Menstrual Cycle Symptoms Research Articles

Light Exposure, Melatonin Secretion, and Menstrual Cycle Parameters: An Integrative Review

Dysfunction in menstrual physiology has pronounced effects on quality of life, involving mood changes, body image, infertility, and pregnancy complications. Light exposure may affect menstrual cycles and symptoms through the influence of melatonin secretion. The purpose of this systematic review is to determine the current state of knowledge about the effects of light and melatonin secretion on menstrual phase and cycle alterations. A brief overview of the influence of melatonin on human physiology is included. There is evidence of a relationship between light exposure and melatonin secretion and irregular menstrual cycles, menstrual cycle symptoms, and disordered ovarian function. In women with a psychopathology such as bipolar disorder or an endocrinopathy such as polycystic ovary syndrome, there seems to be greater vulnerability to the influence of light-dark exposure. Research on the complex role of light-dark exposure in menstrual physiology has implications for treatment of menstrual-associated disorders.

P-14 The Relationship Between Menstrual Cycle Symptoms and the Strength of Sports in Young Women(ISPOG2007)

P-14 The Relationship Between Menstrual Cycle Symptoms and the Strength of Sports in Young Women(ISPOG2007)

Symptom exacerbation and adherence to antiretroviral therapy during the menstrual cycle: a pilot study.

Our objective is to investigate the relationship between drug and menstrual cycle symptoms in HIV+ women receiving antiretroviral therapy (HAART). Interviews were done for 12 weeks with 54 HIV+ women receiving HAART. Patients were asked if they experienced any of 28 symptoms associated with HAART and the menstrual cycle and about HAART adherence. Weeks were divided into menstrual weeks (MWs), premenstrual weeks (PWs), and other weeks. Women reported more bloating (P = .02) and cramps (P = .001) during MWs. Skin problems (P = .08) and breast tenderness (P = .03) were experienced during PWs. Feeling tired/loss of energy (P = .05), joint pain (P = .02), and chills (P = .03) were higher in non-MW/PWs. Women were slightly less adherent during the MWs (89%) than PWs (94%) and other weeks (93%). Feeling sad or depressed (P = .01) was associated with nonadherence. Experiencing certain symptoms associated with both the menstrual cycle and HAART drugs was related with nonadherence.

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

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.

Clinical studies on efficacy of trisequens in adjusting menstrual cycle and menopausal symptoms during perimenopause

目的 观察雌孕激素复方制剂(诺康律)用于控制月经周期与缓解绝经相关症状的临床疗效与副作用.方法采取开放、多中心、自身对照临床研究方法,观察对象为有绝经相关症状或同时有月经紊乱的绝经过渡期或绝经早期妇女.共入组153例,完成观察146例.所用的雌孕激素复方制剂诺康律,含17β-雌二醇与醋酸炔诺酮两种成分,连续治疗3个周期.分别在治疗前、治疗1、2、3个月时采用Greene评分进行绝经相关症状评分.结果治疗后心理症状、躯体症状和血管舒缩症状等评分指标均有显著降低,症状总分从治疗前19±9降低至1个月时的10±7,2个月时的6±6,3个月时的5±10.在用药1个月、2个月和3个月时,95.4%、96.7%和98.6%的人出现规律性月经;不规则出血发生率分别为3.3%、2.7%和0.7%;闭经者分别为1.3%、0.7%和0.7%.副作用中,治疗前乳房胀发生率9.6%(14例),治疗1个月时38.2%(58例),2个月时36.7%(55例),3个月时21.9%(32例).治疗1个月时消化道反应5例(3.3%),2个月时2例(1.3%),3个月时1例(0.7%).无其他严重副作用发生,用药依从性较好,退出率低(4.6%).结论序贯联合应用雌孕激素能够显著缓解绝经相关症状,调整月经周期.不良反应少,依从性好。

Physician views on extended cycling of combined hormonal contraceptives in adolescents: Preliminary findings

To alleviate menstrual cycle symptoms or to accommodate patient preferences, physicians may prescribe hormonal contraceptives (pills, patches, or rings) in extended cycles where hormones are taken for longer than 21 days and menstruation is delayed. No studies have evaluated prescribing extended cycles to adolescents. We sought to determine how frequently physicians prescribe extended cycles of hormonal contraceptives to adolescents, which extended cycling regimens they prescribe, and reasons for use.

Soy, fat and other dietary factors in relation to premenstrual symptoms in Japanese women.

