Global burden and trends in female premenstrual syndrome study during 1990-2019

PURPOSE

Premenstrual syndrome (PMS) is prevalent worldwide and considered a crucial issue regarding women's health. In the present study, the Global Burden of Disease (GBD) Study 2019 dataset was utilized to assess the distributional trends in PMS burden and prevalence in regional, national, and sociodemographic index (SDI) categories.

METHODS

The analytical methods and approaches used in the 2019 GBD study were adopted to investigate the incidence rates and disability-adjusted life years (DALY) related to PMS in 204 countries or regions. Age-standardized incidence rates (ASIR), 95% uncertainty intervals (95% UI), and annual percentage changes (EAPC) were calculated from the data.

RESULTS

The global incidence and disability-adjusted life years of PMS exhibited a declining trend in the year 2019. Regions with medium-low SDI had the greatest burden of PMS, with the regions of South Asia (ASR = 7337.9 per 10,000) exhibiting the greatest Age-standardized incidence rates, while the high-income North American states presented the fastest upward trends in Age-standardized disability-adjusted life year rates. At the national level, 107 nations exhibited a decreasing trend in PMS incidence ASR, while 97 nations exhibited an increasing trend, with the United States presenting the greatest increase.

CONCLUSIONS

The present study highlighted that even though the global PMS incidence and disability-adjusted life years have decreased from the year 1990 to 2019, PMS remains a prevalent health concern for women worldwide. While addressing preventive measures and treatment, it is also important to consider the regional and national differences in PMS to develop further effective and targeted health policies.

Network structure of complex interactions of premenstrual syndrome and influencing factors in young adult women

BACKGROUND

In the transition phase from adolescence to adulthood, premenstrual syndrome (PMS) occurs more commonly, with a variety of symptoms. The occurrence of PMS may be the result of a combination of demographic, physiological, psychological and sociological factors. This study aimed to identify the central symptoms of PMS, and explored the complex influencing factors especially the one-to-one inter-relationships factors with specific symptoms.

METHOD

This is a cross-sectional study conducted in mainland China. 3458 young adult women were assessed. Using the Premenstrual Syndrome Scale (PSS) to assess the PMS, and PSS score was over 6 divided into PMS group, and vice versa. Influencing factors were assessed by a set of self-reported questionnaire. Network analysis was used to examined the interplay of PMS, whilst also considering the influencing factors of PMS.

RESULTS

In summary, 1479 participants were in PMS group. Anxiety had the highest strength centrality (1.12/1.09), shown higher centrality in the both network. Swelling of the hands or feet also shown higher strength centrality (0.89) in PMS group. PMS is associated with a higher history of dysmenorrhea, and neurotic personality. Neurotic personality - depressed mood/nervousness (0.27/0.23), history of dysmenorrhea - abdominal distension (0.21), had significantly higher weight than other edges in PMS group.

CONCLUSION

Anxiety was the most central symptom in the network, and was closely associated with other symptoms like depressed mood, which provided additional evidence for the centrality of emotional features in PMS. Moreover, the influencing factors of PMS combined demographic, physiological, psychological, and sociological factors. According to the central symptoms and factors affecting the specific PMS symptoms in young adult women, targeted intervention is helpful to prevent and alleviate PMS.

LIMITATION

Cross-sectional design cannot infer the directionality of the associations between variables. All data is self-reported with recall bias and the edge weights across the constructs of influencing factors and PMS were fairly small.

Emerging Perspectives on the Impact of Diabetes Mellitus and Anti-Diabetic Drugs on Premenstrual Syndrome. A Narrative Review

Diabetes mellitus (DM) and premenstrual syndrome (PMS) are global health challenges. Both disorders are often linked to a range of physical and psychological symptoms that significantly impact the quality of life of many women. Yet, the exact relation between DM and PMS is not clear, and the management of both conditions poses a considerable challenge. In this review, we aimed to investigate the interplay between DM, anti-diabetic drugs, and the different theories and symptoms of PMS. Female sex hormones are implicated in the pathophysiology of PMS and can also impair blood glucose control. In addition, patients with diabetes face a higher susceptibility to anxiety and depression disorders, with a significant number of patients experiencing symptoms such as fatigue and difficulty concentrating, which are reported in patients with PMS as well. Complications related to diabetic medications, such as hypoglycemia (with sulfonylurea) and fluid retention (with thiazolidinediones) may also mediate PMS-like symptoms. DM can, in addition, disturb the normal gut microbiota (GM), with a consequent loss of beneficial GM metabolites that guard against PMS, particularly the short-chain fatty acids and serotonin. Among the several available anti-diabetic drugs, those (1) with an anti-inflammatory potential, (2) that can preserve the beneficial GM, and (3) possessing a lower risk for hypoglycemia, might have a favorable outcome in PMS women. Yet, well-designed clinical trials are needed to investigate the anti-diabetic drug(s) of choice for patients with diabetes and PMS.

Association between physical activity and risk of premenstrual syndrome among female college students: a systematic review and meta-analysis

BACKGROUND

This study aimed to analyze the relationship between physical activity and the risk of premenstrual syndrome among college students.

METHODS

Eligible studies were searched from the PubMed, Web of Science, and Embase databases. The link between physical activity and the risk of premenstrual syndrome was evaluated using odds ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was tested and their sources were explored by subgroup analysis. A sensitivity analysis was performed to assess the effect of a single study on the pooled results. The included studies were evaluated for publication bias. Five moderate-quality studies were included in this meta-analysis.

RESULTS

Physical activity levels were negatively associated with risk of premenstrual syndrome among college students (OR [95%CI] = 1.46 [1.09, 1.96], P = .011). The pooled results were not influenced after being stratified by the study region and whether multi-factor correction was performed or not. Publication bias was not observed in the included studies.

CONCLUSION

A high level of physical activity is dramatically associated with a reduced risk of premenstrual syndrome among female college students.

Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan

BACKGROUND

Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity.

METHODS

In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time.

RESULTS

During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism.

CONCLUSION

Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information.

TRIAL REGISTRATION

UMIN Clinical Trials Registry number: UMIN000038917.

Laparoscopic sleeve gastrectomy for premenstrual syndrome symptoms in patients with obesity

BACKGROUND

Premenstrual syndrome (PMS) is a pathological condition characterized by a series of abnormal physical, psychological, and behavioral symptoms. We evaluated the effectiveness of laparoscopic sleeve gastrectomy (LSG) in the treatment of patients with obesity and PMS.

METHODS

In this case-control study, 131 patients with obesity (BMI ≥ 27.5 kg/cm2) diagnosed with moderate-to-severe PMS from March 2018 to March 2022 were prospectively selected to undergo LSG or not at their own discretion. Participants self-reported their PMS severity using the Premenstrual Syndrome Screening Tool. Among them, 68 patients chose LSG surgery, and 63 control group patients were followed up without surgery. Data were recorded at baseline and at 3 months post-treatment. We used a multivariate analysis to assess the improvement in PMS symptoms and associated factors.

RESULTS

Of the 131 patients with obesity and PMS, the improvement rate of PMS in the LSG group was 57.35% (n = 39), while the improvement rate of PMS in the control group was 25.40% (n = 16). Furthermore, our study revealed that surgery is an independent factor affecting the improvement of patients with PMS. Additionally, there was a correlation between alcohol use, T2DM and obesity-related metabolic diseases, and BMI with PMS. The changes in BMI, testosterone, and estradiol(E2) levels may also contribute to the improvement of patients with obesity and PMS.

CONCLUSION

LSG can improve the management of obesity in patients with PMS to some extent. Changes in BMI, testosterone, and E2 may be indicative of improvement in patients with obesity and PMS.

The effect of hydrogen-rich water consumption on premenstrual symptoms and quality of life: a randomized controlled trial

BACKGROUND

Premenstrual syndrome (PMS) consists of psychiatric or somatic symptoms negatively affecting the daily life. PMS treatment can involve the use of complementary-alternative approaches. Hydrogen-rich water (HRW) has antioxidant and anti-inflammatory properties that may treat PMS. This study aimed to investigate the effect of drinking HRW on the severity of premenstrual symptoms and the quality of life of women who suffer from PMS.

METHODS

This study is a randomized controlled trial. Participants were randomized into two groups (intervention group=33, control group=32) using the block randomization method. Participants were requested to consume 1500-2000 mL of HRW daily in the intervention group and drink water in the placebo group. Participants began drinking either HRW or placebo water from day 16 of their menstrual cycle until day 2 of the following cycle for three menstrual cycles. The research data were collected using a Demographic Information Form, Premenstrual Syndrome Scale (PMSS), and Short form of the World Health Organization Quality of Life Questionnaire (WHOQOL- BREF).

RESULTS

The intervention group had significantly lower mean scores than the control group in both the first and second follow-ups on the PMSS (P<0.05). In the first follow-up, the intervention group had significantly higher mean scores in the Physical Health and Psychological domains of the WHOQOL-BREF compared to the control group (P<0.05). Group × time interaction was significant for PMSS (F = 10.54, P<0.001). Group × time interaction was insignificant for WHOQOL- BREF (P>0.05).

CONCLUSIONS

The consumption of HRW reduces the severity of premenstrual symptoms and improves individuals' quality of life in physical and psychological domains.

