Premenstrual Symptomatology Research Articles

Family coping and premenstrual symptomatology.

To examine how families cope when the woman experiences premenstrual symptomatology. A descriptive panel design and purposive, nonprobability sampling through interviews and questionnaires. Participants' homes. One hundred four couples who met the study criteria were recruited from medical practices and community seminars and through media announcements. Study outcome measures were formulated after data collection. High-symptom families used spiritual coping strategies more frequently than low-symptom families (R = .427, p = 0.003 in women, p < 0.001 in men). Husbands were more likely than wives to report that their families coped by believing that the problem would go away if they waited long enough (t = -3.06, p = 0.003). Husbands of women with high symptomatology reported that their families used this passive approach to a significant degree (t = -3.43, p = 0.001). Religious or spiritual support may be especially important to families in which the woman suffers from premenstrual symptomatology. These families may also keep problems within the family and be socially detached. Nurses may help by encouraging the use of social supports, religious or spiritual support, and other family resources.

The Biopsychosocial Model: Menstrual Attitudes, Sources of Information, and Premenstrual Symptomatology among Mothers with and without PMS and Adolescent Daughters

Abstract The purpose of this study was to evaluate mothers diagnosed with or without PMS and their firstborn biological adolescent daughters in order to examine the relationship of menstrual attitudes and sources of information with premenstrual symptomatology. Findings of this study demonstrated that 79 percent of the daughters experienced premenstrual symptomatology if their mothers had PMS, whereas only 18 percent of the daughters experienced premenstrual symptomatology if their mothers did not have PMS. Results revealed significant differences in sources of menstrual information between the daughters of mothers with PMS and the daughters of mothers without PMS. Daughters of mothers without PMS reported elementary school, high school, and biology classes as a primary source of menstrual information, whereas daughters of mothers with PMS did not. Mothers with PMS viewed menstruation as debilitating and bothersome. Mothers without PMS viewed menstruation as a natural event and denied any effect of menstr...

The menstrual distress questionnaire: Are the critics right?

The Menstrual Distress Questionnaire (MDQ) is the most widely used method of assessing premenstrual symptomatology. It is also the most frequently criticized instrument in this field. A review of the criticisms made toward the MDQ revealed three major issues concerning the reliability and validity of this instrument and the sample from whom normative data were gathered. These issues were examined in light of 49 studies that used this instrument between 1968 and 1990. Many of the criticisms were found to be justified. A marked lack of adequate research into the MDQ’s reliability, problems associated with the normative sample, and uncertain validity were found. In particular, the MDQ appears to measure constructs unrelated to the menstrual cycle and define premenstrual syndrome inaccurately. In addition, the factor structure of this instrument may be unstable. These conclusions were tempered with the knowledge that the MDQ has not been utilized to its full potential in most of the research conducted to date.

Premenstrual symptoms: the role of irrational thinking.

104 women, between the ages of 18 and 45 years, were surveyed to investigate the relationship between premenstrual symptomatology, as measured by the Modified Menstrual Distress Questionnaire, and irrational thinking, as measured by the General Attitude and Belief Scale. The women who reported greater premenstrual symptomatology also reported significantly higher scores in the "need for comfort" irrationality subscale. This indicated that these women had particular difficulty dealing with hassles and the resulting feelings of tension and irritability in the premenstruum. It was suggested that the absence of significant effects for other rationality-irrationality subscales could be associated with testing at different times during the menstrual cycle. Irrationality, like other conditions (such as anxiety and depression) prevalent in the premenstruum, could change in intensity across phases of the menstrual cycle.

Effect of a nutritional supplement on premenstrual symptomatology in women with premenstrual syndrome: a double-blind longitudinal study.

