Curcumin, a bioactive supplement for premenstrual syndrome and dysmenorrhea: A systematic review of randomised clinical trials

Management of Premenstrual Syndrome: Green-top Guideline No. 48.

Background: Premenstrual syndrome is medically defined as distressing physical and psychological symptoms not caused by organic disease which appear before menstruation regress during the menstruation, perhaps a hormone imbalance, due to lack of progesterone, a poor diet and lack of exercise. Premenstrual tension syndrome is the emotional tension, insomnia, depression, irritability associated with the premenstrual week. Somatic sensations associated with the syndrome are bloating, cramping, tenderness of the breasts, swelling of hands and feet, temporary weight gain. Premenstrual disorder is a condition in which the symptoms of premenstrual syndrome are more severe and cause significant functional impairment .It has been estimated that anywhere from 3 to 9% of women suffer from this disorder (Woods, 2005). In premenstrual syndrome, symptoms can be controlled to some extent by the dietary manipulations. Studies suggest that a diet high in vitamin C, calcium and magnesium was helpful in order to reduce the level of premenstrual tension syndrome. It is advisable to take diet consisting of fruits which is rich in calcium, antioxidant, vitamin A and minerals from one week prior to menstruation. Papaya fruit is an excellent source of dietary fibre, folate, vitamin A, C and E.It also contains small amount of calcium, iron, riboflavin, thiamine and niacin. It is also very rich in antioxidant nutrients flavonoids and carotenes, very high in vitamin A and C & and also low in calorie. Materials and Methods: Premenstrual syndrome is linked to other disorders associated with inadequate calcium, iron, vitamins and minerals. Hence the researcher was interested to reduce the level of premenstrual tension syndrome by providing papaya fruit for adolescent girls. The aim of the study was to determine the outcome of papaya fruit on premenstrual tension syndrome among adolescent girls in selected setting. A Quasi experimental design was adopted. The study was conducted at selected governmentschool, Arakonam.60 adolescent girls were selected.30 in experimental and 30 in control group. Adolescent girls who fulfilled the inclusion criteria were selected by using non probability purposive sampling technique.Results:The demographic variables were age in years, age at menarche, weight in kilogram, body mass index and type of diet. The pretest and posttest level of PMTS was determined by modified premenstrual tension syndrome scale.75 mg of papaya fruit was provided by the researcher from the 5th day of last menstrual period in mid morning for 21 days. Data analysis was done by using descriptive and inferential statistics. The pretest and posttest level of premenstrual tension syndrome were compared and found that in pretest 6(20%)had mild level of premenstrual tension syndrome,24(80%)had moderate level of premenstrual tension syndrome ,none of them comes under severe level of premenstrual tension syndrome and in post test 27(90%) had mild level of premenstrual tension syndrome,3(10%) had moderate level of premenstrual tension syndrome, none of them comes under the severe level of premenstrual tension syndrome. Conclusion:Thus the study concludes that papaya fruit was effective to reduce the level of premenstrual tension syndrome. Theconceptual framework was based on modified Weidenbach’s helping art nursing theory. The research hypothesis formulated for the study was “there is a significant relationship between the premenstrual tension syndrome and papaya fruit” .The outcome was proved in comparing the pretest and post test level of premenstrual tension syndrome where the result showed p<0.05 level of significance. Thus the research hypothesis was accepted. It was also found that papaya fruit have a role in reducing PMTS. This is statistically proved that research hypothesis was accepted as papaya fruit was effective to alleviate PMTS

Premenstrual syndrome (PMS) and dysmenorrhea are common symptoms in women. In this study, we investigated the effects of saffron on PMS and dysmenorrhea in women. In this systematic review and meta-analysis, we comprehensively screened a range of databases, including PubMed, Web of Science, and Science Direct. We included randomized clinical trials investigating the effects of saffron on PMS or dysmenorrhea. Quality assessment of the identified studies was conducted using the Cochrane risk-of-bias assessment tool. Meta-analysis was performed using Comprehensive Meta-Analysis software ver. 2 based on the random effects model. Meta-analysis revealed that saffron had a significant positive effect on the symptoms of PMS in women (standardized mean difference [SMD], -0.64; 95% confidence interval [CI], -0.84 to -0.44). Furthermore, saffron was effective in reducing dysmenorrhea (SMD, -0.51; 95% CI, -1.01 to -0.01). The findings of our meta-analysis indicate that saffron exerts beneficial effects on the symptoms of both PMS and dysmenorrhea in women.