The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis

BACKGROUND

Premenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective monitoring of symptoms over two cycles, otherwise the diagnosis is provisional. We aimed to measure the point prevalence of premenstrual dysphoric disorder.

METHODS

We searched for studies of prevalence using MEDLINE, EMBASE, PsycINFO and PubMed. For each study, the total sample size and number of cases were extracted. The prevalence across studies was calculated using random effects meta-analysis with a generalised linear mixed model. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Pre-registration was with PROSPERO (CRD42021249249).

RESULTS

44 studies with 48 independent samples met inclusion criteria, consisting of 50,659 participants. The pooled prevalence was 3.2 % (95 % confidence intervals: 1.7 %-5.9 %) for confirmed and 7.7 % (95 % confidence intervals: 5.3 %-11.0 %) for provisional diagnosis. There was high heterogeneity across all studies (I2 = 99 %). Sources of heterogeneity identified by meta-regression were continent of sample (p < 0.0001), type of sample (community-based, university, high school) (p = 0.007), risk of bias (p = 0.009), and method of diagnosis (p = 0.017). Restricting the analysis to community-based samples using confirmed diagnosis resulted in a prevalence of 1.6 % (95 % confidence intervals: 1.0 %-2.5 %), with low heterogeneity (I2 = 26 %).

LIMITATIONS

A small number of included studies used full DSM criteria in community settings.

CONCLUSIONS

The point prevalence of premenstrual dysphoric disorder using confirmed diagnosis is lower compared with provisional diagnosis. Studies relying on provisional diagnosis are likely to produce artificially high prevalence rates.

A cross-sectional study of the relationship between premenstrual syndrome and missed nursing care among female nursing staff

Purpose

Premenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine nursing schedules and activities is limited. This study aims to identify the prevalence of PMS among female nursing staff and to examine the relationship between PMS and missed nursing care (MNC).

Method

Between November 1, 2022, and April 30, 2023, this study was conducted among female nursing staff working in nine inpatient departments at Sun Yat-sen University Cancer Center. This study used a cross-sectional design. The participants were recruited through convenience sampling. Data were collected using the standardized Menstrual Distress Questionnaire, the Oncology Missed Nursing Care self-rating scale, and a sociodemographic questionnaire. One-way analysis of variance, Fisher's least significant difference test for post-hoc comparisons, and Spearman's correlation coefficient were utilized for data analysis. A trend test was also performed to explore patterns in the severity of PMS and MNC over time.

Results

We collected a total of 224 questionnaires, with 154 (68.7%) female nursing staff reporting PMS. The most common symptoms were low back pain (91.1%), abdominal discomfort (90.6%), cold hands and feet (87.1%), and lethargy (87.1%). Moreover, 91.5% of the 224 female nursing staff reported at least one MNC activity. The nursing activities most frequently missed or left incomplete were liquid intake and output monitoring as ordered (43.3%), medication administration within 30 min before or after the scheduled time (43.3%), and electrocardiogram monitoring as ordered (42.9%). "Abdominal discomfort" from the Menstrual Distress Questionnaire was significantly correlated with the majority of MNC activities (p < 0.001).

Conclusions

This study provides evidence for a strong association between PMS and MNC among female nursing staff, suggesting that administrators should take the premenstrual conditions of female nursing staff into consideration. It is necessary to provide appropriate understanding and support to mitigate the impact on patient care and safety.

Relationship Between Steroid Hormone Profile and Premenstrual Syndrome in Women Consulting for Infertility or Recurrent Miscarriage

To determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a retrospective cross-sectional study on women attending a hospital-based clinic for fertility concerns and/or recurrent miscarriage. All participants were assessed with a women's health questionnaire which also included evaluation of premenstrual symptoms. Day of ovulation was identified based on the peak mucus symptom assessed by the woman after instruction in a fertility awareness-based method (FABM). This enabled reliable timing of luteal-phase serum hormone levels to be taken and analysed. Between 2011 and 2021, 894 of the 2666 women undertaking the women's health assessment had at least one evaluable serum luteal hormone test. Serum progesterone levels were up to 10 nmol/L lower for symptomatic women compared with asymptomatic women. This difference was statistically significant (p < 0.05) for the majority of PMS symptoms at ≥ 9 days after the peak mucus symptom. A similar trend was observed for oestradiol but differences were generally not statistically significant. ROC curves demonstrated that steroid levels during the luteal phase were not discriminating in identifying the presence of PMS symptoms. Blood levels for progesterone were lower throughout the luteal phase in women with PMS, with the greatest effect seen late in the luteal phase.

[Premenstrual syndrome and premenstrual dysphoric disorder-Overview on pathophysiology, diagnostics and treatment]

Premenstrual syndrome and premenstrual dysphoric disorder become episodically manifest during the second half of the female menstrual cycle and are characterized by psychological and physical symptoms causing relevant functional and social impairments. Mood swings, depression and dysphoria are associated depressive symptoms. Therefore, affective disorders should be considered as a differential diagnosis. Of women in reproductive age 3-8% suffer from premenstrual syndrome and 2% of women are affected by premenstrual dysphoric disorder. Genetic and sociobiographical risk factors are discussed. Furthermore, genetic polymorphisms of specific hormone receptors are considered to be genetic risk factors. From a pathophysiological perspective premenstrual syndrome and premenstrual dysphoric disorder are caused by a complex interaction between cyclic changes of ovarian steroids and central neurotransmitters. An imbalance of estrogen and progesterone in the luteal phase is believed to cause the symptoms. Therefore, the first treatment approach consists of regulation of the menstrual cycle or luteal support with progesterone or synthetic progestins even if their effectiveness has not yet been proven in randomized controlled studies and meta-analyses. The administration of combined oral contraceptives is also an option. Especially treatment with selective serotonin reuptake inhibitors (SSRI) represent an evidence-based approach. In severe cases the administration of gonadotropin releasing hormone (GnRH) agonists with add back treatment can also be considered. In the field of affective disorders premenstrual syndromes represent clinically relevant differential diagnoses and comorbidities, which confront the treating physician with particular clinical challenges. Therefore, this literature review gives the readership a clinical orientation for dealing with these disorders.

Effectiveness of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of students with premenstrual syndrome

BACKGROUND

Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS.

METHODS

A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff's Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P < 0.05 was considered for the analysis.

RESULTS

The results of the study showed that the SIT interventions decreased the PMS severity and most psychological factors so in the intervention group, SIT was able to significantly reduce anxiety, depression, perceived stress, and Sheehan's disability after intervention (P < 0.001). Based on multiple linear regression analysis, the most predictors of HADS were the PSS and SDS (β = 0.285, p = 0.009 and β = 0.236, p = 0.024, respectively).

CONCLUSION

The computer-based SIT counseling approach could reduce the severity of symptoms and psychological factors in students. Therefore, SIT intervention is recommended to manage their PMS.

TRIAL REGISTRATION

IRCT20230130057274N2.

The impact of COVID-19 on menstrual cycle's alterations, in relation to depression and sleep disturbances: a prospective observational study in a population of medical students

BACKGROUND

The sars-Cov-2 pandemic has determined psychological stress, particularly in the young population of medical students. We studied the impact of the pandemic on menstrual cycle alteration in relation to psychological stress, presence of depression, sleep disturbances and post-traumatic stress, on a population of medical students.

METHODS

293 female students at the Faculty of Medicine and Psychology of the Sapienza University of Rome (23.08 years old ± 3.8) were enrolled. In March 2021, one year after quarantine, a personal data sheet on menstrual cycle, examining the quality of the menstrual cycle during the pandemic, compared to the previous period. Concomitantly, the Beck Depression Inventory and the Impact of Event Scale have been administered. A Pearson chi-square test was assessed to evaluate the difference between the characteristics of the menstrual cycle and the scores obtained with the questionnaires.

RESULTS

A statistically significant association between menstrual alterations and stress during pandemic had been found. The onset of depressive symptoms and sleep disturbances was observed in 57.1% and in 58.1% of young women with cycle's alterations, respectively. Amenorrhea was three times more common in female students with depressive symptoms, premenstrual syndrome had a significant correlation with both depression and sleep disturbances. The pandemic has been related to menstrual alterations, with depressive symptoms and sleep disorders. Amenorrhea is connected to depression, as observed on the functional hypothalamic amenorrhea.

CONCLUSIONS

The pandemic affected the menstrual cycle as well as the depressive symptoms and sleep. Practical implications of the study lead to the development of strategies for psychological intervention during the pandemic experience, in order to help medical trainees, with specific attention to women's needs. Future studies should analyze the impact of other types of social stress events, on sleep, depression and the menstrual cycle beside the pandemic.

Effect of vitamin D supplementation on symptoms severity in vitamin D insufficient women with premenstrual syndrome: A randomized controlled trial

BACKGROUND

Premenstrual syndrome (PMS) is one of the most prevalent disorders among reproductive women worldwide that negatively impact women's quality of life. This study aimed to investigate the effect of vitamin D supplementation on the severity of PMS symptoms in vitamin D insufficient women with PMS.