To assess the effectiveness of a vitamin/mineral supplement in controlling symptoms of premenstrual syndrome (PMS), we conducted a double-blind randomized study on 44 women with PMS. Subjects were carefully screened and excluded if underlying physical or psychopathological conditions were noted. Follicular and luteal testing with a menstrual symptom questionnaire, subdividing PMS into four subgroups, was completed for 1 month prior to treatment and for three menstrual cycles during treatment. Subjects were randomly assigned to receive either placebo or six or 12 tablets of the supplement a day for three menstrual cycles. All subjects had significant differences in severity of symptoms between the follicular and luteal phase of the control cycle. Comparing pre- vs posttreatment luteal phase scores, significant placebo effects were noted for two PMS subgroups. Significant treatment effects were noted in three subgroups for the six-tablet group and in all four subgroups for the 12-tablet group. These results suggest that this nutritional supplement may play a role in the management of women with PMS.

Firstborn adolescent daughters and mothers with and without premenstrual syndrome: A comparison

Firstborn adolescent daughters and their mothers with and without premenstrual syndrome (PMS) were evaluated for two menstrual cycles in order to compare menstrual, postmenstrual (follicular), and premenstrual (luteal) symptomatology. Physical and psychological symptoms were evaluated according to the Premenstrual Assessment Form (PAF) and the Utah PMS Calendar II. The onset of the luteal phase was defined as the day of the midcycle surge of luteinizing hormone (LH), determined by utilizing the CUE Ovulation Predicter. The PAF showed that 1) irrespective of diagnosis, severity of symptoms was not significantly different between adolescents and adults; however, 2) when daughters and mothers were grouped according to mother's diagnosis, the PMS mother/daughter dyads experienced significantly more premenstrual symptoms when compared to the non-PMS mother/daughter dyads. Furthermore, the PMS Calendar revealed menstrual cycle phase delineation. There were no significant differences in severity of symptoms between adults and adolescents during the postmenstrual (follicular) phase and the premenstrual (luteal) phase. However, the adolescents experienced significantly more symptoms during the menstrual phase than the adults. 1) There were no significant differences in severity of adolescents' menstrual symptoms and their premenstrual (luteal) symptoms; 2) the number and severity of luteal phase symptoms were significantly greater for the women with PMS and their daughters than women without PMS and their daughters.

Frequency and Severity of Premenstrual Symptoms in Women Taking Birth Control Pills

A retrospective study of a wide range of premenstrual symptomatology using the Premenstrual Assessment Form found little difference between women taking a low-dose birth control pill and non-pill-takers. These data are in keeping with older, but narrower, studies of women taking high-dose pills and raise questions about mechanisms of symptomatic and subclinical premenstrual changes.

Lasting response to ovariectomy in severe intractable premenstrual syndrome

A total of 14 women with severe premenstrual syndrome unresponsive to conservative medical therapy were treated with danazol in doses sufficient to suppress cyclic ovarian steroidogenesis. In each case medical ovarian suppression resulted in complete relief from symptoms. For ongoing symptom relief, each woman elected to undergo bilateral ovariectomy and concomitant hysterectomy. Both medical ovarian suppression and ovariectomy with low-dose conjugated estrogen therapy afforded lasting relief from cyclic symptoms of premenstrual syndrome and a corresponding improvement in overall quality of life. We conclude that cyclic ovarian steroidogenesis is a powerful determinant for the expression of premenstrual symptomatology. Ovariectomy with low-dose estrogen replacement is an effective alternative for the woman with debilitating premenstrual syndrome who does not respond to conventional interventions. (AM J OeSTET GVNECOL 1990;162:99-105.)

