Premenstrual Phase Research Articles

Impact of menstruation on physical and mental health of young adolescent girls

This study was undertaken to study the Impact of Menstruation on Physical and Mental Health of young adolescent girls. Two different phases ( Pre-menstrual phase and post menstrual phase) were taken to assess the impact of the premenstrual symptoms screening tool revised for adolescents (PSST-A), Measure of Adolescent Coping Strategies (MACS), Well-Being Index (WBI–CVSV)andAdjustment Inventory for School Students (AISS–SS) . The age of the subjects ranges from 13 to 16 years ( grade 8th to 10th). Results revealed that the subjects of pre phase of menstruation showed deterioration in premenstrual symptoms screening tool revised for adolescents (PSST-A), Measure of adolescent coping strategies, emotional well-being, psychological well-being, spiritual well-being. The subjects of post menstrual phases showed stronger psychological characteristics in measure of adolescent coping strategies and levels of adjustment. It was also confirmed by the study that the magnitude of the problem comes down during the post phase of menstruation. Physical health was proved a significant factor during menstruation from which other associated symptoms and problems may generate. So, physical and mental health are very much associated with menstruation for the females during their adolescence.

Assessment of serum calcium and magnesium levels in subjects with pre-menstrual syndrome

Women's health is one of the main goals of social and economic development of societies; therefore, problems and diseases compromising women's physical and mental health, such as premenstrual syndrome (PMS), are among health priorities.To estimate and compare the serum levels of calcium and magnesium in subjects with pre-menstrual syndrome and subjects without premenstrual syndrome during pre-and post-menstrual phases.: Healthy women (intern students, hospital staff, non-teaching staff, class 3 and class 4 staff) in the age group of 18-26 years having regular menstrual cycles for the past 6 months were included based on inclusion and exclusion criteria. PMS was diagnosed based on ACOG criteria. 5 mL of venous blood sample was collected in red stoppered plain tube and used for estimation of serum calcium and magnesium levels during premenstrual phase of menstrual cycle. We found that there was no significant difference in the serum calcium levels between cases and controls, but there was significant difference in serum magnesium levels between the cases and controls.Several factors like culture, socioeconomic status, cigarette smoking, alcohol consumption, exercise, dietary habits, age of menarche etc. have also been implicated. Prolonged stress exposure is believed to lead to persistent malfunctions of neuroendocrine system and cause PMS. Lack of micronutrients and certain hormonal agents and are also implicated in the development of PMS. We strongly recommend Lifestyle modifications which include mind-body approaches, aerobic exercise, and supplementation with vitamins, minerals, and complex carbohydrates. Early nutritional supplementation of with the diet rich in these minerals will be effective as preventive and therapeutic strategy.

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review.

Learning objectiveAfter participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women’s mental healthA growing body of research demonstrates menstrual cycle–dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women’s mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.

Mapping the abject: Women's embodied experiences of premenstrual body dissatisfaction through body-mapping

Women's body shame and body dissatisfaction increase in the premenstrual phase of the cycle, associated with premenstrual distress. However, the meaning and consequences of premenstrual body dissatisfaction remain underexplored. The aim of this study was to explore how women who report premenstrual body dissatisfaction construct and experience their bodies, using qualitative arts-based methods. Four hundred and sixty women completed online open-ended survey questions and 16 women took part in body-mapping and an interview. Thematic analysis identified three major themes: construction of the premenstrual body as abject, manifested by positioning of the body and self as fat, leaking and dirty; self-policing and self-regulation through increased scrutinising and concealment of the premenstrual body; and resistance of cultural constructions of idealised femininity. These findings emphasise the need to acknowledge changes in body dissatisfaction across the menstrual cycle, and the implication for women's feelings about the self. Internalisation of negative constructions of the female body plays a role in women's experience of premenstrual change and distress. There is a need for further research to examine the role of body management behaviours in premenstrual body dissatisfaction and distress.