METHODS

In this randomized, double-blind clinical trial, 44 vitamin D insufficient women with PMS received either 50,000 IU vitamin D or a placebo fortnightly for 16 weeks. Participants completed the PMS Daily Symptoms Rating form at beginning and during the last two months of the intervention, and their blood samples were collected to assess 25(OH)D serum levels.

RESULTS

After the four months' intervention, the serum level of 25(OH)D in the vitamin D group raised from 21 ± 8 ng/ml to 40 ± 8 ng/ml (P < 0.001), while in the placebo group it raised from 21 ± 7 ng/ml to 23 ± 7 ng/ml (P = 0.03). Indeed, serum vitamin D levels in the placebo group could not reach a sufficient level. At the end of the intervention, the mean score of total PMS symptoms showed significant improvement in the vitamin supplemented group compared to the controls (p < 0.001). By grouping the PMS symptoms into five subgroups, the mean score of all five subgroups decreased post-supplementation compared to the baseline; however, the highest and lowest decrease were in depression (53 %) and water retention subgroups (28 %), respectively. This indicates a greater improvement in the mean scores of mood symptoms compared to physical symptoms in this study (p < 0.001).

CONCLUSION

Results obtained in this clinical trial represent the helpful effects of vitamin D supplementation on total, physical and mood symptoms in vitamin D insufficient women with PMS.

TRIAL REGISTRATION

This randomized controlled trial at IRCT.ir on 2018-06-20 with Registration No: IRCT20180525039822N1.

The impact of comorbid premenstrual syndrome or premenstrual dysphoric disorder on the clinical characteristics of bipolar disorder among Han Chinese women

Bipolar disorder (BD) is commonly comorbid with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). However, little is known about their relationship. This study aimed to assess the impact of comorbid PMS or PMDD on the clinical characteristics of BD. A cross-sectional study was conducted on 262 women with BD. PMS and PMDD were screened with the Premenstrual Symptoms Screening Tool (PSST). Symptomatic features were assessed with Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS), and atypical features by the depressive episode section of SCID-I/P. The rates of PMS and PMDD among BD were 57.6% and 20.6% according to PSST. No significant difference in the rates of PMS and PMDD was found between BD I, BD II, and BD-NOS. Compared to BD patients without PMS or PMDD, patients with comorbid BD and PMS or PMDD were younger, more educated, had a higher risk of OCD, had an earlier age of onset, scored higher on HAMD-17 and its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and were more likely to have increased appetite and leaden paralysis. In addition, patients with comorbid BD and PMDD were less likely to experience traumatic life events, more likely to have family history of mental disorders and have inflammatory or autoimmune disease, scored higher on HMAD-17, particularly in its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and sleep disturbance. Compared with BD without PMS or PMDD, BD with PMS or PMDD might be a specific subtype of BD characterized with earlier onset age, heavier genetic load, increased symptom severity, and atypical features.

Prevalence of Menstrual Disorder in Women and Its Correlation to Body Mass Index and Physical Activity

Background

Regular menstruation represents reproductive health and quality of life of women. However, many women suffer from menstrual disorders at some point in their life. The occurrence of such abnormalities is affected by two key factors: BMI and physical activity. This study aims to analyse the relationship of these two factors to menstrual disorders.

Materials and Method

A cross-sectional study was conducted among 502 women in Uttar Pradesh, India, from July 2021 to January 2023. Samples were selected using purposive sampling technique. The data were analysed using Pearson's Chi-square test on MS Excel 2013 and IBM SPSS 29.0.0.0 (240) software.

Results

Mean age of the research subjects was 25.84 + 6.30 years, mean weight was 60.29 + 11.22 kg, mean height was 155.34 + 11.77 cm, and mean BMI was 25.36 + 6.06 kg. 68.92% subjects had regular age at menarche. Most common menstrual disorders were PMS (41.63%) and dysmenorrhea (28.29%). As per BMI categories, most disorders were found in obese (94.87%) and underweight (93.62%) subjects. As per physical activity categories, most disorders were found in low (76.55%) and high (76.40%) category subjects. A significant relationship was found between menstrual disorder and BMI (χ2 = 80.49, p < 0.001) and physical activity (χ2 = 70.09, p < 0.001).

Conclusion

The menstrual disorders in women are significantly related to their BMI and physical activity. Women are advised to focus on having a balanced, nutritious diet and indulge in moderate physical activity to improve their reproductive health and quality of life.

The impact of premenstrual disorders on work disruptions among working women: A cross-sectional study

Background

Physical and emotional manifestations of premenstrual disorder cause increased absenteeism, decreased productivity, and decreased work-related quality of life.

Objective

Due to the relatively high prevalence of premenstrual disorders in Iran and limited studies on its work-related problems, this study investigated the relationship between premenstrual disorders and work performance in working women.

Materials and Methods

This cross-sectional study was conducted on 358 working women (teachers and industrial workers) in Yazd, Iran, from July 2019 to January 2020. Data were collected using premenstrual symptom screening tool, the work productivity and activity impairment (a modified version), and functional work capacity questionnaires. Women were classified into 2 groups: women with and without premenstrual disorders. Productivity, functional capacity, and ability to perform activities of daily living were compared between groups.

Results

Among 358 participants, 121 women (33.8%) had premenstrual disorders. The prevalence of premenstrual disorders was significantly higher in teachers than workers (0.41% vs. 24.7%, respectively) (p = 0.002). The work results showed a worse score in the group with premenstrual disorder than the other group and teachers compared to workers (p < 0.001).

Conclusion

This study showed a significant association between premenstrual disorders and worse work productivity, functional work capacity, and ability to perform activities of daily living. Teachers had a higher prevalence of premenstrual disorders and worse work performance than workers, which can be due to higher education levels, work stress, more complex tasks, and increased work responsibility in teachers.

Electroencephalography findings in menstrually-related mood disorders: A critical review

The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological and behavioral dynamics. Menstrually-related mood disorders (MRMDs) comprise cognitive-affective or somatic symptoms that are thought to be triggered by the rapid fluctuations in ovarian hormones in the luteal phase of the menstrual cycle. MRMDs include premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual exacerbation (PME) of other psychiatric disorders. Electroencephalography (EEG) non-invasively records in vivo synchronous activity from populations of neurons with high temporal resolution. The present overview sought to systematically review the current state of task-related and resting-state EEG investigations on MRMDs. Preliminary evidence indicates lower alpha asymmetry at rest being associated with MRMDs, while one study points to the effect being luteal-phase specific. Moreover, higher luteal spontaneous frontal brain activity (slow/fast wave ratio as measured by the delta/beta power ratio) has been observed in persons with MRMDs, while sleep architecture results point to potential circadian rhythm disturbances. In this review, we discuss the quality of study designs as well as future perspectives and challenges of supplementing the diagnostic and scientific toolbox for MRMDs with EEG.

Women with more severe premenstrual syndrome have an enhanced anticipatory reward processing: a magnetoencephalography study

Laboratory studies reveal that young women with premenstrual syndrome (PMS) often exhibit decreased reward processing during the late luteal phase. However, studies based on the self-reports find opposite results (e.g., higher craving for high-sweet-fat food). These differences may lie in the difference between the stimulus used and measuring the different aspects of the reward. The present study was designed to expand previous work by using a classic monetary reward paradigm, simultaneously examining the motivational (i.e., reward anticipation, "wanting") and emotional (i.e., reward outcome, "liking") components of reward processing in women with high premenstrual symptoms (High PMS). College female students in their early twenties with High PMS (n = 20) and low premenstrual symptoms (Low PMS, n = 20) completed a monetary incentive delay task during their late luteal phase when the premenstrual symptoms typically peak. Brain activities in the reward anticipation phase and outcome phase were recorded using the magnetoencephalographic (MEG) imaging technique. No group differences were found in various behavioral measurements. For the MEG results, in the anticipation phase, when High PMS participants were presented with cues that predicted the upcoming monetary gains, they showed higher event-related magnetic fields (ERFs) than when they were presented with neutral non-reward cues. This pattern was reversed in Low PMS participants, as they showed lower reward cue-elicited ERFs than non-reward cue-elicited ones (cluster mass = 2560, cluster size = 891, p = .03, corrected for multiple comparisons), mainly in the right medial orbitofrontal and lateral orbitofrontal cortex (cluster mass = 375, cluster size = 140, p = .03, corrected for multiple comparisons). More importantly, women with High PMS had an overall significantly higher level of ERFs than women with Low PMS (cluster mass = 8039, cluster size = 2937, p = .0009, corrected for multiple comparisons) in the bilateral precentral gyrus, right postcentral gyrus, and left superior temporal gyrus (right: cluster mass = 410, cluster size = 128, p = .03; left: cluster mass = 352, cluster size = 98, p = .05; corrected for multiple comparisons). In the outcome phase, women with High PMS showed significantly lower theta power than the Low PMS ones for the expected non-reward feedback in the bilateral temporal-parietal regions (cluster mass = 47620, cluster size = 18308, p = .01, corrected for multiple comparisons). These findings reveal that the severity of PMS might alter reward anticipation. Specifically, women with High PMS displayed increased brain activities to reward-predicting cues and increased action preparation after the cues appear.

