Premenstrual Symptoms Research Articles

Effect of video-based exercise on premenstrual symptoms: a randomized controlled trial.

This study aims to investigate the impact of Pilates exercises on premenstrual syndrome (PMS) symptoms, perceived stress levels, and pain intensity. Forty-six women with PMS participated in this study and were assigned to the intervention and control groups based on their willingness to participate. The intervention group undertook Pilates practices via video recording twice a week for 8 weeks, while the control group did not engage in regular exercise during the same period. PMS symptoms were assessed using the Premenstrual Syndrome Scale (PMSS), premenstrual stress levels were evaluated using the Perceived Stress Scale (PSS), and premenstrual pain levels were assessed using the McGill Melzack Pain Questionnaire (MPQ) at both the beginning and end of the study. There was a significant difference observed in the PMSS, PSS and MPQ evaluations of the intervention group following their participation in Pilates practices (p < 0.05). Conversely, no significant difference was observed in the PMSS, PSS and MPQ evaluations of the control group at the end of the study (p > 0.05). There was no statistically significant difference between the two groups in PMSS evaluation (p > 0.05) at the end of the study. However, a statistically significant difference was detected in PSS and MPQ evaluations (p < 0.05). Pilates exercise can affectively decrease the perceived stress level and pain severity in PMS affected women. This study highlights the efficacy of Pilates for physiotherapists in PMS symptom reduction. Moreover, the implementation of a self-guided video-based home exercise program could provide patients with practical and time-efficient alternatives.

Intermittent escitalopram treatment and reactive aggression in women with premenstrual irritability and anger: A crossover study

BackgroundSelective serotonin reuptake inhibitors (SSRI) are the primary treatment for premenstrual mood symptoms and particularly effective in reducing reactive aggression in the forms of irritability and anger.The present study examined whether behavioral responses in laboratory measures of reactive aggression are influenced by medication with the SSRI escitalopram in women reporting high levels of premenstrual irritability/anger. MethodsParticipants (N = 34) rated the cardinal mood symptoms of premenstrual dysphoric disorder over three menstrual cycles. During the second and third cycles, participants received escitalopram (20 mg) or placebo in a single-blind, cross-over design. In the luteal phase of the intervention cycles, participants completed two aggression tasks: The Anger-Infused Ultimatum Game (AI-UG) and the Point Subtraction Aggression Paradigm (PSAP). Additionally, they rated expression and control of anger using the State-Trait Anger Expression Inventory-2 (STAXI-2) once in the luteal phase and once in the follicular phase. ResultsWhile irritability/anger was reduced in the treatment (vs. placebo) cycle, no effect of escitalopram was detected in the PSAP. Escitalopram decreased reactive aggressive behavior in the AI-UG but only for a subset of participants who experienced a sharp premenstrual rise in outwardly expressed anger and/or did not experience a premenstrual rise in inwardly expressed anger. LimitationsThe participants' symptoms were based on the severity of only premenstrual irritability/anger, limiting the generalizability to the broader group of PMDD patients. ConclusionThe results suggest that the behavioral consequences of severe premenstrual irritability/anger are not easily captured by traditional measures of reactive aggression and underline the importance of considering individual differences in symptom expression.

The link between childhood traumatic events and the continuum of premenstrual disorders.