Introduction: Among the menstrual disorders of the female reproductive period, Premenstrual Syndrome (PMS) and Dysmenorrhea are the most prevalent. The intensity of the signs and symptoms in each of these conditions may compromise the physical, psychological and social well-being of the woman at the stage of the menstrual cycle. Objective: To compare the signs and symptoms of menstrual disorders in women who practice regular exercise or not. Methods: A cross-sectional study carried out on women who practice exercises regularly and sedentary women. The IPAQ questionnaires and the evaluation of signs and symptoms of dysmenorrhea and PMS were applied to non-sedentary and sedentary students from the Federal University of Sergipe, Campus Lagarto. Results: Both groups had similar data for mean age and the mean Body Mass Index (BMI), therefore, passive of comparison. The prevalence of dysmenorrhea was significantly higher among sedentary women, 82% in the sedentary group and 46% in the non-sedentary group (p < 0.001), as well as some negative impacts on the psychological, social and physical state of both PMS and dysmenorrhea. Conclusion: The prevalence of signs and symptoms of dysmenorrhea was significantly higher in the Sedentary Group. Analyzing the behavior of PMS in relation to the practice of physical exercises, it was observed that the signs and symptoms of depressed mood, fatigue, difficulty to concentrate, lack of interest in social and home activities were more significant in the Sedentary Group.

BackgroundDysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of life. The present study examined the effects of curcumin on the severity of dysmenorrhea and PMS symptoms.MethodsA systematic review and meta-analysis of randomized controlled trials was conducted by searching databases such as the Cochrane Library, EMBASE, Scopus, PubMed, and Web of Science from inception to January 2023. Article screening was performed using Endnote ver. X8 (Clarivate). Review Manager (RevMan ver. 5.3; Cochrane) was used for the quality assessment and meta-analysis. A total of 147 studies were screened, of which five were finally selected for quantitative and qualitative analyses. The studies were conducted between 2015 and 2021, and a total of 379 participants with a mean age of 23.33±5.54 years had been recruited in these studies.ResultsThe meta-analysis showed that curcumin consumption could significantly reduce the severity of dysmenorrhea (mean difference, -1.25; 95% confidence interval [CI], -1.52 to -0.98; three studies; I2=31%) and the overall score of PMS (standardized mean difference, -1.41; 95% CI, -1.81 to -1.02; two studies; I2=0%).ConclusionThe reduction in the severity of PMS and dysmenorrhea has been attributed to curcumin’s anti-inflammatory and antidepressant activities. Although the findings suggest that curcumin may be an effective treatment for reducing the severity of PMS and dysmenorrhea, further research with a larger number of participants from various socioeconomic levels and a longer duration of treatment is needed to evaluate the effective dose of curcumin.

Effect of curcumin on serum brain-derived neurotrophic factor levels in women with premenstrual syndrome: A randomized, double-blind, placebo-controlled trial

Background:DLBS1442, a proprietary and standardized semipolar bioactive extract of the fruit Phaleria macrocarpa, is preclinically proven to have anti-inflammatory properties. The current clinical study evaluated the efficacy and safety of DLBS1442 in alleviating symptoms of premenstrual syndrome and primary dysmenorrhea.Methods:This was an open study over four menstrual cycles (with two control cycles, followed by two treatment cycles). Women with premenstrual syndrome and/or primary dysmenorrhea, 18–40 years of age, and with a regular menstrual cycle were included in the study. In the treatment cycles, DLBS1442 extract was given as a 100 mg capsule two or three times daily (for those with mild and moderate-to-severe baseline abdominal pain, respectively), for an average of six days, ie, three days before until the end of the first three days of the menstrual period. Throughout all four study cycles, daily self-assessment of symptoms related to premenstrual syndrome was made by each subject using a visual analog scale (VAS). Data were descriptively analyzed and profiled in curves of VAS score versus time point evaluation starting from day 5 before menstruation to day 5 of menstruation.Results:Twenty-three subjects of mean age 27.35 ± 5.73 years were evaluable for the intention to treat analysis. Most subjects experienced the primary efficacy variable (abdominal pain), peaking on days 1–2 of the menstrual phase, with a mean VAS score of 36.8 ± 24.3 mm and 30.0 ± 29.6 mm, respectively, during control cycles. DLBS1442 markedly reduced VAS scores by 13.76 ± 28.27 mm (37.46%) and 13.28 ± 29.06 mm (44.28%), respectively. Other symptoms of premenstrual syndrome were also markedly alleviated by DLBS1442. Some mild adverse events were observed and resolved by the end of the study.Conclusion:This preliminary study indicates the effectiveness of DLBS1442 in alleviating primary dysmenorrhea and abdominal pain, as well as other symptoms related to premenstrual syndrome. DLBS1442 was safe and well tolerated in women with premenstrual syndrome and/or dysmenorrhea.

