Moos Menstrual Distress Questionnaire Research Articles

Intake of dietary soy isoflavones in relation to perimenstrual symptoms of Korean women living in the USA

This study was conducted to identify the potential relationship between the dietary intake level of soy isoflavones and perimenstrual symptomatology. The research design was a cross-sectional study. The sample was made up of 84 Korean women living in the USA, aged 28-40 years. The Moos Menstrual Distress Questionnaire (MDQ) and the Food Frequency Questionnaire were used as measurement tools. The soy isoflavone intake was significantly correlated with MDQ scores in the menstrual phase. In conclusion, the beneficial effect of dietary soy isoflavones on certain menstrual symptoms was established, suggesting that soy isoflavones could be one of the dietary factors related to the complexity of premenstrual syndrome (PMS). The positive effect of soy isoflavones on PMS warrants further study.

After 3 months, low dose oral contraceptives reduced pain in adolescent girls with moderate to severe dysmenorrhoea

Design: randomised placebo controlled trial.Allocation: unclear concealment.Blinding: blinded (patients and healthcare providers).Follow up period: 3 months.Setting: a single academic medical centre in New York, USA.Patients: 76 healthy adolescent girls (19...

Prospective, open-label, noncomparative study to assess cycle control, safety and acceptability of a new oral contraceptive containing gestodene 60 μg and ethinylestradiol 15 μg (Minesse®)

Objective A prospective, open-label, noncomparative, multicenter study was carried out in 163 women aged 18–39 (mean 25±5 years), who used an ultra-low-dose oral contraceptive pill (OCP) containing gestodene (GTD) 60 μg/ethinylestradiol (EE) 15 μg for 6 months. The objective of the study was to evaluate the acceptability, safety, bleeding patterns and premenstrual symptomatology in these women. Methods Patients used the OCP from Days 1–24, followed by a 4-day pill-free interval from Days 25–28 of the menstrual cycle. Physical and gynecological examinations were carried out at baseline and after 3 and 6 months, at which time blood pressure, weight, hemoglobin, hematocrit, SGOT, SGPT and urinalysis were also assessed. The Moos Menstrual Distress Questionnaire (MDQ) was completed on three consecutive days (Days 25–27 of the cycle) at baseline and at the end of the third and sixth cycles. Patients kept a menstrual diary throughout the study. Results A total of 146 women completed the study. Ten women discontinued because of adverse events and one undesired pregnancy occurred during treatment. No adverse metabolic effects were observed. The adverse event most frequently reported was breakthrough bleeding, which diminished, however, as the time of OC use increased. Cycle length and duration of bleeding decreased significantly with OC use (p<.01 and p<.05, respectively, after 6 months). Intensity of menstrual bleeding tended to decrease with OC use, but this difference was not statistically significant. Systolic and diastolic blood pressure were significantly lower after 6 months of OC use compared to baseline (p<.02). No alterations were recorded in body weight or laboratory evaluations. Statistically significant changes were found both in the total MDQ score and in several of the factors evaluated, and patients showed a statistically significant improvement in well-being with respect to premenstrual complaints and symptoms. Conclusion This OC regimen is safe, well-accepted and well-tolerated, affects menstrual patterns beneficially by reducing both the intensity and duration of bleeding, provides good cycle control and improves premenstrual symptomatology.

