Menstrual cycle symptoms are associated with changes in low‐grade inflammation

Abstract

A close link between mood, low-grade inflammation and obesity has been demonstrated even in healthy subjects. We investigated the relationship between changes in physical and psychological symptoms and inflammatory markers during the menstrual cycle both in normal weight and in overweight women. Eight healthy normal weight (body mass index 21.6 +/- 1.9 kg m(-2)) and seven overweight (body mass index 30 +/- 2.4 kg m(-2)) young women with normal ovarian function and with no premenstrual syndrome were assessed 15 times throughout their menstrual cycle. At each time point fasting blood was drawn and symptoms were recorded using the Freeman Daily Symptom Record. Independent of weight status, the serum concentrations of highly sensitive C-reactive protein (hs-CRP) and the total scores, in addition to the individual four factors (mood, behaviour, pain and physical symptoms), of the Daily Symptom Record varied significantly during the menstrual cycle (all P < or = 0.04) and paralleled each other. During the menstrual cycle, repeated hs-CRP serum concentrations correlated to the corresponding total symptom score and the factors mood, behaviour and physical symptoms, independent of both weight status and changes in circulating gonadal steroids (all P < or = 0.04). These associations were not observed for tumour necrosis factor-alpha serum levels. The mean hs-CRP concentrations were associated with the mean total symptom score, independent of weight status (r = 0.56, P = 0.04). Healthy young women showed psychological and physical symptoms during the menstrual cycle which changed in association with alterations in low-grade inflammation and which were independent of body weight or plasma levels of gonadal steroids.