Introduction:Premenstrual syndrome (PMS) affects the majority of women and is characterized by physical, behavioral, and mood symptoms, which can have a profound impact on quality of life. PMS symptoms have also been linked to licit substance use. This study examined the relationships between daily/problem use (DPU) of caffeine (Caf+), alcohol (Alc+), and tobacco (Cig+) and PMS symptomology in a sample of college women.Methods:Participants (N = 196) completed an anonymous one-time health survey. Demographic, PMS symptomatology, and DPU of licit substance variables were examined. Independent t-tests compared PMS symptom scores in women with and without Caf+, Cig+, and Alc+ use. One-way analysis of variances examined the associations between PMS symptom severity and number of DPU-positive substances.Results:PMS subscale severity (pain [F(2,190) = 4.47, p = 0.013], affective [F(2,192) = 8.21, p < 0.001], and water retention [F(2,191) = 13.37, p < 0.001]) and total PMS symptom severity [F(2,189) = 10.22, p < 0.001] showed a dose response effect, with the number of licit substances with DPU significantly associated with PMS symptom severity.Conclusions:This study findings provide important new information about the relationship between PMS symptoms and at-risk substance use. These are cross-sectional data, however, and affirm a need for longitudinal research to better understand the associations, with a focus on potential benefits of education and intervention.

Emotional eating is an abnormal eating behavior triggered by emotional states rather than physical hunger. It has been linked to various physiological, psychological, and lifestyle factors and is notably prevalent among females. This study aimed to examine the association between emotional eating and premenstrual syndrome symptoms among female university students in Palestine. A cross-sectional study was conducted at Palestine Polytechnic University in the West Bank, Palestine, involving a sample of 450 female students. Data were collected through a structured, self-administered questionnaire comprising sections on sociodemographic characteristics, medical history, lifestyle behaviors, and nutrition-related information. Standardized instruments included The International Physical Activity Questionnaire to assess physical activity levels, The Mediterranean Diet Adherence Screener to evaluate dietary habits, The Emotional Eating Scale to measure emotional eating behavior, and The Arabic Premenstrual Syndrome Scale to assess the presence and severity of premenstrual syndrome symptoms. A significant association was observed between emotional eating and the severity of premenstrual syndrome symptoms (p < 0.05), particularly within the psychological and behavioral domains. Emotional eating was most prevalent among participants with moderate psychological premenstrual syndrome symptoms (79.0%) and least prevalent among those without such symptoms (42.9%). Similarly, participants with mild overall premenstrual syndrome symptoms reported a high rate of emotional eating (77.3%), while those with no premenstrual syndrome symptoms had the lowest prevalence of emotional eating (25.0%). These findings suggest a gradient relationship between premenstrual syndrome symptom severity and emotional eating behaviors. No significant associations were identified between emotional eating and participants' medical history, lifestyle characteristics, weight status, or dietary habits (p > 0.05). Emotional eating is significantly associated with premenstrual syndrome symptoms across multiple domains. These findings highlight the need for targeted interventions to manage premenstrual syndrome and reduce the risk of disordered eating behaviors among young women.Short SummaryThis study explored how emotional eating - eating in response to feelings rather than hunger - relates to premenstrual syndrome among female university students in Palestine. A total of 450 students from Palestine Polytechnic University completed questionnaires about their eating habits, physical activity, and premenstrual syndrome symptoms. The results showed that students who experienced stronger premenstrual syndrome symptoms were more likely to report emotional eating, especially when they had mood or behavior-related premenstrual syndrome symptoms. Emotional eating was least common among those without premenstrual syndrome. However, emotional eating was not linked to weight, lifestyle, or diet quality. These findings suggest that premenstrual syndrome may increase the likelihood of emotional eating, emphasizing the importance of supporting young women through education and strategies to manage mood and eating behaviors during the menstrual cycle.