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD), collectively known as Premenstrual Disorders (PMDs), cause significant distress and functional impairment, and premenstrual exacerbation (PME) affects a large proportion of women with psychiatric diagnoses. Childhood trauma is one factor that may contribute to PMD/PME risk. This study examines the relationship between childhood trauma and PMDs, PME, and non-PMD psychiatric illness. This study is a secondary analysis of data from a prospective cohort. Participants completed self-assessments on childhood trauma using the Childhood Traumatic Event Scale (CTE-S) and on premenstrual symptoms using the Premenstrual Symptoms Screening Tool (PSST). Psychiatric diagnoses were assessed through structured clinical interviews. Participants were divided into four groups based on their PSST scores and psychiatric illness status: (1) Premenstrual Disorders (PMDs; moderate to severe PMS and PMDD), (2) PME, (3) psychiatric controls (PC; individuals with psychiatric illness but no significant premenstrual symptoms), and (4) healthy controls (HC; individuals with no psychiatric illness and no significant premenstrual symptoms). Statistical analyses, including ANOVA, Tukey's HSD test, Fisher's exact test, and logistic regression, were conducted to examine differences among the groups. Data from 391 participants were analyzed. Participants with PME and PC reported a higher quantity and severity of childhood traumatic events compared to HCs (p <.05). There was a weak but significant correlation between childhood trauma and premenstrual symptom burden across all groups (R = .18, p <.001). Within-group analysis revealed moderate correlations between childhood trauma and premenstrual symptoms driven by the PMD group (R = .42, p = .01). The findings underscore the impact of childhood traumatic events on mental health and premenstrual symptoms and highlight the need for additional research to explore the underlying mechanisms linking childhood trauma to the continuum of premenstrual disorders, to improve the efficacy of trauma-focused interventions for affected individuals.

Effect of dietary carbohydrate quality index on the severity of premenstrual symptoms

The objective of the researchers of this study is to evaluate the effect of the Carbohydrate Quality Index (CQI) in the diet of university students living in dormitories on the severity of premenstrual symptoms. The researchers applied a survey to the students, including questions about their sociodemographic characteristics and eating habits, Food Frequency Questionnaire (FFQ), and Premenstrual Symptom Scale (PMSS). A total of 606 female students were included as participants in the study. CQI value of students with PMS was found to be lower (p < 0.05). It was observed that increasing the CQI could reduce the PMSS score [β (−0.228 (0.18–0.007) 95%CI] (p < 0.05).

7241 Catamenial Diabetic Ketoacidosis

Abstract Disclosure: L. Javed: None. A. Rehan: None. L. Hashim: None. J. Lim: None. Introduction: Diabetic ketoacidosis (DKA) is a common cause of hospitalization and readmission in patients with diabetes mellitus. Etiologies are generally due to medication non-adherence, trauma, infection, or other precipitating illness. In approximately 10% of DKA cases, no discernible precipitating cause can be determined. The word catamenial is derived from a Greek word meaning monthly. It is used to describe the monthly occurrence of menstruation. Catamenial hyperglycemia is a phenomenon in which blood glucose levels change with the different phases in the menstrual cycle. This can precipitate recurrent, unexplained episodes of DKA. Here, we present a similar case. Case description:A 19-year-old woman with type 1 diabetes, gastroparesis, hypertension, dysmenorrhea and cyclical vomiting disorder presented with unrelenting nausea and vomiting for one day. Other symptoms included abdominal &amp; chest pain that the patient attributed to premenstrual symptoms. She is afebrile, doesn’t have any other symptoms of infection and no recent sick contacts. She is compliant with her home insulin regimen of Insulin detemir 20 units BID and pre meal 8 units insulin aspart. Further interrogation reveals she has regular menstrual cycles and has been hospitalized three times in the last three months due to DKA coinciding with premenstrual symptoms, specifically severe abdominal pain and vomiting, typically starting five days before the onset of her menstrual cycle. She is hemodynamically stable and physical exam is significant for mid epigastric tenderness. Significant labs: WBC 16.52 (N&amp;lt;11 K/mm3), glucose 457 mg/dl, anion gap 23, K 4.1 (mmol/L), bicarbonate 18 (≥19 mmol/L), lactate 3.2 (N ≤ 1.9 mmol/L), beta hydroxybutyarate 4.0 (N ≤ 0.27 mmol/L), trop T 6 (N&amp;lt;10 ng/L), BHCG negative . Hba1c a month ago was 9.6%. Infectious work up was negative. EKG showed no signs of ischemia. She was treated per DKA protocol which results in resolution of symptoms and normalization of labs. Since no other precipitating factors for DKA are identified, and her symptoms corresponded with her menstrual periods, she is given a diagnosis of Catamenial DKA and scheduled for regular follow up in endocrinology clinic. Conclusion: This case highlights the importance of considering the association betweenmenstrual cycle phases and blood sugar levels as a possible trigger, underscoring the role of a thorough menstrual history in patients presenting with DKA. The impact of menstrual cycle fluctuations on glycemic control varies among patients however glucose profiles seem to be consistent across cycles for each individual woman. This highlights the need for personalized management strategies including patient education and adjustment of insulin during these periods. Addressing this adequately will improve overall glycemic control, reduce hospitalizations, and help improve the quality of life. Presentation: 6/1/2024

