounted genetic variation in the vitamin D receptor (VDR). Objective To determine whether associations between vitamin D status and individual PMSx are influenced by VDR genotype. Methods Seven hundred sixteen women aged 20-29 years old from the Toronto Nutrigenomics and Health study provided plasma samples and completed a questionnaire on the presence and severity of 15 common PMSx. Plasma 25-hydroxyvitamin D (25(OH)D) concentration was measured and participants were categorized into sufficient (≥ 50 nmol/L) and insufficient (< 50 nmol/L) vitamin D status groups. DNA was obtained from blood samples to genotype for a common VDR single nucleotide variant, rs796858. Using logistic regression, odds of experiencing PMSx were compared between vitamin D-sufficient and insufficient women, stratified by genotype. Results Among CC homozygotes, insufficient vitamin D status was associated with higher odds of experiencing premenstrual fatigue (OR, 2.53; 95% CI, 1.40, 4.56) and nausea (OR, 2.44; 95% CI, 1.00, 5.95). Among TT homozygotes, insufficient vitamin D status was associated with lower odds of experiencing fatigue (OR, 0.44; 95% CI, 0.20, 0.97) and increased appetite (OR, 0.48; 95% CI, 0.22, 1.04). Insufficient vitamin D status was associated with higher odds of increased appetite in women with the CT genotype (OR, 1.78; 95% CI, 1.03, 3.07). VDR genotype modified the association between vitamin D status and the following PMSx: increased appetite (interaction p = 0.027), fatigue (interaction p = 0.016), and nausea (interaction p = 0.039). Conclusion We found evidence that VDR genotype may modify the association between 25(OH)D and some PMSx. Insufficient 25(OH)D was associated with a higher risk of premenstrual fatigue in those with the CC genotype, but lower risk in those with the TT genotype. Supplementary Information The online version contains supplementary material available at 10.1186/s12263-021-00696-2.
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Cheng J, Santiago KA, Abutalib Z, Temme KE, Hulme A, Goolsby MA, Esopenko CL, Casey EK. Menstrual Irregularity, Hormonal Contraceptive Use, and Bone Stress Injuries in Collegiate Female Athletes in the United States. PM R 2021; 13:1207-1215. [PMID: 33340255 PMCID: PMC8262270 DOI: 10.1002/pmrj.12539] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Menstrual irregularity (MI) is common in female athletes and is a component of the Female Athlete Triad (Triad). Many athletes with the Triad are started on hormonal contraceptives (HC) for MI, but this interferes with the ability to monitor menstrual cycle regularity and can mask other causes of MI. There are limited studies investigating the relationship between MI, HC use, and injury in female collegiate athletes. OBJECTIVE To examine the prevalence of and relationship between HC use, MI, and bone stress injuries in female collegiate athletes in the United States. DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS 1020 U.S. female collegiate athletes (age ≥ 18 years). METHODS OR INTERVENTIONS Assessment of risk factors for menstrual irregularity and bone stress injuries was conducted via a one-time survey. MAIN OUTCOME MEASURES HC use, MI, history of stress fractures. RESULTS Current HC use prevalence was 65% (95% confidence interval [CI], 61.9%, 67.8%). Of all athletes, 47% reported past MI. Of the athletes who were not currently using HCs, 32% had current MI. Compared with athletes without past MI, more athletes with past MI reported current HC use (73% vs. 57%) and indicated menstrual cycle consistency as the primary reason for use (24% vs. 4%) (P < .001). Additionally, 25% of athletes reported a history of stress fractures, which was associated with lean/aesthetic sports participation (odds ratio [95% CI]: 1.9 [1.4, 2.5]; P < .001) and less oral contraceptive pill (OCP) use (0.7 [0.5, 1.0]; P = .043). Compared with OCPs, injectable HCs were associated with greater odds of a history of stress fractures (4.5[1.6, 12.3]; P = .004). CONCLUSIONS HC use was prevalent among this cohort of female collegiate athletes, and almost half of the athletes reported past MI. A goal of menstrual cycle regularity was cited by 24% of athletes as a primary reason to use HCs, which shows that more athlete education is needed to avoid masking MI and the Triad with HCs. Further studies elucidating the relationship between HC use, MI, and sports-related injury are warranted.
