Abstract
Women of reproductive age present one or more emotional or physical symptoms in premenstrual phase of their menstrual cycle, which is collectively called premenstrual syndrome (PMS). Estimates show that about 5 to 8% of women suffer from severe PMS. This form has been termed as premenstrual dysphoric disorder (PMDD). Diagnostic criteria have been proposed for PMDD. For the purpose of this research work, the term PMS was used to include variants of premenstrual syndrome in general. Common symptoms include but not limited to breast swelling, food cravings, bloating, mood swings and backache. The etiology of PMS remains unclear; but available evidence suggests that genetics and environmental factors may influence the PMS experience and its severity. The present study was designed to investigate PMS experience and characteristics in two ethnic groups of Caucasian and Asian women living in Denmark. An online survey-based methodology was applied to target Asians and Caucasians women (18-55 years) with PMS, living in different regions in Denmark. The questionnaire consisted of 36 questions to cover the required information for the purpose of this study. Regression analysis was applied to find the association between PMSassociated factors and ethnicity. Asian (47) in comparison with Caucasian women (47) presented with higher ratings of several PMS symptoms such as mood swings, depression and food cravings (p < 0.05). Asian women were also found with higher rate in digestion problems (p < 0.05) and higher rate of cramps and nausea during menstruation and a shorter menstruation period compared with the Caucasians (p < 0.05). This study highlighted that Asian women had higher rates of both psychological and physiological factors in relation to PMS. Potential reasons for a difference between Asian and Caucasian women living in Demark is not clear, and need further investigation.
Highlights
Prospective and retrospective studies collectively suggest that up to 20% of all women within fertile age have premenstrual complaints that can clinically be classified into different forms
It is important to note that hormonal changes in affected women are not abnormal, but premenstrual syndrome (PMS) sufferers are hypersensitive to hormonal changes occurring during the menstrual cycle [3,4]
Out of the 107 the 3.7% (n = 13) were African and were excluded from the study since this ethnicity was not of interest in this study. 43.9% (n = 47) were reported as Caucasian, 14.0% (n = 15) were reported as Asian, 30.8% (n = 33) were reported as Middle Eastern and lastly 7.9% (n = 8) reported as having mixed ethnicity
Summary
Prospective and retrospective studies collectively suggest that up to 20% of all women within fertile age have premenstrual complaints that can clinically be classified into different forms. Neurotransmitter theory is based on the finding that several stabilizing neurotransmitters such as γ-aminobutyric acid (GABA) and serotonin are dysregulated in PMS that can cause the symptoms. This theory is supported by the fact that the symptoms often get better by using antidepressant or anxiolytic medications [5]. Evidence suggests that altered regulation of some neuro-hormones and transmitters such as gamma-aminobutyric acid (GABA) and serotonin might be involved in triggering the PMS symptoms. This has been evidentially supported by evidence that PMS are effectively improved by selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine, Paroxetine and Sertraline [6,7]. Having the bio-psycho-social model, an approach towards the PMS has been presented as multi-dimensional treatment strategies and potentially with inclusion of some prevention approaches [8,9,10]
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