Oral Contraceptives for Dysmenorrhea in Adolescent Girls

To assess whether a low-dose oral contraceptive (OC) is more effective than placebo treatment for dysmenorrhea pain in adolescents. This was a randomized, double-blind, placebo-controlled clinical trial of 76 healthy adolescents aged 19 years or younger reporting moderate or severe dysmenorrhea. Subjects were randomly allocated to receive either an OC (ethinyl estradiol [E2] 20 microg and levonorgestrel 100 microg) or a matching placebo for 3 months. Participants used their usual pain medications as needed during the trial. The main outcome measure was score on the Moos Menstrual Distress Questionnaire (pain subscale) for the third menstrual cycle on treatment. Secondary outcomes included pain intensity (rated 0 to 10), days of any pain, days of severe pain, hours of pain on worst day, and use of pain medications. The mean Moos Menstrual Distress Questionnaire pain score was lower (less pain) in the OC group than the placebo group (3.1, standard deviation 3.2 compared with 5.8, standard deviation 4.5, P = .004, 95% confidence interval for the difference between means 0.88-4.53). By cycle 3, OC users rated their worst pain as less (mean pain rating 3.7 compared with 5.4, P = .02) and used fewer pain medications than placebo users (mean pain pills used 1.3 compared with 3.7, P = .05). By cycle 3, OC users reported fewer days of any pain, fewer days of severe pain, and fewer hours of pain on the worst pain day than placebo users; however, these differences did not reach statistical significance. Among adolescents, a low-dose oral contraceptive relieved dysmenorrhea-associated pain more effectively than placebo. I.

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.

Perimenstrual Symptoms of Korean Women Living in the USA: Applicability of the WDHD(Women's daily health diary)on Prospective Report

To compare perimenstrual (premenstrual, menstrual, postmenstrual) symptoms by concurrent reporting using the Women's Daily Health Diary (WDHD) and by retrospective reporting using the Moos Menstrual Distress Questionnaire (MMDQ). A prospective and retrospective study was conducted among 31 Korean women, aged 27 to 48 yrs, living in the USA. On the prospective report using the WDHD, the most severe complaints were fatigue or tiredness (1.48 +/-.98), sensation of weight gain (.88+/-98), increased appetite (.79+/-.96) in premenstrual phase, fatigue or tiredness (1.34+/-.85), backaches (1.06+/-.79), and bloating or swelling of the abdomen (.93+/-.86) during the menstrual phase. On the retrospective report using the MMDQ, the most severe complaints during the premenstrual phase were fatigue (2.2 6+/-1.65), irritability (2.06+/-1.48), and backaches (1.97+/-1.68) and during the menstrual phase backaches (2.35+/-1.62), fatigue (2.29+/-1.75), and cramps (2.23+/-1.80). According to both measurements of PMS symptomology during the premenstrual and menstrual phases, the most frequently reported symptom was fatigue or tiredness. Highly rated symptoms on the MMDQ and on the WDHD were found to be similar. The WDHD was found to be suitable for daily prospective PMS assessment, which will be necessary for the screening and management of women with severe PMS.

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.

Prospectively reported symptom change across the menstrual cycle in users and non-users of oral contraceptives

The aim of this research was to examine the pattern and incidence of premenstrual change in a reliable manner by addressing key methodological issues. One hundred and eighty-one women from the general population (mean age 30 years) completed a modified version of the Moos Menstrual Distress Questionnaire daily for 70 days.All symptom sub-scales fluctuated significantly across the menstrual cycle. Symptoms were at their lowest during the follicular phase and increased premenstrually. Somatic symptoms peaked menstrually and fluid retention peaked premenstrually. In general, however, symptom severity changed little from the premenstrual to the menstrual phase. A very high incidence of premenstrual change was noted, with over 40% of women demonstrating a 30% premenstrual increase in each symptom sub-scale. Close to 50% of women experienced increases in negative affect and over 70% experienced increases in fluid retention.Oral contraceptive (OC) use did not alter the incidence or severity of premenstrual change. Overall differences in symptom severity, however, were noted, with monophasic OC users reporting higher levels of fluid retention and somatic symptoms than the triphasic OC group. The results of this research suggest that women respond to the occurrence of normal neuroendocrine events that are not dependent on the sequelae to ovulation.

Women's beliefs about the prevalence of premenstrual syndrome and biases in recall of premenstrual changes.