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Affiliation(s)
- Jennifer Cheng
- Department of Physiatry, Hospital for Special Surgery, New York, NY
| | | | - Zafir Abutalib
- Biostatistics Core, Hospital for Special Surgery, New York, NY
| | - Kate E. Temme
- Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Ann Hulme
- Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Marci A. Goolsby
- Department of Primary Care Sports Medicine, Hospital for Special Surgery, New York, NY
| | - Carrie L. Esopenko
- Department of Rehabilitation and Movement Sciences, Rutgers Biomedical Health Sciences, Newark, NJ
| | - Ellen K. Casey
- Department of Physiatry, Hospital for Special Surgery, New York, NY
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Plasma Carotenoids and Premenstrual Symptoms in a Multi-Ethnic Population of Young Women. Nutrients 2021; 13:nu13113870. [PMID: 34836125 PMCID: PMC8618911 DOI: 10.3390/nu13113870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
Premenstrual symptoms are experienced by most women of reproductive age, but effective therapies are limited. Carotenoids may have an attenuating effect on premenstrual symptoms; however, studies to date are equivocal. The objective of the present study was to examine the association between plasma concentrations of seven carotenoids and premenstrual symptom severity in 553 women from the Toronto Nutrigenomics and Health study. Participants provided information on fifteen common premenstrual symptoms and severities. Each participant completed a General Health and Lifestyle Questionnaire and provided a fasting blood sample from which plasma carotenoid concentrations were measured. Multinomial logistic regressions were used to determine associations between plasma carotenoid concentrations and premenstrual symptom severity. Beta-cryptoxanthin was associated with moderate/severe increased appetite for women in the highest compared to the lowest tertile (OR: 2.33; 95% CI: 1.39, 3.89). This association remained significant after adjusting for multiple comparisons. There were no observed associations between other plasma carotenoids and any premenstrual symptoms. In summary, higher concentrations of beta-cryptoxanthin were associated with an increased appetite as a premenstrual symptom, but no associations were observed for any other carotenoid and for any other symptom.
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Zeitoun T, Dehghan Noudeh N, Garcia-Bailo B, El-Sohemy A. Genetics of Iron Metabolism and Premenstrual Symptoms: A Mendelian Randomization Study. J Nutr 2021; 151:1747-1754. [PMID: 33758941 DOI: 10.1093/jn/nxab048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/16/2021] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many women of reproductive age experience adverse psychological and physiological premenstrual symptoms. These symptoms may last for most of the reproductive years and can negatively affect the quality of life of many women. Some studies have examined the role of micronutrients in premenstrual symptoms, but the research on iron has been limited. OBJECTIVES The objective of this study was to evaluate the effects of genetic predictors of iron overload and low iron status on premenstrual symptoms using Mendelian randomization. METHODS We examined 254 White females aged 20-29 y from the Toronto Nutrigenomics and Health Study. DNA was isolated from peripheral white blood cells and genotyped for the homeostatic regulatory iron gene (HFE; rs1800562 and rs1799945), transmembrane protease serine 6 (TMPRSS6; rs482026), transferrin receptor 2 (TFR2; rs3811647), and transferrin (TF; rs738584) polymorphisms. Risk of iron overload or low iron status was determined based on combined genotypes. Binomial logistic regressions were carried out to examine the association between genetic risk of iron overload or low iron status and the presence of premenstrual symptoms. RESULTS Compared with participants with typical risk of iron overload, those with an elevated risk of iron overload were less likely to experience premenstrual symptoms of confusion (OR: 0.13; 95% CI: 0.02, 1.00), headaches (OR: 0.28; 95% CI: 0.08, 0.98), and nausea (OR: 0.13; 95% CI: 0.02, 0.99) after adjusting for BMI, age, and vitamin C and calcium intake. No associations were seen with the other symptoms. There were also no associations between low iron status genotypes and premenstrual symptoms. CONCLUSIONS This Mendelian randomization study demonstrates that women with an elevated risk of iron overload may have a lower risk of experiencing some premenstrual symptoms (headache, confusion, and nausea), suggesting that iron status could impact the risk of certain premenstrual symptoms.