Impact of premenstrual tension syndrome on academic performance among female university students from the United Arab Emirates: A cross-sectional study.

Premenstrual tension syndrome can vary in type and severity among females, potentially affecting their academic performance. This study aims to examine the prevalence and severity of premenstrual tension syndrome symptoms in female university students and their impact on academics. A cross-sectional descriptive study was conducted among female university students from Ras Al Khaimah, UAE over 6 months, from January 1, 2022 to June 30, 2022. The updated premenstrual tension syndrome self-rating scale questionnaire was used to assess the prevalence and severity of symptoms. A total of 251 respondents were included in the study. The chi-square test was used to determine the association between PMT and academic performance. The results showed that 78.9% of the participants experienced premenstrual tension syndrome, with 16.3% of them reporting premenstrual dysphoric disorder. The majority of participants reported mild to moderate symptoms, with anxiety and depressed mood being the most common psychological symptoms. In terms of behavioral symptoms, physical symptoms and feeling overwhelmed were the most prevalent. Furthermore, 90% of participants reported a negative impact on their academic performance, with paying attention in class being the most affected. The study also found that PMT disorder had a significant impact on physical activities and extracurricular activities. Our study showed a high prevalence of premenstrual disorders among female students and their influence on physical activity and extracurricular participation. The study highlights the importance of implementing therapies for PMT syndrome and providing support to improve academic performance and overall quality of life.

The effect of psychological stress on the menstrual cycle among medical students.

To assess the prevalence of menstrual abnormalities among medical students, and to explore its association with stress levels. TThe cross-sectional study was conducted from May 18 to May 28, 2021, in Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, and comprised female medical students in Baghdad. Data was collected using simple random sampling technique and employed an online questionnaire that was distributed through e-mail. The questionnaire had 3 domains: demographic and anthropometric data, menstrual history, and psychological stress. The psychosocial stress levels was assessed using the Perceived Stress Scale-10. Data was analysed using SPSS 25. There were 397 subjects with mean age 20.84±1.621 years (range: 17-24 years). Mean age of menarche was 12.65±1.399 years, mean body mass index was 22.71±6.369kg/m2 and the mean stress score was 22.71±6.016. Dysmenorrhoea was seen in 369(92.9%) cases, and premenstrual symptoms in 391(98.5%). Dysmenorrhoea, premenstrual syndrome and heavy bleeding were significantly associated with stress level (p<0.05). Most students had heavy bleeding and dysmenorrhoea, which were severe enough to require analgesics. There was a significant association between high stress levels and the occurrence of menstrual abnormalities.

Impact of age on premenstrual syndrome prevalence and severity: A population-based survey in Brazil.