Prophylactic heme arginate therapy in acute intermittent hepatic porphyria: A case report

Introduction. Among the acute hepatic porphyrias, a small percentage of patients, predominantly female, present with recurrent cyclic attacks of acute intermittent porphyria that occur more than three times a year and sometimes at intervals of less than a month. In women, the attacks are typically related to the menstrual cycle, requiring several days of hospitalization and administration of heme arginate. For these patients, prophylactic heme arginate therapy may be the optimal treatment modality. Case report. We presented a 40-year-old female patient who has been suffering from porphyria for seventeen years. The first attack occurred in 2003, presenting with severe neurological symptoms, requiring the use of heme arginate (Normosang?, Orphan Europe), which resulted in a favorable therapeutic response. In 2004 and 2007, gonadorelin analogue goserelin (Zoladex?) was used, but without beneficial effects on the course of the disease. In 2008, a preventive administration of heme arginate was initiated. The patient received heme arginate in the early phase of symptoms, every month in the premenstrual phase of the cycle, which resulted in milder symptoms, full recovery within 24 hours, lower doses of Normosang? (1-2 ampoules), and fewer hospital days (1-2 days) per month. This regimen has significantly improved the patient's quality of life and reduced the risk of potential ad-verse effects. Conclusion. Preventive use of Normosang? is the optimal therapeutic modality in patients with frequent, recurrent severe attacks that are unresponsive to other therapeutic regimens. As a result, patients have a better quality of life due to an effective, short-term, targeted treatment regimen.

Knowledge and Awareness on Premenstrual Symptoms – A Cross Sectional Survey

Background: A majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation. The aim of the study is to evaluate the awareness of premenstrual symptoms.
 Materials and Methods: A questionnaire of 16 questions was created and entered in the online survey creator ‘Google Forms’ and shared individually among dental students and specialist and data were collected subject to statistical analysis using SPSS software. Statistical tests used were descriptive statistics and Chi-square tests.
 Results: Regardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches, pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Results of this study 90% of the participants aware about premenstrual symptoms 10% of the participants unaware of premenstrual symptoms and they need an effective education and awareness campaign to increase their knowledge and awareness on premenstrual symptoms. The obtained p-value was >0.05 was considered statistically insignificant.
 Conclusions: The present study indicates the prevalence of premenstrual symptoms, regardless of severity, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Enhanced responsiveness to hypoxic panicogenic challenge in female rats in late diestrus is suppressed by short-term, low-dose fluoxetine: Involvement of the dorsal raphe nucleus and the dorsal periaqueductal gray.

Acute hypoxia, which is panicogenic in humans, also evokes panic-like behavior in male rats. Panic disorder is more common in women and susceptibility increases during the premenstrual phase of the cycle. We here investigated for the first time the impact of hypoxia on the expression of panic-like escape behavior by female rats and its relationship with the estrous cycle. We also evaluated functional activation of the midbrain panic circuitry in response to this panicogenic stimulus and whether short-term, low-dose fluoxetine treatment inhibits the hyper-responsiveness of females in late diestrus. Male and female Sprague Dawley rats were exposed to 7% O2. Females in late diestrus were also tested after short-term treatment with fluoxetine (1.75 or 10 mg/kg, i.p.). Brains were harvested and processed for c-Fos and tryptophan hydroxylase immunoreactivity in the periaqueductal gray matter (PAG) and dorsal raphe nucleus (DR). Acute hypoxia evoked escape in both sexes. Overall, females were more responsive than males and this is clearer in late diestrus phase. In both sexes, hypoxia induced functional activation (c-Fos expression) in non-serotonergic cells in the lateral wings of the DR and dorsomedial PAG, which was greater in late diestrus than proestrus (lowest behavioral response to hypoxia). Increased responding in late diestrus (behavioral and cellular levels) was prevented by 1.75, but not 10 mg/kg fluoxetine. The response of female rats to acute hypoxia models panic behavior in women. Low-dose fluoxetine administered in the premenstrual phase deserves further attention for management of panic disorders in women.