Pre Menstrual Syndrome (PMS) affects women’s quality of life, social and economic performance. The other study discovered that 23- 31 % of reproductive aged women experience PMS to a degree that affects their daily acivity Symptoms of Pre Menstrual Syndrome (PMS) are divided into 4 types, namely type A for Anxiety (Anxiety), type C for Craving (Hungry), type D for Depression and Type H for Hyperhydration (Liquid Stockpiling). Type A is commonly unrecognnized in indonesia. Symptoms of type A consist of anxiety, irritability, labilty and nerves tense. So it is important to know how to reduce the symptoms This study aims to determine the effectiveness of pyridoxin in reducing symptoms of Pre Menstrual Syndrome (PMS) and type of symptoms that can be most resolved. There is an effect of using pyridoxine to reduce PMS. It is known from the significance value of t-test that is 0.000. The type of PMS with the highest symptom reduction is in PMS Type A (Anxiety), because pyridoxine can increase stability estrogen and progesterone activity. Anxiety Pre Menstrual Syndrome probably caused by unstable hormone.

Improved Premenstrual Syndrome Symptoms after NovaSure Endometrial Ablation

BACKGROUND:Eighty percent of women during their reproductive age experience some symptoms attributed to premenstrual phase of the menstrual cycle. Premenstrual syndrome (PMS) is characterized by emotional, behavioral, and physical symptoms that occur during late luteal phase of menstrual cycle and are relieved after the onset of menstruation. Aerobic exercise and yoga are one of the ways to reduce these symptoms. The aim of this study was to compare the effects of aerobic exercise and yoga on PMS.MATERIALS AND METHODS:A total of 72 participants of PMS, referred for physiotherapy treatment (mean age 28 years), were enrolled and allocated into two groups (Group A and B) by simple computerized randomization. Patients in Group A received aerobic exercise and in Group B received yoga movements for 40 min, 3 times a week for 1 month. The pain intensity (Visual Analog Scale) and PMS Scale were measured before, at the end of 15 days, and 1 month of treatment program.RESULTS:Data were analyzed by paired t-test, unpaired t-test, and one-way ANOVA; and the results showed that both aerobic exercise and yoga movements significantly reduced pain intensity and PMS symptoms. Significant reduction in PMS symptoms was found in patients treated with yoga compared to aerobic exercise; however, no significant difference was found in pain intensity between these two groups (P > 0.05).CONCLUSION:It is concluded that both aerobic exercise and yoga movements are effective in treating PMS; however, yoga is more effective in relieving the symptoms of PMS than aerobic exercise.

BackgroundMenstrual complaints are widespread but often stigmatized. The most common is dysmenorrhea, or menstrual cramps, which manifests as mild to severe pain during menstruation and affects >40% of women throughout their reproductive lifespan. Dysmenorrhea is often endured silently or managed through self-medication. Consequently, a vast majority of patients with dysmenorrhea may not be found in medical practices, highlighting the need for direct-to-patient communication to reach a broad and diverse patient population.ObjectivePrimarily, this study aims to reveal the diagnosis status, pain levels, comorbidities, eligibility, and willingness to participate in clinical trials of women affected by dysmenorrhea and menstrual discomfort, based on a broad patient population not necessarily reached in medical practices. Second, this study attempts to test the effectiveness of direct-to-patient communication via online campaigns in engaging patients affected by dysmenorrhea or conditions that may benefit from direct-to-patient communication.MethodsWomen experiencing menstrual pain were reached through a targeted online campaign using Google Ads (Google LLC) and Facebook (Meta Platforms, Inc) in Germany, Austria, and Poland and were surveyed from April to June 2023. This study is observational.ResultsWe surveyed 3546 women, 94.6% (3230/3413) of whom reported symptoms consistent with dysmenorrhea, highlighting the high specificity of the Google and Facebook campaigns. Of the affected women in Germany and Austria, 88.5% (874/988) reported pain levels of 6 or higher on a scale of 0 to 10, with even higher pain levels observed in Poland. Elevated pain levels were correlated with dysmenorrhea symptoms but not with premenstrual syndrome (PMS) symptoms. Notably, of the 3230 women reporting symptoms consistent with dysmenorrhea, only 4.6% (n=149) reported being diagnosed with the condition, regardless of elevated pain levels. This can be attributed to two factors: (1) 90.3% (3065/3395) of surveyed women did not seek medical advice, were uncertain about their diagnosis, or their menstrual-related symptoms were not recognized as pathological and (2) among the 9.7% (330/3395) diagnosed, only half of DYS-affected women (149/318, 46.9%) were diagnosed with dysmenorrhea. The other 53.1% (169/318) were diagnosed with PMS but not dysmenorrhea despite regularly experiencing dysmenorrhea symptoms. The situation was better for PMS. Among the 330 diagnosed women, 77.3% (n=255) were diagnosed with PMS, in line with the 80.1% (2729/3409) PMS prevalence in the survey population. Overall, about 8.6% (235/2729) of women with PMS symptoms reported having been diagnosed with PMS, nearly double the diagnosis rate reported for dysmenorrhea.ConclusionsThe data reveal a significant diagnostic gap for dysmenorrhea, but not necessarily for PMS, even in high-income countries, as observed in Germany, Austria, and Poland. In these 3 countries, most dysmenorrhea-affected women do not seek medical advice, and up to half of dysmenorrhea diagnoses might be missed. Thus, most affected women might not be found in medical settings (doctors’ offices and clinics) despite experiencing significant pain. Online campaigns are shown to effectively reach individuals with menstrual complaints, including those who are undiagnosed or not seeking medical care.