Investigating influencing factors on premenstrual syndrome (PMS) among female college students

BACKGROUND

Premenstrual syndrome (PMS) affects women's physical and mental health. Depression, stress, sleep disturbance, and eating attitude problems have been known to influence PMS. Furthermore, restrictions of daily life due to the COVID-19 pandemic have led to changes in sleep patterns and eating attitudes. Thus, it is necessary to closely examine how these factors affect PMS. This study aimed to examine the levels of PMS, stress, depression, sleep disturbance, and eating attitude problems among female college students who experience dysmenorrhea and determine the factors associated with PMS.

METHODS

A cross-sectional online survey design was conducted using a convenience sample of 143 female college students in C City, South Korea. Data were collected from September 1 to 19, 2021 in South Korea using an online self-administered survey. Differences in participants' level of PMS according to physical health variables (e.g., smoking, water intake, menstrual pain intensity) and psychological issues (i.e., stress, depression, sleep disturbances, and eating attitude problems) were assessed with independent sample t-tests and one-way ANOVAs. Correlational analyses between these variables were also conducted. Additionally, multiple regression was performed to identify the factors influencing PMS.

RESULTS

PMS severity was between normal (27.3%) and premenstrual dysphoric disorder (PMDD) (72.7%). PMS was associated positively with depression (r = .284, p = 001), stress (r = .274, p = .001), sleep disturbance (r = .440, p < .001), and eating attitude problems (r = .266, p = .001). Additionally, menstrual pain intensity (β = 0.204), sleep disturbances (β = 0.375), and eating attitude problems (β = 0.202) were found to influence PMS. The regression model was significant (F = 16.553, p < .001) with an explanatory power of 24.7%.

CONCLUSIONS

Considering the influencing factors of PMS identified in this study, interventions for participants experiencing PMS should be made. We propose that further study should be conducted to examine whether the severity of PMS changes according to menstrual pain, the pattern and degree of its change, and the paths through which sleep quality and eating attitude problems affect PMS.

Low doses of fluoxetine for the treatment of emotional premenstrual syndrome: a randomized double-blind, placebo-controlled, pilot study

INTRODUCTION

The neuroactive metabolite of progesterone, allopregnanolone (ALLO), has been implicated in premenstrual syndrome (PMS) physiopathology and preclinical studies suggested that low doses of fluoxetine increase the ALLO brain concentration.

OBJECTIVES

To assess which low dose of fluoxetine (2 mg/d, 5 mg/d or 10 mg/d), administered exclusively during the luteal phase of menstrual cycle, has a potential effect for preventing or mitigating emotional PMS symptoms.

METHODS

In this randomized, double-blind, placebo-controlled pilot study, we followed 40 women (mean age = 29.7 +/- 7.4 years) with emotional PMS, during two menstrual cycles: cycle 1, without pharmacological intervention; and cycle 2, with pharmacological intervention. Participants took capsules, on average, seven days preceding the likely date of menses. We assessed the severity of PMS symptoms in both cycles using the Daily Record of Severity of Problems scale (DRSP).

RESULTS

There was an increase in the DRSP scores during the late luteal phase of cycle 1, confirming the diagnosis of emotional PMS. Low doses of fluoxetine (5 mg/d: 33.5%; 10 mg/d: 48.4%) reduced DRSP total score in the day before menses (day-1) at cycle 2 compared with day-1 at cycle 1. Fluoxetine 10 mg/d had the most consistent decline in emotional PMS symptoms; 70% of the participants reported a reduction greater than 40% in the DRSP score.

CONCLUSIONS

Low doses of fluoxetine, which may have no or few effect on the serotonergic system, but may interfere in the progesterone metabolization, seem to have some potential to mitigate emotional PMS symptoms. While the 10 mg/d of fluoxetine had the best performance on reducing emotional PMS symptoms, the 5 mg/d dose also seems to have some effect on emotional PMS symptoms. Further larger studies will help establish the lowest effective dose of flouxetine for PMS treatment.

Menstrual disturbances and its association with sleep disturbances: a systematic review

BACKGROUND

Menstrual disturbances harm women's health, and general well-being. As growing evidence highlights the relationship between sleep and menstrual disturbances, it is imperative to comprehensively examine the association between sleep and menstrual disturbance considering the multiple dimensions of sleep. This systematic review aims to identify the association between sleep and menstrual disturbances by evaluating using Buysse's sleep health framework.

METHODS

A comprehensive search of the literature was conducted in PubMed, EMBASE, psychINFO, and CINAHL to identify publications describing any types of menstrual disturbances, and their associations with sleep published between January 1, 1988 to June 2, 2022. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The findings were iteratively evaluated menstrual disturbances and their association with sleep using Buysse's sleep health framework. This framework understands sleep as multidimensional concept and provides a holistic framing of sleep including Satisfaction, Alertness during waking hours, Timing of sleep, Efficiency, and Sleep duration. Menstrual disturbances were grouped into three categories: premenstrual syndrome, dysmenorrhea, and abnormal menstrual cycle/heavy bleeding during periods.

RESULTS

Thirty-five studies were reviewed to examine the association between sleep and menstrual disturbances. Premenstrual syndrome and dysmenorrhea were associated with sleep disturbances in sleep health domains of Satisfaction (e.g., poor sleep quality), Alertness during waking hours (e.g., daytime sleepiness), Efficiency (e.g., difficulty initiating/maintaining sleep), and Duration (e.g., short sleep duration). Abnormal menstrual cycle and heavy bleeding during the period were related to Satisfaction, Efficiency, and Duration. There were no studies which investigated the timing of sleep.

CONCLUSIONS/IMPLICATIONS

Sleep disturbances within most dimensions of the sleep health framework negatively impact on menstrual disturbances. Future research should longitudinally examine the effects of sleep disturbances in all dimensions of sleep health with the additional objective sleep measure on menstrual disturbances. This review gives insight in that it can be recommended to provide interventions for improving sleep disturbances in women with menstrual disturbance.

Volatile organic compounds from human skin as biomarkers of menstruation phase and severity of premenstrual syndrome: An exploratory pilot study

Background and aim

Numerous women of reproductive age experience physical or mental discomfort during their natural menstrual cycle due to paramenstrual symptoms, such as premenstrual syndrome (PMS). To date, there is no established biomarker for the diagnosis of PMS. This study investigated the relationship between skin gas composition and menstruation cycles, and evaluated the possibility of skin gas composition as a biomarker of paramenstrual symptoms.

Methods

We conducted an exploratory pilot study. Healthy Japanese women (aged 20-29 years) underwent blood and skin gas analyses on 1 day corresponding to menstruation, preovulatory, middle luteal, and late luteal phases. Skin gas was collected from the cubital fossa and armpit using a Passive Flux Sampler; samples were analyzed for 65 volatile organic compounds (VOCs) by gas chromatography-mass spectrometry (GC-MS). Non-parametric statistical analysis was performed to identify VOCs related to the menstrual cycle, levels of female hormones, and severity of PMS.

Results

Fourteen women participated; of those, 12 completed the study. Regarding the relationship with the menstrual cycles, seven and four VOCs were significantly and marginally changed, respectively, at the cubital fossa during menstruation. Of those 11 compounds, 10 were also correlated with the levels of serum female hormones. At the armpit, five and three compounds were significantly and marginally changed, respectively, during menstruation. Of those eight compounds, five were also correlated with the levels of serum female hormones. In the study of PMS severity, analysis of the changes in VOCs suggested that ketones and fatty acids are increased during menstruation in the severe PMS group versus the mild PMS group.

Conclusions

The results of this study suggest that certain VOCs emitted in skin gas related to the menstrual cycle, levels of female hormones, and severity of PMS. These findings may advance the metabolic understanding and development of diagnostic biomarkers for menstruation-related symptoms.

Investigating the effect of mindfulness counselling on sexual functioning of women with premenstrual syndrome

Mindfulness exercises can improve a wide range of the psychological and interpersonal consequences of premenstrual syndrome. Nevertheless, there is sparse information about the effect of mindfulness counselling on sexual dysfunction in women with this condition. This study aimed to determine the effect of mindfulness counselling on the sexual functioning of women with premenstrual syndrome. In this controlled randomized study, 112 women diagnosed with premenstrual syndrome referred to selected urban healthcare centers in Isfahan, Iran, were randomly allocated to two groups (intervention and control), each with 56 participants. The intervention group underwent mindfulness counselling in eight 60-minute sessions online via Google Meet. The control group did not receive any kind of intervention. The principal measure was score on the Rosen Female Sexual Functioning Index (FSFI) before, immediately, and one month after the intervention. The data were analyzed by SPSS 23, through descriptive and analytical statistical tests (chi-square, Mann-Whitney, independent t-test, ANOVA, and repeated measure) with a significance level of 0.05. There was no statistically significant difference in the mean FSFI score (or the subscores) between the intervention and control groups (p greater than 0.05) at baseline. In the intervention group, there were significant increases (relative to both baseline and in comparison with the control group) in the mean subscores for sexual desire (P < 0.0001), orgasm (P = 0.01), satisfaction (P = 0.0001), sexual pain (P = 0.003), and general sexual functioning (P < 0.0001) immediately after and one month after the intervention, but the score for sexual arousal was significantly greater only at the one-month evaluation (P < 0.0001) and there were no differences in the scores for vaginal lubrication. On the other hand. Mindfulness counselling was effective in improving the sexual functioning of women suffering from premenstrual syndrome, and should be used for this purpose in healthcare centers.

Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls

BACKGROUND

Sleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic.

METHODS

A cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates.

RESULTS

During the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea.

CONCLUSION

Our study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.

Evaluating the effect of educational intervention based on the health belief model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls

INTRODUCTION

A healthy lifestyle can reduce the rate and symptoms of premenstrual syndrome. Thus, the present study evaluates the effect of educational intervention based on the Health Belief Model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls.

METHODS

This quasi-experimental study was conducted on 80 first-grade high school girls. They were divided into two intervention and control groups (40 people in each group). The data collection tools included the participants' demographic information questionnaire, premenstrual symptoms screening tool, and a researcher-made questionnaire based on the constructs of the health belief model about PMS and the behaviors reducing its symptoms. Data were collected in two phases (before and three months after the educational intervention) via WhatsApp. Educational sessions were held in the form of four 45-min sessions for intervention group subjects regarding PMS and the behaviors that reduce its symptoms during one month via WhatsApp.

RESULTS

According to the results of this study, the mean scores of knowledge about PMS and health belief model constructs (including perceived susceptibility), perceived severity, perceived benefits, perceived self-efficacy, cues to action, lifestyle/behaviors that reduce PMS symptoms) and the percentage of people who did not have PMS symptoms or had a mild type of PMS increased significantly after implementing the educational intervention in the intervention group compared to before the intervention and compared to the control group. Also, the perceived barriers construct score PMS decreased significantly.

CONCLUSIONS

The health belief model education focused on a healthy lifestyle was effective in reducing PMS symptoms. It is recommended to use the educational intervention designed in this study, along with other health care in schools and during puberty as an easy, low-cost, and effective intervention.

Moving online: Implementation of virtual sessions of physical activity and movement training as a therapeutic approach to premenstrual symptoms

Background

Aerobic exercise and movement training improve premenstrual syndrome (PMS) symptoms in women. However, the data is still preliminary, and online-based training has not been evaluated yet. Thus, this pilot study aims to assess the workability and usefulness of an online protocol based on aerobic exercise and movement training as an intervention for premenstrual symptoms.

Methods

A sample of 30 women from the general population was enrolled in this study, with an average age of 28.27 ± 9.35, and an average BMI of 23.47 ± 3.42 kg/m². A total of 29 women completed an eight-week online protocol consisting of 30-min aerobic exercises twice a week, as well as a weekly 30-min movement training protocol. A psychological evaluation was conducted at the baseline and after completing the training via the patients' health questionnaire, the body weight image and self-esteem questionnaire, and the premenstrual symptoms screening tool, looking for changes in well-being and specific symptoms related to menses.

Results

Significant improvements in PMS (p = .015) and mood (p = .011) were recorded, with specific mood effects related to PMS symptomatology. The patients provided positive feedback on the protocol, and adherence was optimal.

Conclusion

The effectiveness of a combination of aerobic and isometric exercises was confirmed as a valuable tool in improving women's well-being and reducing premenstrual symptomatology, even if the protocol is delivered online, which tends to be more affordable for the participants than in-presence sessions. Future studies might assess the difference between online programs and face-to-face interventions.

Investigation of coping behaviors and premenstrual syndrome among university students

This study aims to examine premenstrual syndrome (PMS) in university students and their coping behaviors. 452 female students were included in this descriptive and correlational study. The data were collected using a descriptive information form, the Premenstrual Syndrome Scale (PMSS), and the Premenstrual Change Coping Inventory (PMS-Cope). PMS symptoms were found in 80.5% of students. Seeking positive affect-inducing activities to cope with PMS was found to be a significant predictor of reducing the severity of PMS (β =-0.265, p < .001). In coping with PMS, it is necessary to consider the perceptions of taking medication, seeking social support, or seeking positive affect-inducing activities as a coping method to determine the social and cultural beliefs of university students and control PMS. PMS is a significant health problem and raising awareness of the issue alone may not be enough. It should also be noted that the severity of PMS can vary markedly between ethnic groups, and women's strategies for coping with symptoms and their effectiveness may differ between cultures. It is pivotal to develop strategies for university students to cope with PMS and provide personalized care.

Factors associated with the severity of premenstrual symptoms in women with central obesity: a cross-sectional study

INTRODUCTION

Premenstrual syndrome (PMS) is a common condition that affects social and psychological well-being of women. The risk of PMS is higher among obese women. The aim of this study was to identify the factors that influence the severity of PMS in women with central obesity.

MATERIALS AND METHODS

This cross-sectional study was performed on 30-50 year-old women with abdominal obesity (waist circumference > 80 cm). The following data were collected: demographic data, anthropometric measurements, premenstrual symptoms screening tools, semi-quantitative food frequency questionnaire, 42-item depression, anxiety, and stress questionnaire (DASS-42), as well as serum vitamin D, and renal function tests.

RESULTS

A total of 139 women (mean age of 41.40 ± 7.39 years old) participated in the study. The prevalence of mild, moderate and severe premenstrual symptoms was 38.7% (55/142), 31.7% (45/142) and 27.5% (39/142), respectively. There was no significant difference between the groups in terms of anthropometric measurements and energy-adjusted nutrient intakes (p > 0.05). There was a significant relationship between moderate PMS and energy-adjusted saturated fatty acid (SFA) (p = .018, OR = .010 and 95% CI for OR: < .001 and .452), and energy-adjusted riboflavin (p = .042, OR = .005, 95% CI for OR: < .001 and .821), and between severe PMS and age (p = .034, OR = .906, 95% CI for OR: .826 and .993), and energy-adjusted monounsaturated fatty acid (MUFA) intake (p = .041, OR = 23.789, 95% CI for OR: 1.138 and 497.294).

CONCLUSION

High intakes of MUFA and younger age were associated with a greater severity of PMS, while riboflavin intake was associated with reduced PMS severity.

The Effect of Zinc Supplementation on the Improvement of Premenstrual Symptoms in Female University Students: a Randomized Clinical Trial Study

Zinc is an essential microelement that plays many important functions in the body. It is crucial for the regulation of cell growth, hormone release, immunological response, and reproduction. Thus, this trial aimed to evaluate the effects of zinc supplementation in comparison with placebo on the improvement of premenstrual symptoms in female university students. This triple-masked, randomized, placebo-controlled, parallel trial was conducted among 69 female students aged 18-35 with premenstrual syndrome that living in dormitories of Hamadan University of Medical Sciences, in west of Iran. Participants were randomly assigned to two groups of equal number; one group received 220 mg of elemental zinc (n = 33) and the other group received placebo (n = 36) on a regular daily for 24 weeks. The premenstrual syndrome was assessed by Premenstrual Symptoms Screening Tool-Adolescent (PSST-A) questionnaire for all participants. Chi-square and t-student tests were used to compare the percentage or mean of parameters between two groups. All statistical analysis conducted by SPSS version 16. The mean age in the intervention group was 25.64 [Formula: see text] 0.53 years, and in the control group was 24.38 [Formula: see text] 0.51 years (P = 0.087). After 24 weeks of intervention, PMS physical and psychological symptoms such as anger, anxiety, depressed mood, overeating, breast tenderness, headaches, muscle pain, bloating, and weight gain significantly decreased in zinc group compared to placebo group (P < 0.001). We observed a significant increase in relationship with friends, classmates, and coworkers (p = 0.003) after 24 weeks of intervention with zinc compared to placebo. In conclusion, zinc, as a simple and inexpensive treatment, was associated with improvement of PMS symptoms. Given that this is among the first studies to evaluate the effect of zinc supplementation on PMS, additional studies are warranted to confirm these findings.

Impact of relaxation therapy on premenstrual symptoms: A systematic review

Relaxation therapy (RT) is considered to be helpful in the management of symptoms of premenstrual syndrome (PMS). This systematic review (SR) was conducted to find the impact of RT on PMS management, which could be utilized in clinical and community populations. Five major databases like Google Scholar, PubMed, ResearchGate, Scopus, and Web of Science were used as search engines. The Joanna Briggs Institute checklist is used to analyze the quality of articles selected for this review. Only 35 different studies among 71 relevant articles which focused on the topic were selected for this SR. All of the 35 different trials reported that the selected RTs, namely Laura Mitchell, Jacobson, Benson, relaxation unnamed, yoga, aerobic exercise, and massage, significantly decreased PMS. The outcome of this SR suggests that the selected seven RTs effectively relieve PMS and ensure a productive life for all reproductive women.

Prevalence and patterns of premenstrual disorders and possible association with sexual harassment: a cross-sectional study of young Arab women

BACKGROUND

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent a range of both psychiatric and physical symptoms that impair quality of life and interfere with daily activities in females.

AIMS

To assess the prevalence of PMS and PMDD in Egypt, Jordan and Syria, its demographic associations and the potential link to sexual harassment (SH).

METHODS

We used an Arabic version of the premenstrual symptoms screening tool (PSST) to assess the prevalence of PMS and PMDD. Another two-part questionnaire was used to assess the harassment experience.