Eye movement pattern of attention bias to emotional stimuli in women with high premenstrual symptoms

Background and objectivesPremenstrual Syndrome (PMS) refers to a group of symptoms linked to the menstrual cycle. Women with PMS have cognitive mode of rumination, which leads to their attention bias to emotional stimuli. This study investigated the biases for emotional information in women with high premenstrual symptoms (HPMS) compared with women with low premenstrual symptoms (LPMS). MethodsA total of 38 women with HPMS and 44 women with LPMS completed self-report questionnaires and a free viewing task with eye-tracking technology. ResultsThe questionnaire results indicate that women in the HPMS group had higher levels of rumination than those in the LPMS group. The eye-tracking results show that women in the HPMS group had an orientation bias towards negative emotional stimuli in the early cognitive process. In the late cognitive process, women in the HPMS group had accelerated attentional disengagement to positive emotional stimuli and difficult attentional disengagement to negative emotional stimuli. Further correlation analysis revealed positive relationships between the scores of initial fixation latency bias of positive pictures in premenstrual phase and the scores of symptom rumination in both groups and between the scores of initial fixation latency bias of positive pictures in premenstrual phase and the scores of brooding in HPMS group. LimitationsThis study used a retrospective questionnaire to assess the symptoms of PMS. ConclusionsWomen with HPMS had impaired attentional engagement and disengagement to emotional stimuli compared with women with LPMS, and it may be related to their cognitive mode of rumination.

The Disturbing Effect of Neuromuscular Fatigue on Postural Control Is Accentuated in the Premenstrual Phase in Female Athletes.

This study explored the fatigue effect on postural control (PC) across menstrual cycle phases (MCPs) in female athletes. Isometric maximal voluntary contraction (IMVC), the center of pressure sway area (CoParea), CoP length in the medio-lateral (CoPLX) and antero-posterior (CoPLY) directions, and Y-balance test (YBT) were assessed before and after a fatiguing exercise during the follicular phase (FP), mid-luteal phase (LP), and premenstrual phase (PMP). Baseline normalized reach distances (NRDs) for the YBT were lower (p = 0.00) in the PMP compared to others MCPs, but the IMVC, CoParea, CoPLX, and CoPLY remained unchanged. After exercise, the IMVC and the NRD decrease was higher at PMP compared to FP (p = 0.00) and LP (p = 0.00). The CoParea, CoPLX, and CoPLY increase was higher in the PMP compared to FP (p = 0.00) and LP (p = 0.00). It was concluded that there is an accentuated PC impairment after exercise observed at PMP.

Managing the premenstrual body: a body mapping study of women\u2019s negotiation of premenstrual food cravings and exercise

BackgroundWomen’s eating behaviours and exercise patterns have been found to fluctuate across the menstrual cycle, manifested by premenstrual food cravings and reduced exercise. However, the meaning and consequences of premenstrual changes in eating and exercise behaviours remains underexplored. The aim of this qualitative study was to explore how women who feel negatively about their premenstrual bodies construct and experience premenstrual changes to eating and exercise practices, which disrupt their usual patterns of body management.MethodsFour hundred and sixty women aged 18–45 completed an online survey in response to a Facebook advertisement targeted at women who feel negatively about their bodies during the premenstrual phase of the cycle. Participants reported moderate premenstrual distress, high body shame and high risk of disordered eating attitudes using standardised measures. Sixteen women reporting rich accounts of premenstrual body dissatisfaction were invited to participate in body-mapping, involving visually illustrating experiences on a life-sized outline of the body, followed by a telephone interview. Thematic analysis was used to explore qualitative survey, interview, and body-mapping data.Results and discussionResults found that outside of the premenstrual phase these women engaged in restrictive eating and intensive exercise behaviours, which were disrupted by premenstrual cravings, hunger, fatigue, pain and feeling physically uncomfortable. For a minority of the women, this facilitated self-care in reducing the strict management of their bodies during the premenstrual phase. Others experienced feelings of guilt, shame, self-disgust and pushed their bodies physically through increased exercise.ConclusionsThese findings emphasise the need to acknowledge changes in body management across the menstrual cycle, with implications for women’s mental health and feelings about the self. Internalisation of pressures placed on women to manage their bodies through restrictive eating behaviours and rigorous exercise plays a role in women’s premenstrual body dissatisfaction and distress.Plain English summaryThe current study aimed to explore how women who feel negatively about their premenstrual bodies construct and experience premenstrual changes to eating and exercise practices. Outside of the premenstrual phase these women engaged in restrictive eating and intensive exercise behaviours which were disrupted by premenstrual cravings, hunger, fatigue, pain and feeling physically uncomfortable. Some women allowed themselves to take a premenstrual break from their usual strict eating and exercise behaviours, whereas others felt guilt, shame, self-disgust and physically pushed their bodies through increased exercise. These findings emphasise that changes to eating and exercise behaviours across the menstrual cycle and pressures placed on women to manage their eating and exercise behaviours have implications for women’s premenstrual distress and body dissatisfaction.