To evaluate the relationship between premenstrual disorders (PMD) and age, we analyzed the prevalence and severity of psycho-emotional and physical symptoms in a representative sample of Brazilian women. This observational and retrospective study analyzed data from Brazilian women aged 20-49 years from five regions of the country who reported premenstrual symptoms. Participants completed a premenstrual symptom screening questionnaire and self-reported the presence and severity of their symptoms. Among 23 104 women reporting does premenstrual symptoms, 38.91% (n = 8990) experienced PMD caused functional impairment. Finally, 5121 participants agreed to complete the adapted version of the screening questionnaire. The age group distribution was 20-29 (46.7%), 30-39 (38.3%), and 40-49 years (15%). The most prevalent and severe physical symptom was acne/oily skin in participants aged 20-29 years and headache in women aged 30-49 years. Regarding psycho-emotional symptoms, the most prevalent was anxiety/tension in women aged 20-29 years and 40-49 years and irritability/anger in those aged 30-39 years. Irritability/anger was the most severe symptom in all groups. PMD significantly impacts the quality of life of Brazilian women with varying intensity. Physical symptoms associated with PMD vary with age, while psycho-emotional symptoms, particularly irritability/anger and anxiety, were intense in Brazilian women of reproductive age. These findings inform early diagnosis and individualized treatment approaches for PMD, addressing the needs of women.

Risk Factors for Low Quality of Life among Women Using Different Types of Contraceptives in Saudi Arabia: A Questionnaire-Based Study.

This study aimed to assess and identify the risks for poor quality of life among female Saudi contraceptive users by administering an online questionnaire. The validity of the Arabic version of the Spanish Society of Contraception Quality of Life (SEC-QOL) questionnaire was assessed by incorporating the relevant items into an exploratory factor analysis and a subsequent confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha coefficient. p < 0.05 was statistically significant. Questionnaires completed by 652 eligible women were analyzed. The most common contraception method was oral pills (51.5% of respondents). Analysis of the internal consistency of the questionnaire revealed that overall reliability was >0.7, which is considered adequate (Cronbach's alpha = 0.845). Analysis of risk factors associated with higher overall SEC-QOL scores (worse overall quality of life) revealed several statistically significant variables. A "not good" relationship with their husbands, "heavy" menstrual flow, and premenstrual breast symptoms (breast pain, hypersensitivity, and increased size) were identified as risk factors for poor quality of life due to their association with the highest scores (poor quality of life). The Arabic version of the modified SEC-QOL is a valid and reliable tool to measure the quality of life of Saudi contraceptive users.

Prevalence of Moderate-to-Severe Premenstrual Syndrome or Premenstrual Dysphoric Disorder and Associated Variables Among Young Women in a Tertiary Health Care Center in Eastern India.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that is predominantly characterized by mood symptoms, and debilitating physical and cognitive symptoms, which have a direct or indirect impact on work efficiency, social and personal relationships, and overall quality of life. This study was conducted to determine the prevalence of moderate to severe PMS and PMDD among young women in India and investigate sociodemographic and other associated factors. We conducted a cross-sectional study that included 198 young women between 17 and 30 years of age who were medical students or nursing staff from a medical college in Eastern India. Data were collected regarding sociodemographic information, menstrual patterns, age of menarche, sexually active status, body mass index, and level of physical activity, which were analyzed to find correlations with moderate to severe PMS or PMDD. The Premenstrual Symptoms Screening Tool was used for diagnosing moderate to severe PMS or PMDD. The data were analyzed using Statistical Product and Service Solutions (SPSS, version 24.0; IBM SPSS Statistics for Windows, Armonk, NY) software. Forty-six (23.5%) respondents were diagnosed with moderate-to-severe PMS, of which four (2%) were diagnosed with PMDD. Among those diagnosed with moderate-to-severe PMS/PMDD, 39 (27.3%) were of the age group 17-24 years, and seven (13.2%) were of the age group 25-30 years, which was a statistically significant difference (p=0.05). Thirty-eight (30.6%) students were diagnosed with moderate-to-severe PMS, as compared to eight (11.1%) working professionals, which was also a statistically significant difference. Moderate-to-severe PMS significantly impacts quality of life. Considering its prevalence among young subjects, it is important to make young girls aware of the condition and educate them regarding various ways to manage their symptoms.