The present study investigated the relationship between women's beliefs about the prevalence of premenstrual syndrome (PMS) and biases in recall of premenstrual changes. Forty-nine women completed the Moos Menstrual Distress Questionnaire (R. H. Moos, 1968) both retrospectively and prospectively. Afterward, they were asked about their beliefs concerning the prevalence of PMS. The women reported higher premenstrual changes when they completed the retrospective questionnaire. Seventy-five percent of the women believed that the majority of women have premenstrual changes. From this percentage, those who answered that the majority also experience PMS were more biased in their premenstrual changes in the retrospective assessment. Many women have a misperception about the meaning of PMS; consequently, they amplify their premenstrual changes in recall, reflecting women's cultural stereotypes rather than their actual experiences.

A comparison of cycle control and effect on well-being of monophasic gestodene-, triphasic gestodene- and monophasic desogestrel-containing oral contraceptives

This was an open-label multicenter study to compare the cycle control and effect on well-being of two oral contraceptives containing gestodene and one containing desogestrel. A total of 2419 healthy women ≤ 41 years of age were randomized to receive oral contraceptives containing monophasic gestodene (Minulet®; n = 806, mean age 24.5 years), triphasic gestodene (Tri-Minulet®; n = 808, mean age 24.6 years) or monophasic desogestrel (Mercilon®; n = 805, mean age 24.6 years). Subjects were to participate in the study for up to 13 treatment cycles. A modified Moos Menstrual Distress Questionnaire was used to evaluate menstrual symptoms and to assess overall well-being.A total of 698 women were withdrawn from the study, 154 due to adverse events. Cycle control with gestodene was superior to that with desogestrel at almost all time points, particularly for breakthrough bleeding and/or spotting, which occurred significantly less frequently with gestodene than with desogestrel at cycles 1–1 and 9–11 (p < 0.05). Generally, the proportion of subjects with breakthrough bleeding and/or spotting was almost twice as great with desogestrel as with gestodene. The duration of bleeding was not consistently different between the gestodene and desogestrel groups; however, the intensity of bleeding was greater with gestodene at all time points (p < 0.05). The latent period before withdrawal bleeding was significantly longer for monophasic gestodene at cycles 1–5 and 8–10 (p < 0.05). Treatment significantly improved overall well-being at cycles 6 and 9 with triphasic gestodene and at cycle 13 with desogestrel; however, no statistically significant differences among treatment groups in overall well-being scores or individual factors of well-being could be identified. All three treatments were well tolerated. The most common drug-related adverse events were headache (14.2%), breast pain (6.2%), nausea (4.1%), metrorrhagia (5.9%) and abdominal pain (3.5%). The incidence of adverse events in all treatment groups was similar, with the exception of metrorrhagia, which occurred in more patients in the desogestrel group than in the gestodene treatment groups (p < 0.05).

Generalized use of over-the-counter analgesics: relationship to premenstrual symptoms.

This study tested the hypothesis that use of nonprescription analgesics among women scoring high on premenstrual distress may generalize to time periods beyond the premenstrual phase. Fifty three female undergraduates completed Form C of the Moos Menstrual Distress Questionnaire and described their typical use of analgesics during the "average week." Results showed that symptoms of premenstrual distress were significantly related to both the frequency of analgesic use and the quantity consumed per occasion. These findings support the generalization hypothesis proposed by Blechman and her colleagues.

Generalized use of over‐the‐counter analgesics: Relationship to premenstrual symptoms

This study tested the hypothesis that use of nonprescription analgesics among women scoring high on premenstrual distress may generalize to time periods beyond the premenstrual phase. Fifty three female undergraduates completed Form C of the Moos Menstrual Distress Questionnaire and described their typical use of analgesics during the “average week.” Results showed that symptoms of premenstrual distress were significantly related to both the frequency of analgesic use and the quantity consumed per occasion. These findings support the generalization hypothesis proposed by Blechman and her colleagues. © 1997 John Wiley & Sons, Inc.