RESULTS

22,021 women agreed to fill the questionnaire; the majority (65%) aged 18-25 years old. PMS was more prevalent in Egyptian women 77.7% followed by women from Jordan 72.9% then Syria 66.3%. PMDD prevalence followed the same order (40%, 34.7% and 28.2%). Both conditions were significantly associated with obesity and working in medical careers (P = .001). 5733 women agreed to share their sexual harassment experience. Results showed a significant association between the diversity and frequency of sexual harassment and the frequency of the pre-menstrual conditions, PMS Frequency was 87.6%, 80.7% and 78% in participants who were harassed on daily basis Vs. once weekly or monthly vs. few times in their lifetime (p = .04). A similar statistically significant difference was noticed regarding having PMDD (66.4% vs. 47.6% vs. 42.5%).

CONCLUSION

The study showed high levels of both PMS and PMDD. The data provided by this study also sheds light on a potential link between SH and developing Pre-menstrual disorders.

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.

Clinical correlates of women endorsing premenstrual suicidal ideation: a cross-sectional study

BACKGROUND

Prevalence of premenstrual syndrome (PMS) may be as high as 13-18%, but it remains under-recognized and is associated with increased suicidal ideation (SI), plans, and attempts in epidemiological studies. The present study reports on women endorsing premenstrual SI (PMSI) and characterizes this at-risk group and its clinical correlates.

METHODS

A cross-sectional study assessed demographics, anxiety and depression severity, psychiatric diagnoses, menstrual symptoms, SI, and trauma in adult women at a major medical center over 11 months.

RESULTS

Three hundred two women were assessed. Of 153 participants endorsing premenstrual symptoms, 41 (27%) reported new or worsening concurrent premenstrual passive or active SI. Women who reported PMSI were significantly more likely to be single, unemployed, and childless as well as significantly more likely to report interference from premenstrual symptoms, histories of psychiatric hospitalization, adverse childhood events, suicide attempts, and current and past depression and anxiety compared to women without PMSI. The final regression model indicated the most significant predictors of PMSI were history of a depression diagnosis, severity of current depressive symptoms, and having experienced 3 or more childhood adverse events.

CONCLUSION

Nearly one-third of women reporting premenstrual symptoms endorsed concurrent SI, a clinically valuable demonstration of the importance of this predictable cyclic risk factor.

Menstrual cycle and exogenous attention toward emotional expressions

Several studies suggest that the menstrual cycle affects emotional processing. However, these results may be biased by including women with premenstrual syndrome (PMS) in the samples. PMS is characterized by negative emotional symptomatology, such as depression and/or anxiety, during the luteal phase. This study aimed to explore the modulation of exogenous attention to emotional facial expressions as a function of the menstrual cycle in women without PMS. For this purpose, 55 women were selected (from an original volunteer sample of 790) according to rigorous exclusion criteria. Happy, angry, and neutral faces were presented as distractors, while both behavioral performance in a perceptual task and event-related potentials (ERPs) were recorded. This task was applied during both phases of the menstrual cycle (luteal and follicular, counterbalanced), and premenstrual symptomatology was monitored daily. Traditional and Bayesian ANOVAs on behavioral data (reaction times and errors in the task) and ERP indices (P1, N170, N2, and LPP amplitudes) confirmed the expected lack of an interaction of phase and emotion. Taken together, these results indicate that women free of PMS present steady exogenous attention levels to emotionally positive and negative stimuli regardless of the menstrual phase.

Effect of internet-based counselling with a cognitive-behavioural approach on premenstrual syndrome

Objectives

To assess the effect of internet-based counselling with a cognitive-behavioural approach on symptom severity of women with premenstrual syndrome (PMS) and their quality of life during the perimenstrual and late follicular phases of the menstrual cycle. Moreover, the PMS-related disability and attitude toward menstruation were investigated as secondary outcomes.

Data description

We provide data generated in a randomized controlled trial with two-parallel arms carried out on 92 female university students aged 18–35 years who had moderate to severe PMS, residing at halls of the Tabriz University of Medical Sciences. PMS severity was assessed during two menstrual cycles before intervention (baseline) and during two cycles just after ending the two-month intervention using Daily Record of Severity of Problems (DRSP) and the quality of life using the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q-SF) on days 1–2 and 11–13 of the menstrual cycle at the baseline and post-intervention. Also, the PMS-related disability was assessed using Sheehan Disability Scale (SDS) and attitude toward menstruation using Menstrual Attitude Questionnaire (MAQ) at the baseline and post-intervention. Participant satisfaction and views on intervention effectiveness were also assessed using a single Likert question.

The relationship between high physical activity and premenstrual syndrome in Japanese female college students

BACKGROUND

In recent years, moderate physical activity has attracted the attention of experts and women as a way to cope with premenstrual syndrome (PMS). Studies investigated the effects of exercise on PMS, but only a few reports focused on the relationship between physical activity, which included not only exercise but also routine bodily movements, and PMS. Therefore, the present study investigated the relationship between the amount of physical activity and PMS symptoms among sexually mature female students.

METHODS

A total of 381 female university students in Japan were surveyed using a paper or web-based questionnaire with the same content. The questionnaire consisted of basic information, PMS symptoms, and physical activity based on the International Physical Activity Questionnaire (IPAQ). Participants were divided into two groups (≥ 3000 The Metabolic Equivalent of Task (MET)-minutes/week and < 3000 MET-minutes/week) based on their total physical activity as calculated using the IPAQ guidelines. The two groups were then compared in terms of the severity of their PMS physical and psychological symptoms as calculated based on the American College of Obstetricians and Gynecologists' PMS diagnostic criteria. The Wilcoxon's rank-sum test was used for statistical analyses. We then divided the participants based on the presence or absence of each symptom and used the chi-square test to compare the intergroup differences in ratios. The statistical significance level was set at p < 0.05.

RESULTS

Those with total physical activity of ≥ 3000 MET-minutes/week had lower total PMS symptom scores (p < 0.01), physical symptom scores (p = 0.01), and psychological symptom scores (p = 0.01) compared with those with total physical activity of < 3000 MET-minutes/week.

CONCLUSION

These results suggest that young women with high physical activity (≥ 3000 MET-minutes/week) have milder symptoms of PMS.

Premenstrual syndrome is associated with an altered spontaneous electroencephalographic delta/beta power ratio across the menstrual cycle

Premenstrual syndrome is associated with altered spontaneous brain activity in the late luteal phase, but the fluctuation patterns of brain activity throughout the menstrual cycle have not been revealed. Furthermore, it is also unknown whether the altered spontaneous brain activity during the whole menstrual cycle is further associated with their habitual use of maladaptive emotion regulation strategies. Based on the two reasons, electroencephalogram data and cognitive emotion regulation questionnaire from 32 women with high premenstrual symptoms (HPMS) and 33 women with low premenstrual symptoms (LPMS) were measured in the late luteal and follicular phases. Delta power, theta power, beta power, and the slow/fast wave ratios (SW/FW, including theta/beta power ratio [TBR] and delta/beta power ratio [DBR]) were calculated using both fixed frequency bands and individually adjusted frequency bands (based on the individual alpha peak frequency). The results showed that for the frontal and central DBR, as assessed both with fixed and individualized frequency bands, there was no difference between the two phases of the LPMS group, whereas there was a difference between the two phases of the HPMS group with a higher DBR in the late luteal phase than in the follicular phase. Further correlation results revealed that for women with HPMS in the late luteal phase, the frontal and central DBR values, as assessed both with fixed and individualized frequency bands, were positively correlated with self-blame and rumination. Consequently, HPMS was characterized by a fluctuation across the menstrual cycle in the DBR, which was further associated with maladaptive emotion regulation.

The Effectiveness of Transdiagnostic Treatment Program on Clinical Symptoms and Emotion Regulation in Girls Adolescents with Premenstrual Syndrome

BACKGROUND

Premenstrual Syndrome (PMS) is the experience of some physical and psychological symptoms periodically in the last days of the menstrual cycle that interferes with academic, social and family functioning. We aimed to evaluate the effectiveness of Transdiagnostic Treatment Program (TTP) on clinical symptoms and emotion regulation in girl's adolescents with PMS.

METHODS

This experimental trial study was carried out on 32 girls adolescents with PMS referred to two medical centers located in Tehran, Iran from Mar 21, 2019, to Oct. The patients randomized in 2 groups, 1-intervention (n=16, 8 sessions, 90-minute weekly) and 2-control (n=10).The PMS Screening Tool (PSST) and Emotion Regulation Questionnaire (ERQ) before and after treatment were filled out by participant. The SPSS software and P<0.05 considered for data analysis and as significant levels respectively.

RESULTS

The study sample was 32 girls adolescents with PMS (mean age intervention and control were 16.30±2.02 and 16.40±1.6, P=0.915). The score of two questionnaires, PSST (symptom, effect) and ERQ (cognitive reappraisal, suppression) between two groups in before treatment were the same. After intervention the change of variable symptom (-1.05 vs -0.02, P<0.001), effect (-0.53 vs -0.04, P<0.001), cognitive reappraisal (0.67 vs 0.02, P<0.001) and suppression (-0.64 vs -0.07, P<0.001) were significant between two groups.

CONCLUSION

TTP is an effective technique for controlling clinical symptoms and emotion regulation in girl's adolescents with PMS.