Alcohol use and premenstrual symptoms in social drinkers

The relationship between premenstrual dysphoria and alcohol acquistion and use patterns was studied in 14 women over 35 days on a clinical research ward. A 7-day drug-free baseline was followed by 21 days of alcohol availability and a post-alcohol drug-free period of 7 days. Women could earn alcohol or 50 cents for 30 min of performance on a simple operant task. The Premenstrual Assessment Form (PAF) was administered during baseline and at the premenstruum. Menstrual cycle phase was associated with changes in alcohol use by 8 of the 14 women. Five women drank more during the premenstruum and scored higher on 12 of 18 PAF factors than women whose drinking remained the same (N = 6) or decreased (N = 3). Women who increased drinking had significantly higher PAF scores on impaired social functioning, hostility/anger and hysteroid features (P less than 0.05, 0.01). Women who drank less during the premenstruum reported more pain and physical discomfort, whereas women who drank about the same amount were relatively asymptomatic. PAF profiles reported at the premenstruum and baseline PAF profiles based on recall of the preceding three menstrual cycles were concordant in 13 of the 14 women (P less than 0.001-0.0001). These data suggest that women's perceptions of premenstrual symptomatology are stable through time.

Effects of a premenstrual syndrome education program on premenstrual symptomatology

This exploratory study was conducted to determine the effects of an educational program on the number and severity of premenstrual symptoms as well as the number of premenstrual days with symptoms. Participants were a convenience sample of 47 employed women, whose scores on Abraham's Menstrual Symptomatology Questionnaire were in the moderate to severe range. Women were randomly divided into control and experimental groups, and those in the experimental groups participated in an education program. Both groups recorded daily on Abraham's Menstrual Symptom Diary for 19 anxiety, appetite, edema, and depression symptoms. Participants in the education program had fewer occurrences of anxiety and appetite symptoms and fewer severe edema and depression symptoms, as well as fewer days with symptoms, than women who did not participate in the educational program. The findings support the idea that client education can promote self-care and improve health status.

Lasting response to ovariectomy in severe intractable premenstrual syndrome

A total of 14 women with severe premenstrual syndrome unresponsive to conservative medical therapy were treated with danazol in doses sufficient to suppress cyclic ovarian steroidogenesis. In each case medical ovarian suppression resulted in complete relief from symptoms. For ongoing symptom relief, each woman elected to undergo bilateral ovariectomy and concomitant hysterectomy. Both medical ovarian suppression and ovariectomy with low-dose conjugated estrogen therapy afforded lasting relief from cyclic symptoms of premenstrual syndrome and a corresponding improvement in overall quality of life. We conclude that cyclic ovarian steroidogenesis is a powerful determinant for the expression of premenstrual symptomatology. Ovariectomy with low-dose estrogen replacement is an effective alternative for the woman with debilitating premenstrual syndrome who does not respond to conventional interventions.

Coping Responses of Men Whose Partners Experience Premenstrual Symptomatology

While premenstrual syndrome (PMS) has received much attention from researchers and the media, little has been done to document systematically the effect of premenstrual symptomatology on relationships and family functioning. An exploratory study was conducted of the coping responses of men whose partners reported either high or low levels of premenstrual symptomatology. Men in this study used a wide variety and combination of coping responses. Men actively respond to their partners' premenstrual symptomatologies with a variety of coping strategies, some of which may be amenable to nursing intervention.

Assessing Premenstrual Syndrome Using the Premenstrual Experience Assessment

A comprehensive assessment device was developed and validated on 878 women. The inventory seems useful both in research and clinical practice. The instrument solicits information on medical, gynecological and psychological conditions, life-event stressors, sociocultural influences and premenstrual symptomatology. Responses generated a number of significant findings. One of seven women experienced severe premenstrual discomfort, one out of two women described themselves as having mild premenstrual discomfort, and severity of symptoms is a matter of degree rather than type, and women on oral contraceptives differed from nonusers with regard to reporting less interference premenstrually with sexual behavior and feelings and less difficulty with eating behavior and water retention.

Comparison of retrospective and prospective assessment of premenstrual symptoms.