A comparison of cycle control and effect on well-being of monophasic gestodene-, triphasic gestodene-and monophasic desogestrel-containing oral contraceptives

This was an open-label, multicenter study to compare the cycle control and effect on well-being of two gestodene-containing and one desogestrel-containing oral contraceptive. Healthy women aged < 45 years were randomized to receiue oral contraceptives containing monophasic gestodene (n = 3 74; mean age 24.7 years), triphasic gestodene (n = 362; mean age 25.1 years) or desogestrel (n = 361; mean age 25.2 years). This paper describes preliminary data from subjects who had completed up to nine treatment cycles. A modified Moos Menstrual Distress Questionnaire was used to measure menstrual distress and to calculate overall well-being.A total of 94 women were withdrawn from the study, 62 due to adverse events. Cycle control with gestodene was superior to that with desogestrel at almost all time-points, particularly for breakthrough bleeding and/or spotting, which occurred significantly less often with gestodene at cycles 1-3 than with desogestrel (p < 0.05). The mean duration of bleeding was slightly shorter with gestodene compared with desogestrel (by 0.25 days), but the intensity of bleeding was higher (p < 0.05). Treatment did not significantly affect overall well-being, but behavioral change and negative effect were improved to a significantly greater extent by gestodene than by desogestrel (p < 0.05). Tolerance of the three treatments was excellent; the most common drug-related adverse events were headache (11.5%), breast pain (4.6%), nausea (3.5%), abdominal pain (2.7%) and metrorrhagia (2.5%).

The symptomatology of progestogen intolerance

It is common for women receiving oestrogen replacement therapy to experience adverse symptoms whilst taking cyclical progestogen. This study highlights the similarity of these symptoms to those experienced in pre-menstrual syndrome and confirms that the Moos Menstrual Distress Questionnaire is an appropriate tool for future research. The data also indicate that progestogens vary in the type of symptoms they cause. Norethisterone is more likely to cause symptoms from the Moos pain symptom cluster than either medroxyprogesterone or dydrogesterone, but is less likely to cause negative affect symptom cluster symptoms. The relative levels of oestrogen and progestogen may influence the severity of progestogenic symptoms.

The relationship between the menstrual cycle and female sexual interest in women with PMS complaints and volunteers

This study assesses the influence of menstrual cycle phases and hormones on female sexual interest in both a nonclinical sample of volunteers ( n = 18) and women who complained of premenstrual tension ( n = 150). Women were assessed prospectively for two menstrual cycles with daily symptom charts. In addition mental status was assessed clinically and the Moos Menstrual Distress Questionnaire completed in the follicular and premenstrual phases. On the basis of these assessments women were assigned to subject groups. During the second cycle, daily 24-h urinary estrogens and urinary pregnanediol were determined. Sexual interest and feelings of well-being were recorded on a daily symptom rating chart. Sexual interest was found to be significantly higher in the follicular and ovulatory phases, than in the luteal, premenstrual, or menstrual phases. Sexual interest and feelings of well-being were correlated ( R = 0.29). Sexual interest and feelings of well-being were not correlated with urinary estrogen or pregnanediol levels.

A double-blind clinical trial on a herbal remedy for premenstrual syndrome: a case study

A herbal remedy Vitex agnus castus was tested against a placebo for the relief of symptoms associated with the premenstrual syndrome (PMS). The trial was a formally conducted double-blind randomised controlled trial on a volunteer sample of self-diagnosed sufferers of PMS using a form of the long-established Moos menstrual distress questionnaire. The main focus of interest after pilot studies was in symptoms of negative effect. These were fully explored both by individual symptoms and as a group. In only one reported symptom (‘feel jittery or restless’) was a statistically significant difference shown between Vitex and placebo. The other main symptoms' groups studied included those of impaired concentration, fluid retention and pain. Statistical analysis revealed a similar pattern of effect for Vitex and placebo with the exception of the fluid retention group where there was some difference, but not of statistical significance. Generally the pattern of effect for both treatments was a dramatic improvement at the end of the first cycle with relative stability over the next two cycles. The only exception to this was the reported symptom ‘feel jittery or restless’ in the negative affect group which, under Vitex, had a sustained effect in comparison to placebo. At the end of the trial period detailed statistical analysis could find no difference between those who completed and those who withdrew with respect to age, marital status, cycle length and employment. It is concluded that, in this clinical trial, Vitex showed little difference in treatment effect to that of the placebo in the majority of symptoms associated with PMS. There were suggestions, however, from both the subjects' spontaneous responses and the findings with the fluid retention group, that further investigations would be justified.