The relationship between the severity of perimenstrual symptoms and a regular exercise habit in Japanese young women: a cross-sectional online survey

Background

Experiencing perimenstrual symptoms is a major health concern for young women. Women in the reproductive age experience menstruation about once a month, and many experience perimenstrual symptoms. Drug therapies such as painkillers (commonly used) and hormonal medications help to achieve symptomatic relief from perimenstrual symptoms. However, many women are concerned about tolerance and compliance of the drugs used to treat perimenstrual symptoms and lack awareness on how to cope with perimenstrual symptoms. If the association between exercise habits and the severity of symptoms is emphasized in young women, methods for coping with perimenstrual symptoms can be established, not relying only on pharmaceuticals. The objective of this study was to determine the differences in the severity of perimenstrual symptoms in young Japanese women with and without a regular exercise habit.

Methods

A cross-sectional study using an online survey was sent among 500 Japanese women aged 18–25 years. The severity of perimenstrual symptoms was assessed using the Menstrual Distress Questionnaire (MDQ). The differences in MDQ scores between those with and without exercise habits (exercise for more than 30 min for 2 days a week) were compared using the chi-square test and Mann–Whitney U test. The logistic regression analysis detected subscales of the premenstrual and menstrual symptoms affected by an exercise habit.

Results

282 (56.4%) young Japanese women were answered this survey. Respondents were divided into the exercise group (n = 157) and the non-exercise group (n = 125). The exercise group had significantly low premenstrual and menstrual MDQ scores. The results of the logistic regression analysis stated that the subscale related to negative emotion before menstruation was associated with an exercise habit. In the analysis performed during menstruation, a statistically significant association was detected between an exercise habit and a behavioral change such as avoiding interaction with others.

Conclusions

This study suggested that exercise habits may reduce the severity of perimenstrual symptoms and could help to develop a non-pharmacological coping strategy. In addition, this study provides useful information for young women who want to prevent perimenstrual symptoms but do not have an exercise habit. Further, it may encourage young women to start exercising.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01720-2.

Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common disorders of the luteal phase of the menstrual cycle and are characterized by moderate to severe physical, affective, or behavioral symptoms that impair daily activities and quality of life. PMS and PMDD have recently raised great interest in the research community for their considerable global prevalence. The etiology of PMS/PMDD is complex. Ovarian reproductive steroids (estradiol and progesterone) are considered pathogenetic effectors, but the key feature seems to be an altered sensitivity of the GABAergic central inhibitory system to allopregnanolone, a neurosteroid derived from progesterone produced after ovulation. Also, a reduced availability of serotonin seems to be involved. New insights point to a role for genetic and epigenetic modifications of hormonal and neurotransmitter pathways, and inflammation is the potential link between peripheral and neurological integrated responses to stressors. Thus, new therapeutic approaches to PMS/PMDD include inhibition of progesterone receptors in the brain (i.e., with ulipristal acetate), reduced conversion of progesterone to its metabolite allopregnanolone with dutasteride, and possible modulation of the action of allopregnanolone on the brain GABAergic system with sepranolone. Further research is needed to better understand the interaction between peripheral inflammatory molecules (cytokines, interleukins, C-reactive protein, and reactive oxygen species) and the brain neurotransmitter systems in women with PMS/PMDD. If confirmed, neuroinflammation could lead both to develop targeted anti-inflammatory therapies and to define prevention strategies for the associated chronic inflammatory risk in PMS/PMDD. Finally, the observed association between premenstrual disorders and psychological diseases may guide prompt and adequate interventions to achieve a better quality of life.

The effect of a social network-based cognitive behavioral therapy intervention on the severity of premenstrual syndrome symptoms: a protocol of a randomized clinical trial study

Background

Premenstrual syndrome (PMS) is one of the most widespread menstrual disorders in women of reproductive age. This recurrent syndrome is a combination of physically, mentally, or behaviorally disturbing changes occurring during the secretory phase of the menstrual cycle. The aim of this study is to determine the effect of a cognitive-behavioral therapy-based educational intervention using social networks on PMS in female health center employees in Rudbar, Iran.

Methods/design

A randomized superiority controlled trial will be conducted involving 140 female employees of health centers affiliated with the Guilan University of Medical Sciences, Rudbar. The study involves a block size of 4 and 6 in a randomly varied order, 140 women who meet all the inclusion criteria will be randomly and equally divided into 2 groups: the intervention and the control groups. Those in the former group will receive a cognitive-behavioral therapy-based treatment for eight consecutive weeks on the social network platform WhatsApp; however, those in the control group will not be offered any treatment except usual care practices (unprotocolized usual care). The study’s primary outcome is the severity of PMS symptoms, and the secondary outcomes include general self-efficacy, work-related quality of life, the impact of PMS on daily life, coping with the symptoms, and experiencing anxiety and depression at the beginning of the study to identify people with PMS. A daily record of the symptoms will be completed for two consecutive months by all female employees aged 20–45 years who wish to participate in the study. According to the initial screening, those with moderate to severe PMS will be included. We will use the MLwin software for the analyses. All questionnaires will be completed by both groups immediately and 8 weeks after the termination of the treatment. The data will be analyzed using linear mixed-effects modeling with random intercepts and slopes.

Discussion

It is anticipated that the findings of the present study may demonstrate the effectiveness of the cognitive behavioral therapy intervention on the severity of PMS symptoms that could guide healthcare providers in opting for suitable treatment alternatives for the syndrome.

Ethics and dissemination

The research proposal is approved by the Human Ethics Committee of Qazvin University of Medical Sciences (IR.QUMS.REC.1399.252). The results of this intervention trial will be submitted for publication in a peer-reviewed research journal.

Trial registration

Iranian Registry of Clinical Trials IRCT20180218038789N4. Registered prospectively on October 28, 2020

Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder

BACKGROUND

Suicide is the second leading cause of death among Americans ages 10 to 34, with alarming recent increases in suicide rates among those assigned female at birth. A large body of evidence points to menstrual cycle influences on self-injurious thoughts and behaviors (STBs), suggesting that neurobiological hormone sensitivities, such as in premenstrual dysphoric disorder (PMDD), may drive suicide risk in females. However, existing studies of STBs in PMDD use cross-sectional self-report measures of PMDD with poor validity. As a first step to establish accurate prevalence rates of STBs in PMDD, we examined the lifetime prevalence of STBs in a large global survey of patients reporting a diagnosis of PMDD based on daily ratings.

METHOD

Individuals with self-reported PMDD symptoms were invited to an online survey through online support groups for PMDD and social media posts from PMDD awareness accounts. Participants reported demographics, whether they had been diagnosed with PMDD by a healthcare provider using daily ratings, STBs using the Columbia Suicide Severity Rating Scale, and history of lifetime comorbid psychiatric diagnoses.

RESULTS

Of 2,689 survey completers, 599 (23%) reported a diagnosis with PMDD based on two months of daily ratings and were included in analyses. We observed high rates of lifetime active suicidal ideation (72%), planning (49%), intent (42%), preparing for an attempt (40%), and attempt (34%), as well as non-suicidal self-injury (51%). The majority (70%) of the sample reported at least one lifetime comorbid psychiatric diagnosis. Predictors of lifetime active suicidal ideation included nulliparity, low-to-moderate (vs. high) income, and history of diagnosis with major depression or post-traumatic stress disorder. Predictors of lifetime attempts among those reporting lifetime active ideation included older age, nulliparity, lower income, and history of diagnosis with post-traumatic stress disorder or borderline personality disorder.

CONCLUSIONS

These data indicate high rates of STBs among those reporting prospective diagnosis of PMDD and highlight the need for prospective research on mechanisms and prevention of STBs in PMDD. Clinical practice guidelines for PMDD should accommodate comorbidities and recommend frequent screenings for STB risk. STBs should be considered for inclusion in future iterations of the DSM PMDD diagnostic criteria.

Internet-based cognitive-behavioral therapy for premenstrual syndrome: a randomized controlled trial

Background

Premenstrual syndrome (PMS) is a common problem of women of reproductive age, affecting various aspects of their lives. However, limited studies have investigated the effect of internet-based cognitive-behavioral therapy (ICBT) on PMS. Therefore, we aimed to assess whether ICBT can reduce symptom severity of women with PMS and improve their quality of life during the perimenstrual and late follicular phases of menstrual cycle.

Methods

The study included 92 university students aged 18–35 years who had moderate to severe PMS. The participants were allocated into two groups of 46 using block randomization. The intervention group underwent ICBT for two menstrual cycles, while the control group received no intervention. Before and after the intervention, all participants filled the Daily Record of Severity of Problems (DRSP) for two menstrual cycles and the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q-SF) on days 1–2 and 11–13 of the menstrual cycle. Data were analyzed using univariate general linear models.

Results

Four students in the intervention group were lost to follow-up. Following the intervention, the mean score of total PMS symptoms was significantly lower in the intervention group than in the control group (10.4 vs. 20.2, adjusted difference: − 9.9 [95% CI − 13.3 to − 6.6]), and the score of perimenstrual quality of life was significantly higher (64.2 vs. 50.3, 14.1 [8.5 to 19.8]). However, there was no significant intergroup difference in the late follicular quality of life (68.3 vs. 67.3, 1.9 [− 4.4 to 8.1]).