Premenstrual syndrome (PMS) and primary dysmenorrhea are common gynecological problems and inflammation may have a role in their etiology. Curcumin is a polyphenolic natural product for which there is increasing evidence of anti-inflammatory and iron chelation effects. This study assessed the effects of curcumin on inflammatory biomarkers and iron profile in young women with PMS and dysmenorrhea. A sample of 76 patients was included in this triple-blind, placebo-controlled clinical trial. Participants were randomly allocated to curcumin (n = 38) and control groups (n = 38). Each participant received one capsule (500 mg of curcuminoid+ piperine, or placebo) daily, from 7 days before until 3 days after menstruation for three consecutive menstrual cycles. Serum iron, ferritin, total iron-binding capacity (TIBC) and high-sensitivity C-reactive protein (hsCRP), as well as white blood cell, lymphocyte, neutrophil, platelet counts, mean platelet volume (MPV) and red blood cell distribution width (RDW), were quantified. Neutrophil: lymphocyte ratio (NLR), platelet: lymphocyte ratio (PLR), and RDW: platelet ratio (RPR) were also calculated. Curcumin significantly decreased the median (interquartile range) serum levels of hsCRP [from 0.30 mg/L (0.0-1.10) to 0.20 mg/L (0.0-1.3); p = 0.041] compared with placebo, but did not show any difference for neutrophil, RDW, MPV, NLR, PLR and RPR values (p > 0.05). The treatment schedule was well-tolerated, and none of markers of iron metabolism statistically changed after the intervention in the curcumin group (p > 0.05). Curcumin supplementation may have positive effects on serum hsCRP, a marker of inflammation, with no any changes on iron homeostasis in healthy women with PMS and dysmenorrhea.

Background: Premenstrual syndrome (PMS) causes a variety of disturbing symptoms that can affect mood, cognition, and physical well-being and have effects on the regular lives of females, especially students. Objective: Assessment of female students’ knowledge, attitude, and awareness regarding PMS, evaluation of the prevalence of PMS in Bangladesh, and its impact on the regular life of female students in Bangladesh. Study Design: Cross-sectional study using a semi-structured questionnaire. Method: Primary data were collected by conducting an online survey with a semi-structured questionnaire. Data collection was carried out from March 2021 to October 2021. The subjects’ age range was 13–35. A total of 366 female students participated in the survey from different demographic profiles. Results: 74.86% of respondents were between the ages of 21 and 25, and they were mostly undergraduate students (71.31%). 77.05% of respondents were familiar with the term PMS. PMS symptoms were experienced by almost all participants (94%) to different extents. 140 participants (38%) experienced PMS one week before their period. On the other hand, 152 participants (42%) were moderately affected by PMS physical symptoms. 43% of participants rated PMS psychological and behavioral symptoms as moderately severe. The most common PMS symptom, according to 259 female students, was cramping, followed by headache and backache. PMS causes 65.85% of participants to lose concentration during educational activities. 59.56% of the participants claimed PMS causes difficulty at work and in other regular activities. Conclusion: PMS is highly prevalent among female students in Bangladesh. The majority of students experience a lack of concentration on educational activities due to PMS. PMS has an impact on both their personal and professional lives. Personal hygiene, sexual health, and overall awareness about PMS should be promoted more through education and social awareness programs.