To evaluate the relations of intakes of soy, fat and other dietary components to premenstrual symptoms. Cross sectional study. Three colleges and two nursing schools. One hundred and eighty-nine Japanese women aged 19 to 34 years. Intakes of nutrients and foods, including soy products and isoflavones, were estimated by a semiquantitative food frequency questionnaire. Change in menstrual cycle symptoms were assessed by the Moos Menstrual Distress Questionnaire (MDQ). Spearman rank correlation of soy and other dietary factors with changes in MDQ scores between the follicular and the premenstrual phases after controlling for age, marital status, exercise, smoking status, age at menarche and number of days of bleeding. Neither soy product nor isoflavone intake was significantly associated with change in MDQ score in the premenstrual phase. Intakes of total, saturated and monounsaturated fats were significantly correlated with change in scores for total MDQ and subscale 'pain' in the premenstrual phase after controlling for the covariates. Intake of cereals/potatoes/starches was significantly inversely correlated with a change in total MDQ score in the premenstrual phase. High intake of fats and low intake of foods with high concentration of carbohydrate may be associated with premenstrual symptoms.

Factor structure of the Modified Moos Menstrual Distress Questionnaire: assessment of prospectively reported follicular, menstrual and premenstrual symptomatology

Despite the wide usage of the Moos Menstrual Distress Questionnaire (MDQ) in menstrual cycle research, the factor structure of the questionnaire has received relatively little attention since derived by Moos in 1968. This issue is one of considerable importance given that the methods of data collection used by Moos have since been subject to serious criticism. The aim of the current study was to determine whether Moos’ factors could be replicated based on daily and prospective completion of the MDQ in women who were unaware of the study aims. One hundred and eighty-seven women from the general community (mean age 30 years) completed a modified version of the MDQ daily for 70 days.Principal components analysis of the modified MDQ items during the follicular, late luteal and menstrual phases indicated that a six-factor solution similar to that derived by Moos best summarized the data. A number of symptoms, however, loaded highly on more than one factor. This created some instability in the solution and may explain the discrepancies in previous research. Nonetheless, it was concluded that the Moos factors effectively represent the structure of menstrual cycle symptoms.

Assessing the assessment measures for menstrual cycle symptoms

A review of measures of menstrual cycle symptoms is provided. This will enable researchers and clinicians to make the appropriate choice of method for their study requirements. In recent years, these measures have taken the form of retrospective questionnaires (rating severity of symptoms from memory) and prospective diaries (daily checklists of symptoms). Many of these draw on aspects of the well-known retrospective questionnaires, the Menstrual Distress Questionnaire and Premenstrual Assessment Form, in their development and validation. Each measure will be briefly described, followed by comments on its development, psychometric properties and finally an evaluation of its strengths and weaknesses. It concludes with an examination of the implications arising from the review, and some recommendations that menstrual cycle researchers and clinicians may wish to consider, as they decide upon the most appropriate measure for their needs.

Female Troubles: An Analysis of Menstrual Cycle Research in the NINR Portfolio As a Model for Science Development in Women’s Health

The National Institute for Nursing Research (NINR) has been active in developing a research portfolio of investigator-initiated studies in addressing the cause and consequences of menstrual cycle and menopause-related health problems. This chapter provides an overview of the nature and level of research activity funded by NINR since its inception in 1986, major findings generated by the most successful award recipients, the impact on the broader field of women's reproductive health and directions for future research. Presented here is an analysis of research designs and methodologies framed within the context of 4 stages of scientific development in the field: exploratory, descriptive studies in well women; illness as a biobehavioral phenomenon; knowledge generation in understudied populations; and the development and testing of clinical therapeutics for symptom management and health promotion strategies. Nursing science contributions to the NINR portfolio of women's health research has been focused primarily on the definition and management of the symptoms of premenstrual syndrome and menopause. The increasing numbers of intervention studies suggests a coming-of-age in nursing science with respect to the development of evidence-based outcome data for the management of menstrual cycle and menopause-related symptoms. Clearly, the range and diversity of NINR grant-funded activity suggest that menstrual cycle research is a strong area of interest in nursing science.

Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives

Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives

Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives

The prevalence of significant symptom change (symptom cyclicity) prospectively rated over multiple menstrual cycles has not been established in a non-clinical population. Seventy-three women charted 57 symptoms over 2-6 menstrual cycles each. Symptoms, and summarized symptom scores within seven symptom groups, were tested for changes between the follicular phase and the luteal phase of each cycle. Recurrent symptom cyclicity over multiple cycles within individuals was ascertained and the stability between cycles of mean symptom scores for both the follicular phase and the luteal phase. Forty-five percent of the participants experienced cyclicity over multiple cycles in at least one symptom and 23% in at least one symptom group. Eighteen percent of the participants consistently reported a higher symptom score during the luteal phase compared to the follicular phase (a PMS-like pattern) in all symptoms in which they experienced a change. The remaining 27% experienced a varying direction of change in the same symptom between cycles, or consistently experienced a lower symptom score during the luteal phase (a reverse PMS-like pattern) of the cycles they charted. Recurrent cyclicity was experienced by 16% of the participants in one symptom; in two symptoms by 15%; in 3 8 symptoms by 14%; in one symptom group by 19% and in two symptom groups by only 4% of participants. Average symptom severity did not vary significantly between cycles. Due to the varied direction of symptom severity change over multiple cycles, prospective daily ratings are necessary to achieve a true picture of menstrual related symptom cyclicity in the general population.