Effect of Estrous Cycle on Behavior of Females in Rodent Tests of Anxiety.

Anxiety disorders are more prevalent in women than in men. In women the menstrual cycle introduces another variable; indeed, some conditions e.g., premenstrual syndrome, are menstrual cycle specific. Animal models of fear and anxiety, which form the basis for research into drug treatments, have been developed almost exclusively, using males. There remains a paucity of work using females and the available literature presents a confusing picture. One confound is the estrous cycle in females, which some authors consider, but many do not. Importantly, there are no accepted standardized criteria for defining cycle phase, which is important given the rapidly changing hormonal profile during the 4-day cycle of rodents. Moreover, since many behavioral tests that involve a learning component or that consider extinction of a previously acquired association require several days to complete; the outcome may depend on the phase of the cycle on the days of training as well as on test days. In this article we consider responsiveness of females compared to males in a number of commonly used behavioral tests of anxiety and fear that were developed in male rodents. We conclude that females perform in a qualitatively similar manner to males in most tests although there may be sex and strain differences in sensitivity. Tests based on unconditioned threatening stimuli are significantly influenced by estrous cycle phase with animals displaying increased responsiveness in the late diestrus phase of the cycle (similar to the premenstrual phase in women). Tests that utilize conditioned fear paradigms, which involve a learning component appear to be less impacted by the estrous cycle although sex and cycle-related differences in responding can still be detected. Ethologically-relevant tests appear to have more translational value in females. However, even when sex differences in behavior are not detected, the same outward behavioral response may be mediated by different brain mechanisms. In order to progress basic research in the field of female psychiatry and psychopharmacology, there is a pressing need to validate and standardize experimental protocols for using female animal models of anxiety-related states.

Sex differences in sleep and influence of the menstrual cycle on women's sleep in junior endurance athletes.

Previous research shows that female athletes sleep better according to objective parameters but report worse subjective sleep quality than male athletes. However, existing sleep studies did not investigate variations in sleep and sleep stages over longer periods and have, so far, not elucidated the role of the menstrual cycle in female athletes' sleep. To address these methodological shortcomings, we investigated sex differences in sleep and sleep stages over 61 continuous days in 37 men and 19 women and examined the role of the menstrual cycle and its phases in 15 women. Sleep was measured by a non-contact radar, and menstrual bleeding was self-reported. Associations were investigated with multilevel modeling. Overall, women tended to report poorer subjective sleep quality (p = .057), but objective measurements showed that women obtained longer sleep duration (p < .001), more light (p = .013) and rapid eye movement sleep (REM; hours (h): p < .001, %: p = .007), shorter REM latency (p < .001), and higher sleep efficiency (p = .003) than men. R2 values showed that sleep duration, REM and REM latency were especially affected by sex. Among women, we found longer time in bed (p = .027) and deep sleep (h: p = .036), and shorter light sleep (%: p = .021) during menstrual bleeding vs. non-bleeding days; less light sleep (h: p = .040), deep sleep (%: p = .013) and shorter REM latency (p = .011) during the menstrual than pre-menstrual phase; and lower sleep efficiency (p = .042) and more deep sleep (%: p = .026) during the follicular than luteal phase. These findings indicate that the menstrual cycle may impact the need for physiological recovery, as evidenced by the sleep stage variations. Altogether, the observed sex differences in subjective and objective sleep parameters may be related to the female athletes' menstrual cycle. The paper provides unique data of sex differences in sleep stages and novel insights into the role of the menstrual cycle in sleep among female athletes.

Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder.

Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD and their fluctuations during the menstrual cycle. Methods: A total of 100 women were diagnosed as having PMDD based on psychiatric interviews and a prospective investigation of three menstrual cycles. A total of 96 individuals without PMDD were recruited as controls. Their symptoms, namely insomnia, inattention, and fatigue as well as functional impairment were assessed by using the premenstrual symptoms screening tool, the Pittsburgh insomnia rating scale, the attention and performance self-assessment scale, and the fatigue-assessment scale during both premenstrual and follicular phases. Results: In both the premenstrual and follicular phases, women with PMDD experienced more severe insomnia, inattentiveness, and fatigue than did women in the control group. A paired t-test demonstrated that women with PMDD had more severe severity insomnia, inattentiveness, and fatigue in the luteal phase than in the follicular phase. A repeated-measures analysis of variance demonstrated that the interaction period of PMDD and a menstrual cycle was significantly associated with insomnia, inattentiveness, and fatigue. A further correlation analysis demonstrated that all three symptoms were positively associated with self-reported functional impairment due to PMDD. Conclusions: Our results demonstrated that women with PMDD experienced an exacerbation of insomnia, memory problems, difficulty maintaining focus, and fatigue in the premenstrual phase. These symptoms are correlated with PMDD symptoms severity and functional impairment, and as such, they should be evaluated, and interventions should be employed in the late luteal phase of women with PMDD.

Premenstrual tension syndrome and its impact on family function

Background: Premenstrual tension syndrome (PMTS) is defined as periodic physical, cognitive, behavioral and mood changes during the premenstrual phase, about 90% of women report some PMS symptoms which adversely affect their normal performance. Objectives: To estimate the prevalence and risk factors of PMTS among undergraduate female students at Suez University, and its effect on family function. Methods: An analytic cross-sectional study was conducted using an online questionnaire. Two validated tools were used for assessment; the PMTS-OR scale for premenstrual tension syndrome assessment and family APGAR score for family function assessment, 190 participants among female students at Suez University shared in the study during the period between February to April 2020. Results: The mean age of participants was 19.95 years, 60.5% of them were students in theoretical colleges, 3.7% had no PMTS while 14.7%, 42.1%, 39.5% had mild, moderate, and severe premenstrual tension syndrome, respectively. Drinking coffee, late sleep, regularity of menstruation and educational attainment were significantly associated with PMTS. 15.8% were severely dysfunctional, 45.3% of participant had moderate family dysfunction, and 38.9% were highly functional. There was a statistically significant relationship between family dysfunction and both regularity of menstruation and premenstrual tension syndrome. Moderate and severe forms of PMTS were associated with increased probability of having family dysfunction. Conclusions: This study proved that PMTS is highly prevalent among undergraduate female students at Suez University and has a significant association with family dysfunction, so health awareness programs to girls and their families are needed to improve knowledge regarding menstrual disorders.

Perceived occupational competence and value among university students with premenstrual dysphoric disorder

Introduction Premenstrual dysphoric disorder (PMDD) is defined as a mental health issue and is assessed using DSM-V diagnostic criteria. Premenstrual dysphoric disorder comprises emotional, behavioral, and physical symptoms that occur in the premenstrual phase and resolve shortly after the start of menstruation. These symptoms and functional impairment may negatively affect occupational competence and value. This study investigated perceived occupational competence and value in university students with premenstrual dysphoric disorder. Methods This cross-sectional study was performed at a public university with 35 students with PMDD and 35 age-matched students without PMDD. Occupational competence and value were evaluated using the Occupational Self-Assessment (OSA). Results There was a significant difference between the groups in OSA competence score ( p &lt; 0.05), while there was no significant difference in OSA value score ( p &gt; 0.05). Conclusion This study demonstrated that university students with PMDD experience more occupational competence challenges than peers without PMDD. Further studies should be performed to determine the role of occupational therapy in the rehabilitation of PMDD.