The comparability of ratings of premenstrual symptoms obtained by different methods of data collection was studied. Ongoing ratings were compared with retrospective reports. A consecutive series ( n = 17) of women attending a premenstrual syndrome (PMS) evaluation and treatment center completed daily diary cards over the course of one menstrual cycle as well as a retrospective evaluation of their premenstrual symptomatology. Comparisons were made between postmenstrual and premenstrual ratings on the diary cards to confirm the presence of premenstrual symptomatology Retrospective ratings of premenstrual symptomatology showed higher mean scores reflecting greater symptomatology than was recorded in daily diary cards. Analysis of predictors of retrospective reports, using multiple regression analysis, with postmenstrual and premenstrual ratings as predictors, indicated significant associations between the retrospective and prospective ratings of premenstrual symptoms. There were no significant assocations between the retrospective ratings of premenstrual symptoms and prospective ratings of postmenstrual symptoms, suggesting the specificity of retrospective report in reflecting symptoms experienced prior to menstruation. The significance of these findings for clinical practice is discussed.

Premenstrual symptom changes and plasma β-endorphin/β-lipotropin throughout the menstrual cycle

The β-endorphin (BE) hypothesis of premenstrual symptomatology was assessed in 15 healthy, drug-free normally cycling women. Cycle-phase assignment was aided by measurement of basal body temperature and plasma progesterone. For the entire group, peripheral plasma BE concentrations by radioimmunoassay (with substantial β-lipotropin (BL) cross-reactivity) were generally unvarying across the menstrual cycle. High and low symptom subgroups were defined by retrospective and prospective daily self-reports of premenstrual changes. For the cycle studied, moderate to extreme symptom severity was defined according to premenstrual increases in impaired concentration, water retention and negative affect. No between-groups difference was observed for any cycle-phase for absolute values of β-endorphin (BE/BL). When difference scores were examined, there was a positive time-lag correlation between follicular-to-periovulatory changes in BE/BL and the subsequent luteal increase in impaired concentration over the periovulatory baseline (rs=0.82); considering the number of comparisons, however, the correlation fails to reach significance. The salience of various types of stressors on mood was assessed; there was a trend for “task-demands” to account for a greater percentage of negative attributions premenstrually compared to post-menstrually, for the entire group. The relative inconsistency in plasma BE/BL from cycle to cycle may be related in part, to the lack of stability in certain cycle characteristics from month to month. Future studies of BE/BL across the menstrual cycle may benefit from a demanding task in a provocative stress-paradigm.

Psychiatric screening in the premenstrual syndrome.

Prospective daily ratings of premenstrual symptomatology were obtained from 40 women for one full menstrual cycle. Nineteen of these women were complaining of suffering from a premenstrual syndrome. The General Health Questionnaire (GHQ) was administered in the mid-follicular and late luteal phases of the cycle. Women who were complaining of the premenstrual syndrome showed significant premenstrual increases in premenstrual symptoms, of a magnitude that was significantly greater than those of control subjects. The GHQ scores of the women who were complaining of premenstrual syndrome were significantly higher than those of the control subjects in both the follicular and luteal phases of the cycle. The mean GHQ score of the group with premenstrual syndrome was significantly elevated above the published normal value. Fifty-six per cent of those who complained of premenstrual syndrome had follicular GHQ scores which were higher than the recommended threshold for clinical psychiatric disturbance. Only 10.5% of the control group were above this threshold. General Health Questionnaire scores were stable across phases of the cycle and were correlated to the severity of symptoms of premenstrual syndrome. Premenstrual Moos Menstrual Distress Questionnaire (MDQ) scores were related strongly to follicular MDQ scores. A high proportion of women who complain of premenstrual syndrome show evidence of a more general psychiatric problem which should be evaluated before therapy.