Prevalence of menstrual cycle symptom cyclicity and premenstrual dysphoric disorder in a random sample of women using and not using oral contraceptives

Background. The prevalence of symptom cyclicity and premenstrual dysphoric disorder in randomly recruited samples of women has not been ascertained. We assessed this prospectively in 83 Icelandic women, aged 20–40 years, using and not using oral contraceptives (OCs).Methods. A check list of 57 symptoms, divided into 7 symptom groups, was used to assess experiences. All symptoms and summarized symptom scores within symptom groups were tested for significant change between the follicular and the luteal phase of each menstrual cycle. When a symptom or a summarized symptom score was higher during the luteal phase compared to the follicular phase the cyclicity is labelled ‘expected’ cyclicity and the opposite ‘unexpected’ cyclicity.Results. The women charted from 1–7 menstrual cycles each, with 66 of them charting 3–4 cycles. Cyclicity was never displayed by 9.6% of participants; 80.7% displayed expected cyclicity and 72.3% unexpected cyclicity at least once. Cyclicity in somatic symptoms was most often demonstrated by participants. Expected and unexpected cyclicity in summary symptom scores in well‐being and in psychoemotional symptoms was very similar among participants. There was not much difference in cyclicity between non OC users and OC users. Fifty‐one percent of the participants were self‐defined with premenstrual syndrome with 2%–6% of them meeting the criteria of premenstrual dysphoric disorder.Conclusions. The normalcy of cyclicity found in this study might explain the high prevalence of premenstrual syndrome in many recall surveys. The importance of prospective daily ratings for establishing symptom cyclicity in women cannot be over emphasized.

Menstrual cycle moods and symptoms in young, healthy women: A heuristic model

There is a need for development of theoretical models in menstrual cycle research. Changes in moods and symptoms related to the menstrual cycle are problematic for a small, hut significant proportion of women, and the complexity of such interrelationships remains a barrier to more effective management. The present study provides empirical data on symptoms-mood interrelationships, using a sample of 370 healthy undergraduate women, all of whom responded to the Eight State Questionnaire, and the Menstrual Distress Questionnaire, within the context of a between-groups experimental design. Effects due to age, oral contraceptives, and menstrual cycle phase were tested using MANOVA procedures. Although age effects were not significant, physical symptoms were elevated both menstrually and premenstrually, while use of the contraceptive pill significantly reduced negative mood states. In addition, a nonrecursive heuristic model is postulated, providing hypotheses as to putative "causal influences." Overall, the empirical (LISREL) model suggests that menstrual cycle symptoms and mood states are discrete constructs, which interact reciprocally.

Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives

Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives

Prevalence of menstrual cycle symptom cyclicity and premenstrual dysphoric disorder in a random sample of women using and not using oral contraceptives.

The prevalence of symptom cyclicity and premenstrual dysphoric disorder in randomly recruited samples of women has not been ascertained. We assessed this prospectively in 83 Icelandic women, aged 20-40 years, using and not using oral contraceptives (OCs). A check list of 57 symptoms, divided into 7 symptom groups, was used to assess experiences. All symptoms and summarized symptom scores within symptom groups were tested for significant change between the follicular and the luteal phase of each menstrual cycle. When a symptom or a summarized symptom score was higher during the luteal phase compared to the follicular phase the cyclicity is labelled 'expected' cyclicity and the opposite 'unexpected' cyclicity. The women charted from 1-7 menstrual cycles each, with 66 of them charting 3-4 cycles. Cyclicity was never displayed by 9.6% of participants; 80.7% displayed expected cyclicity and 72.3% unexpected cyclicity at least once. Cyclicity in somatic symptoms was most often demonstrated by participants. Expected and unexpected cyclicity in summary symptom scores in well-being and in psychoemotional symptoms was very similar among participants. There was not much difference in cyclicity between non OC users and OC users. Fifty-one percent of the participants were self-defined with premenstrual syndrome with 2%-6% of them meeting the criteria of premenstrual dysphoric disorder. The normalcy of cyclicity found in this study might explain the high prevalence of premenstrual syndrome in many recall surveys. The importance of prospective daily ratings for establishing symptom cyclicity in women cannot be over emphasized.