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Affiliation(s)
- Tara Zeitoun
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Negar Dehghan Noudeh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bibiana Garcia-Bailo
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Conzatti M, Maciel RF, Perez AV, De Castro DH, Sbaraini M, Wender MCO. Premenstrual Syndrome and Female Sexual Function. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:186-196. [PMID: 33302813 DOI: 10.1080/0092623x.2020.1856988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To examine the relationship between Premenstrual Syndrome (PMS) and female sexual function (FSF) with the luteal (LP) and follicular phases (FP). METHOD We performed a cross-sectional survey using the Female Sexual Function Index (FSFI) questionnaire in the LP and FP. We used the Brazilian's version of the Premenstrual Symptoms Screen Tool (PSST) and the Daily Record of Severity of Problems (DRSP) for diagnosis of PMS. RESULTS There was no difference in the FSF between groups in both cycle phases. We found an association between LP and worst scores on FSFI. CONCLUSION PMS does not affect FSF.
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Affiliation(s)
- Maiara Conzatti
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Faculdade de Medicina, Universidade do Vale do Taquari (UNIVATES), Rio Grande do Sul, Brasil
| | - Rossana Figini Maciel
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Amanda Vilaverde Perez
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Mariana Sbaraini
- Programa de Pós-graduação em Cardiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maria Celeste Osório Wender
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Geta TG, Woldeamanuel GG, Dassa TT. Prevalence and associated factors of premenstrual syndrome among women of the reproductive age group in Ethiopia: Systematic review and meta-analysis. PLoS One 2020; 15:e0241702. [PMID: 33156860 PMCID: PMC7647055 DOI: 10.1371/journal.pone.0241702] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/20/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Premenstrual syndrome is a clinical condition characterised by the cyclic occurrence of physical and emotional symptoms, which can interfere with normal activity. It significantly affects the health-related quality of life and can result in decreased work productivity. The prevalence of premenstrual syndrome varies widely in different countries and different regions of the same country. Thus, this study was aimed to estimate the pooled prevalence of premenstrual syndrome and its associated factors among women in Ethiopia. MATERIALS AND METHODS Published studies searched from electronic databases such as PubMed/Medline, google scholars, HINARI, Science Direct, Cochrane Library, and EMBASE were used. All studies done among women of the reproductive age group in Ethiopia and reported in the English language were included. The current study was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two authors extracted the data independently by using Microsoft excel extraction format and transported to STATA 14 software for analysis. I2 test was used to assess heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence and associated factors of premenstrual syndrome. The prevalence and odds ratio with 95% confidence interval (CI) were presented using a forest plot. RESULTS After careful screening of 33 studies, nine studies were included in our systematic review and meta-analysis. The pooled prevalence of premenstrual syndrome in Ethiopia was found to be 53% (95% CI: 40.64, 65.36). Subgroup analysis by university versus high school showed a pooled prevalence of 53.87% (95% CI: 40.97, 67.60) and 56.19% (95% CI: 6.80, 105.58), respectively. The pooled odds ratio shows that age at menarche, menstrual pattern and hormonal contraceptive use had no statistically significant association with premenstrual syndrome. CONCLUSION More than half of the women under reproductive age group were experiencing premenstrual syndrome in Ethiopia.
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Affiliation(s)
- Teshome Gensa Geta
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tamirat Tesfaye Dassa
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Chumpalova P, Iakimova R, Stoimenova-Popova M, Aptalidis D, Pandova M, Stoyanova M, Fountoulakis KN. Prevalence and clinical picture of premenstrual syndrome in females from Bulgaria. Ann Gen Psychiatry 2020; 19:3. [PMID: 31969927 PMCID: PMC6964059 DOI: 10.1186/s12991-019-0255-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Premenstrual syndrome (PMS) and its more severe form premenstrual dysphoric disorder (PMDD) are highly prevalent conditions, but there seems to be ethnic and cultural variances in their distribution. AIMS To explore the prevalence of PMS/PMDD and their typical clinical features in a Bulgarian population. MATERIALS AND METHODS This investigation was designed and executed as a cross-sectional descriptive study. Three hundred and five conveniently recruited females with no psychiatric history filled in a self-evaluation questionnaire based on DSM-IV tapping on different symptoms of PMS. The prevalence of the conditions was calculated. RESULTS 32.1% (N = 98) of the tested females (mean age 31.04 ± 6.31) suffered from PMS and 3.3% (N = 10) were diagnosed with PMDD. The leading symptoms in the sample were irritability, fatigue and changes in appetite, depressed mood, mood swings, and anxiety, and abdominal bloating, breast tension and tenderness. Most of the symptoms were moderately severe. Mild and moderate cases of PMS were near equally distributed and more frequent than severe ones. CONCLUSION PMS is a common condition which is usually mildly expressed, but severe cases are not an exception. The clinical picture is dominated by almost equally distributed psychological and somatic symptoms.