Brain reactivity during aggressive response in women with premenstrual dysphoric disorder treated with a selective progesterone receptor modulator

Premenstrual dysphoric disorder (PMDD) is a psychiatric condition characterized by late luteal phase affective, cognitive, and physical impairment. The disorder causes significant suffering in about 5% of women in their reproductive age. Altered sensitivity of cognitive-affective brain circuits to progesterone and its downstream metabolite allopregnanolone is suggested to underlie PMDD symptomatology. Core mood symptoms include irritability and anger, with aggression being the behavioral outcome of these symptoms. The present study sought to investigate the neural correlates of reactive aggression during the premenstrual phase in women with PMDD, randomized to a selective progesterone receptor modulator (SPRM) or placebo. Self-reports on the Daily Record of Severity of Problems were used to assess PMDD symptoms and gonadal hormone levels were measured by liquid chromatography tandem mass spectrometry. Functional magnetic resonance imaging was performed in 30 women with PMDD, while performing the point subtraction aggression paradigm. Overall, a high SPRM treatment response rate was attained (93%), in comparison with placebo (53.3%). Women with PMDD randomized to SPRM treatment had enhanced brain reactivity in the dorsal anterior cingulate cortex and dorsomedial prefrontal cortex during the aggressive response condition. The fronto-cingulate reactivity during aggressive responses depended on treatment, with a negative relationship between brain reactivity and task-related aggressiveness found in the placebo but not the SPRM group. The findings contribute to define the role of progesterone in PMDD symptomatology, suggesting a beneficial effect of progesterone receptor antagonism, and consequent anovulation, on top-down emotion regulation, i.e., greater fronto-cingulate activity in response to provocation stimuli.

Effectiveness of STP on knowledge regarding prevalence and Management of Pre-menstrual syndrome among adolescent girls

Background of the study: Developing country like India, the status of nutrition in women is least attended. Malnutrition, vitamin and mineral deficiencies results in many disorders including Pre menstrual symptoms. Equal to men, the women in India, considered as backbone in the family and society. From the ancient period, the health of the women especially menstrual problems has been neglected. Epidemiologic surveys have estimated that as many as 80% of women of reproductive age experience some symptoms attributed to the premenstrual phase of the menstrual cycle. Objectives of the study: To evaluate the effectiveness of structured teaching program on knowledge regarding prevalence and management of Pre-menstrual syndrome among adolescent girls. Materials and Methods: The research approach used in this study was Evaluative in nature and design adopted was pre-experimental one group pre test -post test design. Total of 60 adolescent girls were selected by using Non Probability Purposive sampling technique. A structured online questionnaire (Google Forms) method was used to assess the knowledge of students regarding prevalence and management of Premenstrual syndrome on 1st and 14th Day of Data collection. On 7th day investigators administered the Structured teaching Programme through Online platform (Google meet). Data was analyzed using descriptive and inferential statistics. Results: Most (48.3%) of the subjects in the pre-test had moderate knowledge regarding prevalence and management of pre-menstrual syndrome, whereas in the post-test all the subjects (100%) had scored between 23 and 35 indicating adequate knowledge. Pre-test and post-test knowledge score of subject ranged between 09-32 and 23-35 respectively. The mean pre-test and post-test knowledge score of subjects was 19.1 and 28.46 respectively. The mean post-test knowledge score was significantly higher than mean pretest knowledge score (t =9.36) at 0.05 level of significance (t(59)=2.0,). Th

Steroid Hormone Sensitivity in Reproductive Mood Disorders: On the Role of the GABAA Receptor Complex and Stress During Hormonal Transitions.

Women worldwide are two to three times more likely to suffer from depression in their lifetime than are men. Female risk for depressive symptoms is particularly high during the reproductive years between menarche and menopause. The term “Reproductive Mood Disorders” refers to depressive disorders triggered by hormonal fluctuations during reproductive transitions including the perimenarchal phase, the pre-menstrual phase, pregnancy, the peripartum period and the perimenopausal transition.Here we focus on reproductive mood disorders manifesting in adult life. We propose a research agenda that draws together several reproductive mood disorders and investigates which genetic, endocrinological, neural, and psychosocial factors can explain depressive symptoms during phases of hormonal transitions in women. Based on current research it is assumed that some women experience an increased sensitivity to not only fluctuations in reproductive steroids (estrogen and progesterone), but also stress-related steroids. We integrate both dynamics into the concept of “steroid hormone sensitivity,” expanding on the concept of “reproductive hormone sensitivity.” We suggest that a differential response of the stress steroid system including corticosteroids, neurosteroids, like allopregnanolone and the GABA-A Receptor complex, as well as a differential (epi)genetic risk in serotonergic and GABAergic signaling, are moderators or mediators between changes in the reproductive steroid system and the physiological, affective, and cognitive outcomes manifesting in reproductive mood disorders. We point to the lack of research on the role of psychosocial factors in increasing a woman's stress level and at some point also the sensitivity of her stress steroid system within the etiology of Reproductive Mood Disorders.Drawing together the evidence on various reproductive mood disorders we seek to present a basis for the development of more effective pharmacological, social, and psychological treatment interventions and prevention strategies for women susceptible to these disorders. This could pave the way for new research as well as medical and psychological teaching and practice- such as a new type of Practice for Gynecological Psychoneuroendocrinology- with the aim of working on and ultimately offering more integrative forms of support not yet available to women suffering from depression during hormonal transitions. In medical history women have been left alone with this integrative challenge.