The relationship between self-reported menstrual symptomatology and aggression measured in the laboratory

This study investigated the relationship between the severity of self-reported menstrual cycle symptoms and a laboratory measure of aggression. Two groups of women were recruited, one group reporting low and one group reporting moderate to high perimenstrual symptoms. Scores from the Negative Affect subscale of the Menstrual Distress Questionnaire (MDQ) were used to define groups. Each of 40 subjects (20 high symptom and 20 low symptom) participated in three testing sessions of the ©Point Subtraction Aggression Paradigm, an established methodology for measuring aggression in the laboratory. There were two significant findings: (a) the high symptom group emitted higher rates of aggressive response than the low symptom group independent of which menstrual cycle phase they were in when tested; and (b) rates of aggressive response were significantly correlated with the MDQ's Negative Affect and Behavior Change scales for the menses and premenstrual phases (but not for the remainder of the cycle). These findings indicate that self-reports of perimenstrual symptoms are predictive of an individual's tendency to respond aggressively when provoked, and suggest that retrospectively linking self-reported menstrual symptom severity with behavior is problematic because individuals endorsing or not endorsing these symptoms may differ behaviorally regardless of menstrual cycle phase.

Relation between sodium balance and menstrual cycle symptoms in normal women.

To determine whether sodium balance affects expression of menstrual symptoms. Prospective study of menstrual symptoms during three cycles: a baseline month (usual intake of sodium, 115 mmol/d) followed by 2 months of sodium restriction (intake of sodium, 73.0 mmol/d). Added salt was allowed during the last month. Investigators were aware of the diet sequence. Outpatient. Meals were prepared by a metabolic kitchen during the 2 months that the participants received salt-restricted diets. 13 healthy menstruant women. Plasma sodium levels, urinary sodium excretion, and plasma renin activity were measured for five time periods during the baseline cycle and the two cycles of salt-restricted diet. Eleven women completed a questionnaire assessing somatic symptoms and sensory cravings at the same time every day during the 3-month study period. Sodium restriction was associated with a mean decrease (+/- one half of the 95% CI) in plasma sodium levels of 0.9 +/- 0.9 mmol/L from a mean of 139.3 mmol/L during the baseline cycle (P = 0.018), a decrease in urinary sodium excretion of 40.3 +/- 18 mmol/d from a mean of 117 mmol/d during the baseline cycle (P = 0.001), and an increase in plasma renin activity of 0.14 +/- 0.08 ng/(L . s) from a mean of 0.28 ng/(L . s) during the baseline cycle (P = 0.008). During the luteal phase of the sodium restriction cycle, significant decreases in plasma sodium levels of 1.23 +/- 0.5 mmol/L (from values of 138.8 mmol/L during the follicular phase) and increases in urinary sodium excretion of 27.2 +/- 10 mmol/d (from values of 65.5 mmol/d during the follicular phase) preceded periods when menstrual symptoms were most severe. Ratings of breast tenderness increased sixfold to eightfold in the late luteal phase (P < 0.001) and those of swelling or bloating increased twofold to threefold during early menses (P < 0.001) compared with nadir symptom ratings during each cycle. Sodium cravings increased in the luteal phase of all cycles but were not accompanied by increased sodium intake when access to added salt was allowed. Breast tenderness and bloating did not result from sodium retention in the luteal phase of the menstrual cycle. During normal and sodium-restricted diet cycles, women actually had urinary sodium loss, not retention, during the luteal phase; severity of menstrual symptoms was unchanged.

Contribution of generalized negative affect to elevated menstrual cycle symptom reporting.

We investigated women's belief that they suffered from premenstrual syndrome (PMS) by monitoring patterns of symptom reporting over a 5-week period in relation to the underlying trait of negative affect. We expected that women reporting high negative affect would be more likely to report menstrual cycle distress than those reporting low negative affect. One hundred twenty-one women rated the typical occurrence and severity of premenstrual changes on a retrospective questionnaire and then made daily ratings of their changes for the duration of one cycle. In addition, they completed a questionnaire measuring positive and negative affect. Data analysis revealed a clear subgroup whose retrospective reports of premenstrual change were not substantiated by the cycle of their daily ratings. Although this subgroup also reported more negative affect, the magnitude of the effect was relatively small. The possible contribution of both negative outlook and the meaning of the self-identified label of PMS are discussed.

Changes in Australian women's perception of the menopause and menopausal symptoms before and after the climacteric

The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be ‘a relief’ or ‘a nuisance’ significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.