Conclusions

The ICBT could reduce the symptom severity of women suffering from PMS while improving their perimenstrual quality of life. However, it had no significant effect on the late follicular quality of life. Therefore, this intervention can be used for women with PMS.

Trial registration The Iranian Registry of Clinical Trials, Identifier: IRCT20100414003706N34, Registered prospectively on 19 June 2019, https://www.irct.ir/trial/38394.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01589-7.

The effect of estrogen hormone on premenstrual syndrome (PMS) occurrences in teenage girls at Pesantren Darul Arqam Makassar

OBJECTIVE

PMS symptoms can include anxiety, quick temper, excessive strain on the breasts, increased or decreased appetite, nausea, vomiting, acne, low back pain, to faint. This study aimed to determine the effect of estrogen hormone in Adolescent Girls who experienced premenstrual syndrome at Darul Arqam, Makassar.

METHODS

The research design used the cross-sectional approach using the purposive sampling technique to get the samples of female teenagers who had PMS and another 25 samples of female teenagers who did not have PMS. The respondent who had experienced PMS filled in the daily diary sheets, did the blood taking of five ccs and underwent the examination of estrogen level using ELISA method. The study was conducted for three months, and the data were analyzed using the Mann-Whitney U test.

RESULT

The research result indicated that the mean value of estrogen hormone in adolescent girls who experienced PMS was 148.32pg/ml higher than the female teenagers who did not experience PMS of 98.00pg/ml. The analysis result indicated that Ha was accepted, and H0 was rejected since the mean value in PMS teenagers was higher compared to the non-PMS teenagers with the value of p=0.000<α=0.05. This result showed a significant effect of estrogen hormone in adolescent girls who experienced PMS compared to those who did not experience PMS. The adolescent girls who experience mild PMS with the mean value of estrogen hormone were 130.73pg/dl, while those who experienced severe PMS of 162.14pg/ml.

CONCLUSION

It was found that the value of p=0.000<α=0.05, which indicated that there was a significant effect of the levels of estrogen hormone between the non-PMS, mild PMS, and severe PMS.

Premenstrual syndrome prevalence in Turkey: a systematic review and meta-analysis

The aim of this study was to determine the prevalence of premenstrual syndrome among reproductive age women living in Turkey with a systematic review and meta-analysis study. In this study were scanned keywords ['premenstrual syndrome' and prevalence and Turkish] in the databases including Turkish Medline, PubMed, Google Scholar, Scopus and ISI Web of Knowledge. This study included full-text research articles from conducted in Turkey, published in Turkish or English between 2014 and 2018 and indicating prevalence. This study included a total of 18 studies conducted in Turkey reporting the prevalence of premenstrual syndrome. A total of 6890 women participated in these studies. The overall premenstrual syndrome prevalence in the studies examined in this systematic review was 52.2%. Subgroup prevalence was found to be 59% in high school students, 50.3% in university students and 66% of women in general population. In the meta-regression analysis showed that there was no significant relationship between the mean age of the participants with the prevalence of premenstrual syndrome. The results of the study showed that premenstrual syndrome was prevalent among Turkish reproductive age women. Health professionals should organize training for women to gain the ability to manage PMS symptoms. Further interventional studies are needed to cope with PMS.

Lomens-P0 (mixed extracts of Hordeum vulgare and Chrysanthemum zawadskii) regulate the expression of factors affecting premenstrual syndrome symptoms

BACKGROUND/OBJECTIVES

Premenstrual syndrome (PMS) is a disorder characterized by repeated emotional, behavioral, and physical symptoms before menstruation, and the exact cause and mechanism are uncertain. Hyperprolactinemia interferes with the normal production of estrogen and progesterone, leading to PMS symptoms. Thus, we judged that the inhibition of prolactin hypersecretion could mitigate PMS symptoms.

MATERIALS/METHODS

Hordeum vulgare L. extract (HVE), Chrysanthemum zawadskii var. latilobum extract (CZE), and Lomens-P0 the mixture of these extracts were tested in subsequent experiments. The effect of extracts on prolactin secretion at the in vitro level was measured in GH3 cells. Nitric oxide and pro-inflammatory mediator expression were measured in RAW 264.7 cells to confirm the anti-inflammatory effect. Also, the hyperprolactinemic Institute for Cancer Research (ICR) mice model was used to measure extract effects on prolactin and hormone secretion and uterine inflammation.

RESULTS

Anti-inflammatory effects of and prolactin secretion suppress by HVE and CZE were confirmed through in vitro experiments (P < 0.05). Treatment with Lomens-P0 inhibited prolactin secretion (P < 0.05) and restored normal sex hormone secretion in the hyperprolactinemia mice model. In addition, extracts significantly inhibited the expression of pro-inflammatory biomarkers, including interleukin-1β, and -6, tumor necrosis factor-α, inducible nitric oxide synthase, and cyclooxygenase-2 (P < 0.01). We used high-performance liquid chromatography analyses to identify tricin and chlorogenic acid as the respective components of HVE and CZE that inhibit prolactin secretion. The Lomens-P0, which includes tricin and chlorogenic acid, is expected to be effective in improving PMS symptoms in the human body.

CONCLUSIONS

The Lomens-P0 suppressed the prolactin secretion in hyperprolactinemia mice, normalized the sex hormone imbalance, and significantly suppressed the expression of inflammatory markers in uterine tissue. This study suggests that Lomens-P0 may have the potential to prevent or remedy materials to PMS symptoms.

Investigation of the Relationship between Premenstrual Syndrome, and Childhood Trauma and Mental State in Adolescents with Premenstrual Syndrome

PURPOSE

This study was aimed at investigating the relationship between premenstrual syndrome (PMS), and childhood trauma and mental state in adolescents with PMS.

DESIGN AND METHODS

This descriptive study was conducted with 702 students between September 2020 and November 2020. An Information Form, the PMS Scale, the Childhood Trauma Questionnaire (CTQ) and Symptom Checklist (SCL)-90 were used as the data collection tools.

RESULTS

The mean scores the participants with PMS obtained from the Symptom Checklist (SCL)-90 and Childhood Trauma Questionnaire (CTQ) were higher than were those obtained by the participants without PMS. The Pearson correlation analysis revealed a positive and weak statistically significant relationship between the PMS Scale, and SCL-90 and CTQ.

CONCLUSIONS

The results of the study demonstrated that adolescents with PMS suffered from childhood traumas and mental problems more.

Leptin, ghrelin, & insulin levels and food intake in premenstrual syndrome: A case-control study

OBJECTIVES

The objective of this study was to evaluate the relationship between food intake and serum levels of leptin and ghrelin in the luteal (LP) and follicular (FP) phases of the MC (menstrual cycle) in participants with and without PMS (premenstrual syndrome).

METHODS

This was a case-control study with healthy participants aged 20-45 years with regular menstrual cycles (24-35 days) with and without PMS. After the Daily Record of Severity of Problems (DRSP) was filled out for two months (PMS diagnosis), a nutritional assessment was carried out based on twelve food intake records (for two menstrual cycles) to quantify food intake.

RESULTS

Of the 69 participants analyzed, 35 experienced PMS and 34 did not experience PMS. For participants with PMS, calorie and carbohydrate intake was higher during LP than in FP (p = 0.004 and p = 0.003, respectively), whereas these changes were not observed in participants without PMS (p > 0.05). There were interactions between the groups and the MC phases (LP and FP) for the intake of calories (p = 0.028) and carbohydrates (p = 0.001). There was a marginal negative relationship between the levels of ghrelin and calorie intake in FP (rS = -0.314, p = 0.066) in the PMS group and a negative relationship between the levels of ghrelin and leptin in LP (rS = -0.490, p = 0.004) in the group without PMS.

CONCLUSIONS

These results indicated a higher calorie and carbohydrate intake during LP in participants with PMS, in addition to the hypothesis that the roles of ghrelin and leptin in energy regulation may be different in participants with PMS compared to those without PMS.

Altered resting-state functional networks in patients with premenstrual syndrome: a graph-theoretical based study

Premenstrual syndrome (PMS) is a menstrual cycle-related disorder. Previous studies have indicated alterations of brain functional connectivity in PMS patients. However, little is known about the overall organization of brain network in PMS patients. Functional magnetic resonance imaging data deriving from 20 PMS patients and 21 healthy controls (HCs). Pearson correlation between mean time-series was used to estimate connectivity matrix between each paired regions of interest, and the connectivity matrix for each participant was then binarized. Graph theory analysis was applied to assess each participant's global and local topological properties of brain functional network. Correlation analysis was performed to evaluate relationships between the daily rating of severity of problems (DRSP) and abnormal network properties. PMS patients had lower small-worldness values than HCs. PMS-related alterations of nodal properties were mainly found in the posterior cingulate cortex, precuneus and angular gyrus. The PMS-related abnormal connectivity components were mainly associated with the thalamus, putamen and middle cingulate cortex. In the PMS group, the DRSP score were negatively correlated with the area under the curves of nodal local efficiency in the posterior cingulate cortex. Our study suggests that the graph-theory method may be one potential tool to detect disruptions of brain connections and may provide important evidence for understanding the PMS from the disrupted network organization perspective.