Relationship between Anxiety and Premenstrual Syndrome

The relationship between symptoms of the premenstrual syndrome and anxiety was assessed for 68 women. The syndrome as measured by a modified version of the Moos Menstrual Distress Questionnaire, was correlated significantly with trait anxiety, as measured by Spielberger's State-Trait Anxiety Inventory. Trait anxiety was correlated with all three subtypes from the questionnaire: behavioral, psychological, and physical, most strongly for the psychological subtype. These findings suggest a role for stress-management training in the treatment of the premenstrual syndrome.

Premenstrual emotional changes a prospective study of symptomatology in normal women

Fifty-one subjects completed a modified version of the Moos Menstrual Distress Questionnaire daily for 8 weeks. The true purpose of the study was not revealed. These prospective data showed no pattern of increase in symptoms of negative affect during the premenstrual or menstrual phases, although the majority of women retrospectively reported having experienced premenstrual tension during the study. Explanations for this discrepancy in terms of an information processing bias and the popularising of internal hormonal explanations are offered. A number of demographic and menstrually related variables are investigated and found to show no relationship to the experience of PMT in this sample. No evidence is found to suggest that older women are more likely to experience PMT.

TREATMENT OF SEVERE PREMENSTRUAL SYNDROME WITH OESTRADIOL PATCHES AND CYCLICAL ORAL NORETHISTERONE

40 patients with premenstrual symptoms were randomly allocated to receive placebo patches or active treatment with transdermal oestradiol patches (2 x 100 μg) to suppress ovulation. Norethisterone 5 mg was given in each group from day 19-26 of the cycle to ensure a regular withdrawal bleed. Treatment was for 6 months with crossover at 3 months. Patients completed the Moos menstrual distress questionnaire (MDQ) and the premenstrual distress questionnaire (PDQ) daily throughout the study. 5 patients withdrew, 4 because of skin reactions and 1 because of considerable improvement with initial (active) treatment. After 3 months, both groups showed improvement in MDQ and PDQ scores. In general, between 3 and 6 months, patients who switched from active treatment to placebo had deteriorating scores while patients who switched from placebo to active treatment maintained or improved upon their initial gains. Significant improvements occurred after changing to active treatment in five of six negative MDQ symptom clusters and in six of ten PDQ symptoms.

Premenstrual failure of alpha-adrenergic stimulation on hypothalamus-pituitary responses in menstrual migraine.

In nine women suffering from menstrual migraine (MM), and in six healthy asymptomatic volunteers, plasma beta-endorphin (beta-EP), growth hormone (GH), norepinephrine (NE), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) concentrations were measured in response to clonidine (0.075 mg, i.v.) stimulation. In MM patients clonidine testing was performed in both the early and the late luteal phases of the menstrual cycle. Premenstrual symptoms were prospectively evaluated in the actual cycle using the Moos Menstrual Distress Questionnaire. beta-EP (after gel chromatography) and GH were measured using radioimmunoassay. NE and MHPG were evaluated by HPLC using electrochemical detection. In both phases of the menstrual cycle clonidine significantly reduced NE and MHPG levels in MM patients and controls in a similar way. In MM patients beta-EP and GH plasma levels were stimulated by clonidine only in the early luteal phase, whereas they remained unchanged when they were stimulated in the premenstrual period. In controls the response of both hormones was not affected by the menstrual cycle. The lack of hormonal response to clonidine in MM may suggest a postsynaptic alpha 2-adrenoreceptor hyposensitivity during the premenstrual period. This demonstrates a transient vulnerability of the neuroendocrine/neurovegetative systems, and could thus be a factor facilitating the precipitation of both behavioral changes and migraine attacks.