Clinical Correlates of Premenstrual Suicidal Ideation Among Women in Makkah Population.

Introduction Suicidal ideation (SI), planning, and attempts have been found to be more common in women with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study assessed the association between PMS, PMDD, and SI within the Makkah population,in Saudi Arabia. Methodology A descriptive cross-sectional study that simply characterizes the prevalence of a health outcome in a specified population was done on 733 women using an online questionnaire. Data about demographics, menstrual cycle, PMS, past psychiatric history, prior history of PMDD, and previous drug treatment for PMDD were collected. The chi-square and Fisher exact tests were applied. Results Of the participants, 540 (73.7%) had an age represented the age of 18-25 years old, 551 (75.2%) were single, 592 (80.8%) did not have children, 352 (48.0%) had a four-year college education, and 552 (75.3%) had a monthly income of less than 5000 SR. Exactly 704 (96.0%) were menstruating, 539 (73.5%) had regular menstrual cycles, 640 (87.3%) reported low shock trauma, 201 (27.4%) reported a history of anxiety, and 541 (73.8%) reported an impact of premenstrual disorders on mental health. Of them, 662 (90.3%) experienced premenstrual symptoms, 53 (7.2%) had a previous diagnosis of premenstrual symptoms, and 62 (8.5%) had a history of a suicide attempt. Those aged 18 to 25 years, who have no children, have a monthly income of less than 5000, are unemployed, have irregular menstruation, have medical interventions due to premenstrual symptoms, have a lifelong history of depression or anxiety, and have a history of high shock trauma had a significantly higher prevalence of a history of a suicide attempt. These factors were independent predictors on regression analysis. Conclusion The link between PMD and the likelihood of suicide attempts highlights how crucial it is to treat severe PMDs in the context of mental health.

The predictive role of common symptoms of premenstrual syndrome in the clinical practice of nurses: a cross-sectional study

BackgroundFemale nurses with high occupational stress are one of the groups at risk of premenstrual syndrome (PMS). The symptoms of this syndrome may affect the reduction of work efficiency, accuracy in doing work, concentration, and increased absenteeism of nurses and can lead to significant economic losses. This study aimed to determine the predictive role of common PMS symptoms in the clinical performance of nurses in public hospitals in Sanandaj, Iran.MethodsThe present study was a descriptive-analytical and cross-sectional study. In this study, 318 nurses participated in the census method based on the inclusion criteria. Data collection tools were premenstrual symptom screening questionnaires and nurses’ clinical performance evaluations. Data analysis was done with Spearman’s correlation tests, simple linear regression, multiple regression, t-test, one-way variance analysis, Tukey’s post hoc tests, and LSD using SPSS version 22 statistical software.ResultsThe average PMS score of the participants was 30.8 ± 11.45, which indicates severe PMS. Nurses’ average clinical performance score was 45.78 ± 35.29, indicating an average performance. The findings showed that PMS has a significant inverse correlation with clinical performance and its components. Simple linear regression showed that PMS can predict 26.5% of nurses’ clinical performance variance. Simple regression showed that with an increase of one standard deviation in the PMS score, the nurses’ clinical performance score decreased by 0.517 standard deviations and vice versa. However, by controlling confounding variables, with an increase of one standard deviation in the PMS score, the clinical performance score of nurses will decrease by 0.396 standard deviations and vice versa.ConclusionsPaying attention to reducing or controlling PMS symptoms may help improve nurses’ performance. Therefore, hospital and nursing managers can improve the performance and efficiency of their workforce by identifying nurses and other employees suffering from PMS and planning and using different methods to reduce its symptoms.

