Abstract
Emerging data suggest that more than two-thirds of premenstrual disorders (PMDs), including premenstrual syndrome and premenstrual dysphoric disorder, have symptom onset during the teen years. Adulthood adiposity has been associated with PMDs; however, the association with childhood and adolescent body size is unknown. To examine the association between childhood and adolescent body size and risk of PMDs in young adulthood. This prospective cohort study included 6524 US female participants from the Growing Up Today Study (1996-2013). Data were analyzed from February 26, 2020, to June 23, 2021. Body mass index (BMI) was estimated using self-reported height and weight through adolescence and converted to BMI for age (z score). In 2013, premenstrual symptoms and identified PMDs were assessed with a validated scale based on the Calendar of Premenstrual Experiences. The associations of BMI for age with PMDs and premenstrual symptoms were examined using log-binomial and linear regressions, respectively. Among 6524 participants (mean [SD] age, 26 [3.5] years; 6108 [93.6%] White), 1004 (15.4%) met the criteria for a PMD. Baseline BMI for age reported at a mean (SD) age of 12.7 (1.1) years was associated with increased risk of PMDs (confounding-adjusted relative risk, 1.09 per unit of z score; 95% CI, 1.03-1.15) and higher burden of premenstrual symptoms (β = 0.06; 95% CI, 0.04-0.08). Associations were particularly pronounced for premenstrual dysphoric disorder and for PMDs with symptom onset before 20 years of age and remained in the absence of psychiatric comorbidities, including depression, anxiety, and disordered eating behavior. When analyzing BMI change over time, individuals with high BMI throughout adolescence had a higher burden of premenstrual symptoms (β = 0.17; 95% CI, 0.08-0.27) compared with those with normal BMI throughout adolescence. Individuals with high BMI early followed by a mild decrease later did not report higher premenstrual symptoms (β = 0.06; 95% CI, 0.00-0.12). In this cohort study, childhood body size was associated with PMD risk and premenstrual symptoms in young adulthood. These findings suggest that maintaining a normal body mass in childhood may be considered for lowering the burden of PMDs in adulthood.
Highlights
Premenstrual disorders (PMDs), characterized by emotional and physical symptoms before menstruation, affect millions of women of reproductive age globally.[1]
Baseline body mass index (BMI) for age reported at a mean (SD) age of 12.7 (1.1) years was associated with increased risk of Premenstrual Disorder (PMD) and higher burden of premenstrual symptoms (β = 0.06; 95% CI, 0.04-0.08)
In this cohort study, childhood body size was associated with PMD risk and premenstrual symptoms in young adulthood
Summary
Premenstrual disorders (PMDs), characterized by emotional and physical symptoms before menstruation, affect millions of women of reproductive age globally.[1]. Premenstrual disorders include premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), which is a more disabling form predominated by psychological symptoms and accompanied by impaired social functioning.[1]. These chronic and cyclic conditions have profound effects on quality of life[2] and major health consequences (eg, suicidal behavior[3] and hypertension[4]). Few childhood risk factors have been identified for PMDs, except for childhood abuse[7] and pubertal timing.[6]. Both cross-sectional[8] and prospective[9] studies indicate that adulthood adiposity is positively associated with PMDs. Both cross-sectional[8] and prospective[9] studies indicate that adulthood adiposity is positively associated with PMDs Such association may be attributable to obesity present already in childhood.[10].
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