Assessment of premenstrual symptomatology: A re-evaluation of the predictive validity of self-report

The predictive validity of subject's self-reports of the severity of four groups of symptoms associated with the premenstrual syndrome (PMS) was assessed by canonical correlation of retrospective self-reports of usual symptom severities with prospectively obtained symptom severity scores from the next two cycles. Prospective scores from the second cycle were then correlated with retrospective recall scores obtained after the end of that cycle. A measure of inter-cycle variability was obtained by correlation between two consecutive sets of prospective scores. The symptoms studied were tension, depression, cognitive and physical (‘water retension’) symptoms. It was found that subjects' recall of a particular cycle predicted 72% of the variance in that cycle's prospective severity scores, indicating that the subjects correctly interpreted the severity of premenstrual symptoms and distinguished them from symptoms present in the follicular part of the cycle. Retrospective reports of usual PMS symptomatology predicted 21% of the variance in symptom scores in the next menstrual cycle and 12% of the variance in the following one. Despite this decrease, averaging the scores from the two prospective cycles improved the prediction to 23%. Prospective scores from one cycle predicted only 14% of the variance in prospective scores from the next, suggesting a high degree of inter-cycle variability. Women's self-reports of their usual PMS symptomatology reflect their experience more accurately than has been thought. The finding of marked inter-cycle variability suggests that arguments for the use of a single cycle of prospective data in PMS evaluation are fallacious and that retrospective self-report may be clinically useful and relatively valid.

Personal and Family Impact of Premenstrual Symptoms

An exploratory study of premenstrual symptomatology, coping strategies, personal and family impact, and alterations in family functioning attributed to premenstrual symptoms was conducted. A sample of 83 women and 32 men completed a questionnaire before an evening lecture on premenstrual syndrome. Women reported a total of 74 different recurrent premenstrual symptoms, with the most frequently reported category being the "tension states." Men used multiple coping techniques to deal with their spouse's symptoms with offering support and expressing anger as the most frequently reported. Recurrent negative family impact themes emerged from the content analysis: increased conflict, decreased family cohesion, and disrupted communication among family members. Nursing implications are discussed.

Help-seeking for premenstrual symptomatology: a description of women's experiences.

The new consumer‐oriented literature on PMS both directly and indirectly suggests that the health care system, and in particular physicians, offer little acknowledgement, understanding or assistance to women seeking care for perimenstrual distress. In fact clinical reports point to disrespectful, dismissing and antagonistic attitudes on the part of health care providers as an important stress for women seeking help. Although some writers claim that physician bias and female stereotypes pervade all aspects of women's health care, others charge that gynecological and reproductive health care is even more prone to these abuses because of the nature of the problems. This pilot study was conducted to explore the experiences of women seeking help for premenstrual symptomatology. The sample consisted of 83 women who attended an evening lecture on premenstrual symptoms sponsored by a local civic group. Single, brief overview questions were used to obtain general information about symptoms, experiences with the he...

Psychiatric and social aspects of premenstrual complaint.

A number of fundamental methodological problems exist in the area of premenstrual symptomatology and psychiatric ill-health. In the study described these have all been taken into account. The study has been so designed as to make expressly clear the definition of premenstrual complaint being employed and material gathered by means of a retrospective questionnaire is checked by means of an interview administered to a sub-sample and the use of a menstrual diary (Sampson & Jenner, 1977; Dalton, 1978). The use of an interview also permits a careful check to be made of the accuracy displayed by women asked to estimate their particular position in the menstrual cycle at the time of completion of the questionnaire. The use of the premenstrual interview, together with a standardized, semi-structured psychiatric interview specifically designed for the population under study, and a standardized, semi-structured social maladjustment schedule, permits a detailed assessment of the inter-relationship between premenstrual, psychiatric and social variables. Finally, the use of a general practice sample of women attending their general practitioners for many and varied reasons, together with a sample of women drawn from attenders at a specialized premenstrual tension treatment clinic, permits a comparison to be made between the symptom profiles of women in a general practice population who have not overtly identified themselves to the treatment agencies as premenstrual sufferers with a group of women who have so identified themselves. In this way, a more accurate estimate of the numbers of women in general practice samples who manifest a degree of premenstrual complaint equivalent to that shown by special treatment clinic attenders can be achieved.