Efficacy of 0.5 mg Dienogest Tablets in Treating Premenstrual Syndrome-like Symptoms: A Comparative Study with a Low-Dose Estrogen–Progestin Combination

Dysmenorrhea treatment with 0.5 mg dienogest tablets twice daily (1 mg/day) has proven useful, but its effect on premenstrual disorders has not yet been evaluated. This study aimed to evaluate the efficacy of 0.5 mg dienogest tablets in relieving premenstrual syndrome (PMS)-like symptoms during the treatment of dysmenorrhea in comparison with that of continuous low-dose estrogen–progestin (LEP/COC) drospirenone/ethinylestradiol combination, which is considered effective in treating premenstrual dysphoric disorder. During the standard course of dysmenorrhea treatment with dienogest or LEP/COC, PMS-like symptoms were scored based on patients’ reports, and the treatment effects were compared. As a result, the dienogest group experienced a significant improvement in PMS-like symptoms compared with the LEP/COC group over the 6-month study period (p &lt; 0.01). Furthermore, dienogest was more effective in providing relief from PMS-like symptoms, with 89.7% of patients reporting a complete resolution of PMS-like symptoms at 6 months, compared with 47.1% in the LEP/COC group (p &lt; 0.01). These results indicate that dienogest is effective in relieving PMS-like symptoms, similar to LEP/COC. Further studies are needed to determine whether 0.5 mg dienogest tablets, which are only available in Japan, are effective in treating premenstrual disorders diagnosed via standard methods.

Association between severe premenstrual disorders and change of romantic relationship: A prospective cohort of 15,606 women in Sweden

BackgroundPremenstrual disorders (PMDs) affect women's quality of life, yet the impact on romantic relationships remains unclear. This study aimed to examine the association between severe PMDs and relationship disruption and initiation. MethodsWe conducted a prospective cohort study of 15,606 women during 2009–2021 in Sweden. PMDs were assessed with the modified Premenstrual Symptom Screening Tool at baseline (one-time retrospective self-report), while relationship status was obtained from national population registers during follow-up. Poisson regression was employed to assess the risk of relationship change. ResultsAt baseline (mean age 33.5 years), 1666 (10.6 %) women met the criteria for severe PMDs. All women were followed for 9.1 years on average for any change of relationship status. Among married/cohabiting women, PMDs were positively associated with relationship disruption (Incidence risk ratio, IRR =1.21, 95 % CI: 1.01–1.43, p = 0.03). A more pronounced association was suggested for premenstrual dysphoric disorder (IRR = 1.22, 95 % CI: 1.01–1.45, p = 0.03) than severe premenstrual syndrome (IRR = 1.01, 95 % CI: 0.43–1.96, p = 0.98) and among women without depression/anxiety (IRR = 1.21, 95 % CI: 1.00–1.47, p < 0.05) than among those with (IRR = 0.99, 95 % CI: 0.61–1.54 p = 0.96) and IRR = 1.01, 95 % CI: 0.57–1.72, p = 0.97). Among single women, a null association was found between PMDs and relationship initiation (IRR = 1.05, 95 % CI: 0.95–1.15, p = 0.32). LimitationsPMDs were not assessed using prospective symptom charting. ConclusionsMarried/cohabiting women with probable severe PMDs have an increased risk of relationship disruption. PMDs were not associated with relationship initiation in single women. Healthcare professionals should recognize relationship challenges in women with severe PMDs, and they may require support to maintain healthy relationships.

Premenstrual syndrome among medical versus non-medical workers and its association with work-related quality of life