English

BACKGROUND Premenstrual symptoms are generally seen 7 - 10 days before the menstruation period and are collectively called as premenstrual syndrome. Dysmenorrhea is the most common premenstrual symptom that affects the lifestyle and activity of young women. This study was aimed at estimating the prevalence of premenstrual symptoms and its severity in female medical student population of Government Medical college, Patiala, Punjab. METHODS 500 female medical students aged between 18 - 28 years were included in the study. Female students were asked to fill preformed questionnaire to elicit gynaecological information as well as the 4-point grading scale menstrual distress questionnaires. Symptoms were divided into two groups: physical symptoms and behavioural / psychological symptoms. RESULTS Only 30.24 % of the students reported one or more symptoms; of these, 22.76 % were having mild, 5.6 % moderate and 1.87 % severe degree of symptoms. From physical and behavioural / psychological symptoms, it was noticed that behavioural / psychological symptoms predominate. Among physical symptoms, breast tenderness is experienced most followed by bloating, and weight gain during premenstrual phase. Among psychological / behavioural symptoms, irritability predominates followed by restlessness &amp; mood swings. CONCLUSIONS Diagnosis is best achieved through daily rating symptoms over at least one menstrual cycle; clinicians can ask patients to choose their worst symptoms and chart the severity daily, or can select a validated scale such as the Daily Record of Severity of Problems. Disappearance of symptoms after menstruation is the key to diagnosis. KEYWORDS Premenstrual Syndrome, Depressive Disorder, Prevalence, Dysmenorrhea

Paranoid Hostility but Not Depressive Symptoms Associated with Cytokines During the Premenstrual Phase in Young Women

It is well known that some women, during their premenstrual phase, express Hostility (Ho) and Depressive symptoms (De). Various studies indicate that Ho and De correlate with circulating concentrations of cytokines. These data support the hypothesis of an inflammation-sensitive mechanism linked to certain psychological states. The aim of this study was to correlate Ho and De with selective proinflammatory cytokines during the menstrual cycle in young women. Twenty-two physically healthy medical students, mean age 22.95+2.83(SD), were studied. All reported regular menses that ranged between 27-33 days. Blood was drawn three times across a single cycle: at follicular phase (FL), at mid luteal phase (ML) and at late luteal phase (LL) corresponding to the premenstrual phase. The following proinflammatory cytokines were determined at each sample: Interleukin 8 (IL-8), Interleukin 6 (IL-6), Interleukin 1α (IL-1α), and Tumor Necrosis Factor-α (TNF-α). Immediately before blood sampling the women completed the Zung self-rating depression scale and the hostility and direction of hostility questionnaire (HDHQ), which comprises five subscales: urge to act out hostility, criticism of others, paranoid hostility, self-criticism and delusional guilt. Spearman’s rank correlation was used to determine the relation between variables at the specific time points; ρ&lt;0.05 was considered significant. Mean values of cytokines did not change significantly throughout the menstrual cycle. Paranoid hostility was positively correlated with IL-8 (Rs=0.476, p=0.046), IL-1α (Rs=0.458, p=0.048) and TNF-α (Rs=0.518, p=0.023) in LLphase. No other significant correlation was found. Cytokines correlate with paranoid hostility and this correlation is probably related with the premenstrual hormonal changes. It is difficult to evaluate the clinical significance of our findings, nevertheless, when exploring the above association, it is necessary to take into consideration the phase of the cycle as well as the special aspects of Ho we seek to study.