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Affiliation(s)
- Petranka Chumpalova
- University Multiprofile Hospital for Active Treatment "Doctor Georgi Stranski", 8A Georgi Kochev Blvd., 5800 Pleven, Bulgaria.,2Department of Psychiatry and Medical Psychology, Medical University-Pleven, 113, Storgozia Distr., 5800 Pleven, Bulgaria
| | - Rossitza Iakimova
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", 1 Lyuben Russev Str., 1113 Sofia, Bulgaria.,4Department of Psychiatry and Medical Psychology, Medical University-Sofia, 1 Georgi Sofiyski Blvd., 1000 Sofia, Bulgaria
| | - Maya Stoimenova-Popova
- University Multiprofile Hospital for Active Treatment "Doctor Georgi Stranski", 8A Georgi Kochev Blvd., 5800 Pleven, Bulgaria.,2Department of Psychiatry and Medical Psychology, Medical University-Pleven, 113, Storgozia Distr., 5800 Pleven, Bulgaria
| | - Daniil Aptalidis
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", 1 Lyuben Russev Str., 1113 Sofia, Bulgaria
| | - Milena Pandova
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", 1 Lyuben Russev Str., 1113 Sofia, Bulgaria
| | - Maria Stoyanova
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", 1 Lyuben Russev Str., 1113 Sofia, Bulgaria
| | - Konstantinos N Fountoulakis
- 53rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Jarosz AC, El-Sohemy A. Association between Vitamin D Status and Premenstrual Symptoms. J Acad Nutr Diet 2018; 119:115-123. [PMID: 30177298 DOI: 10.1016/j.jand.2018.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Premenstrual symptoms are experienced by up to 95% of women, and few treatments are available. Previous studies suggest that 25-hydroxyvitamin D (25(OH)D) may be associated with the severity of premenstrual symptoms, but the findings have been inconclusive. OBJECTIVE The objective of this study was to determine whether vitamin D status is associated with the severity of individual premenstrual symptoms. DESIGN/PARTICIPANTS Cross-sectional analysis of 998 women aged 20 to 29 years recruited at the University of Toronto campus from 2004 through 2010. MAIN OUTCOME MEASURES Participants provided data on their premenstrual symptoms in a premenstrual symptom questionnaire. Fasting overnight blood samples were collected, and plasma 25(OH)D was measured. Participants with plasma 25(OH)D concentrations <20 ng/mL were considered to have inadequate vitamin D status, and those with ≥20 ng/mL, adequate vitamin D status. STATISTICAL ANALYSES PERFORMED Multinomial logistic regressions were used to calculate the odds ratio (OR) and 95% confidence interval for the associations between vitamin D status and the severity of 15 premenstrual symptoms. Adjustments were made for age, body mass index, ethnicity/race, physical activity, hormonal contraceptive use, season of blood draw, use of analgesics, and calcium intake. RESULTS Compared with participants with adequate vitamin D status, those with inadequate vitamin D status had an increased risk (odds ratio [OR]; 95% CI) of experiencing the following mild symptoms: confusion (OR=1.72; 95% CI, 1.14 to 2.59) and desire to be alone (OR=1.47; 95% CI; 1.03 to 2.10), as well as the following moderate/severe symptoms: cramps (OR=1.50; 95% CI, 1.02 to 2.21), fatigue (OR=1.51; 95% CI, 1.04 to 2.21), anxiety (OR=1.63; 95% CI, 1.02 to 2.63), confusion (OR=2.23; 95% CI, 1.18 to 4.21), and sexual desire (OR=1.65; 95% CI, 1.09 to 2.51). Vitamin D status was not associated with other premenstrual symptoms (acne, bloating, mood swings, increased appetite, headache, clumsiness, insomnia, depression, or nausea). CONCLUSION Findings suggest that inadequate vitamin D status may be associated with increased severity of some, but not all, premenstrual symptoms.
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