BackgroundPremenstrual syndrome (PMS) is a commonly underestimated disorder that negatively impacts a woman’s life. Medical workers, who live a more stressful life, may report an increased rate of PMS. Studies on the relationship between PMS and work-related quality of life for medical professionals are scarce, particularly in the Arab world. This study aimed to compare the frequency of PMS among medical versus non-medical workers at Zagazig University and to assess the association between PMS and their work-related quality of life.MethodsA comparative cross-sectional study was conducted. The sample population consisted of 48 medical and 48 non-medical female workers aged 18–45 years from Zagazig University. The two groups filled out a questionnaire with 3 parts: sociodemographic and occupational data, the Premenstrual Symptoms Screening Tool (PSST), and the Work-Related Quality of Life Scale (WRQL).ResultsSevere PMS was reported in 45.8% of medical workers versus 20.8% of non-medical workers with a statistically significant difference between both groups (p = 0.009). Binary logistic regression showed that being a medical worker, clinical specialty, ≥ 8 years of work, ≥ 24 working hours per week, and having a non-set hourly schedule were predictors for severe PMS. PMS was found to be a statistically significant predictor of poor WRQL (p < 0.001). There was a highly significant negative correlation between the PMS score and the WRQL score (r = − 0.302, p < 0.001).ConclusionAmong medical workers, PMS is more common and more severe, and WRQL is worse and negatively correlated with PMS. We suggest further studies with larger samples to prove this association and planning for public health programs to screen for and manage PMS among medical workers in our community.

Luteal phase sertraline treatment of premenstrual dysphoric disorder (PMDD): Effects on markers of hypothalamic pituitary adrenal (HPA) axis activation and inflammation

RationalePremenstrual dysphoric disorder (PMDD) is characterized by severe affective symptoms during the luteal phase of the menstrual cycle. There is some evidence of altered interactions between the hypothalamic pituitary gonadal (HPG) and hypothalamic pituitary adrenal (HPA) axes in PMDD. There is also evidence that similar affective disorders such as major depression and perinatal depression are associated with dysregulation in immune factors, but this has not been characterized in PMDD. AimsThe goals of this exploratory study were to identify 1) whether HPA-HPG axis interactions and immune markers differ between PMDD patients and controls across the menstrual cycle; 2) how luteal phase sertraline treatment impacts stress and inflammatory markers. MethodsParticipants were females age 18–50 with regular menstrual cycles, not using psychotropic or hormonal medications, and were assigned to a control group or PMDD group based on prospective daily symptom ratings and clinical interview. Blood was drawn in the follicular and luteal phases, during laboratory sessions involving a mildly stressful task. In a second luteal phase, PMDD participants received open-label sertraline (50 mg/d) from ovulation to menses. Serum cortisol and ACTH were measured via ELISA and operationalized as area under the curve with respect to ground (AUCg), and peak level following laboratory task. Serum TNF-α, IL-6, CXCL-8, and IL-1β were measured using multiplex kits. Serum allopregnanolone (ALLO) was measured by gas chromatography/mass spectroscopy. To characterize HPA-HPG axis interactions across the menstrual cycle in PMDD participants and controls, multilevel linear models predicted cortisol and ACTH from the interaction of cycle phase (controlling for sertraline treatment), ALLO, and group. To determine the effects of sertraline treatment on inflammatory markers and how groups might differ in cyclical change on each marker, multilevel linear models predicted inflammatory markers from cycle phase (controlling for sertraline treatment) and group. A final set of exploratory models tested whether inflammatory markers predict premenstrual symptom score severity. ResultsThe sample included n=77 participants (41 controls, 36 PMDD); 28 participants with PMDD completed sertraline treatment. Group x phase x ALLO interactions showed that higher ALLO levels predicted lower cortisol peak in the treated luteal phase (interaction between phase and ALLO, p=0.042), and there was a higher cortisol peak in the treated luteal phase than the untreated luteal phase (p=0.038). CXCL-8 was significantly associated with premenstrual symptom severity after controlling for group and cycle phase (p=0.011). There were no main effects of group, phase, or ALLO on cortisol AUCg, ACTH AUCg, IL-6, CXCL-8, IL-1β, nor TNF-α (p’s>0.05). ConclusionSerum markers of HPA axis and immune function did not vary by menstrual cycle phase nor PMDD status. However, sertraline treatment in the luteal phase was associated with higher ALLO levels predicting lower cortisol peak in response to mild laboratory stress, suggesting that sertraline treatment may normalize HPG-HPA axis interactions among individuals with PMDD. Greater premenstrual symptomatology was associated with higher levels of the inflammatory marker CXCL-8, but further research is needed into the potential role of inflammation in PMDD.

The Effect of Yoga on Premenstrual Distress, Quality of Life, and Stress Level.

The study aims to evaluate the effect of yoga on the premenstrual syndrome, perceived stress level and the quality of life. The study was conducted as a randomized controlled trial at a university in Turkey. A yoga group = 39, a control group = 41, total of n = 80 female students participated in the study. In the study, firstly, the preview was made, then the yoga group was applied two days a week for eight weeks, the second follow-up was made after the application, and lastly, the last follow-up was made in the 24th week. Four questionnaire surveys were applied on students. When the yoga group compared with the control group in terms of premenstrual syndrome, the quality of life and perceived stress level in the 2nd follow-up, a statistically significant decrease was found in the mean between the menstrual and premenstrual period, and the quality of life increases in the yoga group compared to the control group students. Practicing yoga in university students with premenstrual syndrome reduced premenstrual symptoms and raised quality of life. Yoga can be recommended to girls with premenstrual syndrome (PMS) to reduce PMS and improve quality of life.

Mental health and quality of life in patients with premenstrual exacerbation: a cross-sectional study in Japan

Background In the classification of premenstrual disorders (PMDs), premenstrual exacerbation (PME) is listed as one of the variants of PMDs, along with core PMD. However, the incidence of PME and its impact on mental health and quality of life have not been investigated. Therefore, we investigated the proportion of PME among women seeking treatment for premenstrual symptoms in Japan and compared the levels of anxiety, depression and quality of life between women with PME and those with core PMD. Methods Women who presented to the Department of Obstetrics and Gynaecology of a single institute for treatment of premenstrual symptoms and were diagnosed with PMDs using patient diaries were included in the study. Based on the diagnosis, patients were divided into two groups (core PMD and PME) and their responses to a questionnaire on mental health and quality of life at the first visit were analysed. Results A total of 32 women were diagnosed with PMDs (22 with core PMD and 10 with PME). All underlying medical conditions in women with PME were psychiatric disorders. There were no significant differences in various factors between the two groups. In terms of mental health, the PME group had higher levels of anxiety and depression than the core PMD group. Regarding quality of life, the PME group had lower scores than the core PMD group in all domains except physical and social functioning. Conclusions Patients seeking treatment for premenstrual symptoms included many PME. Women with PME were more anxious and depressed than those with core PMD, and their quality of life was low in both physical and psychological domains. Patients with PME should be diagnosed and treated more appropriately.

Comparison of Prevalence of Premenstrual Syndrome Symptoms among Medical and Non-medical Professional Females and its Association with Depression, Anxiety, and Stress: A Cross-sectional Study

Comparison of Prevalence of Premenstrual Syndrome Symptoms among Medical and Non-medical Professional Females and its Association with Depression, Anxiety, and Stress: A Cross-sectional Study

The relationship between trauma, stress, and premenstrual symptoms: the role of attributional style and trait anger

ABSTRACT Aims The aim of this study was to examine potential mediators of the relationship between traumatic experiences, perceived stress, and the subjective, retrospectively measured, intensity of symptoms of premenstrual disorders. It was hypothesised that pessimistic attributional style and trait anger mediate the said relationship. Methods The study sample comprised 150 non-clinical subjects (aged 18–31; M = 21.82; SD = 2.19). Study variables were assessed with self-report questionnaires: the Premenstrual Symptoms Screening Tool (PSST); the Traumatic Experiences Checklist (TEC); the Perceived Stress Scale-4 Short Form (PSS-4); the Attributional Style Questionnaire (ASQ); and the State-Trait Anger Expression Inventory-2 (STAXI-2 – trait anger subscale). Correlation and mediation analyses were performed. Results The symptoms of premenstrual disorders were significantly and positively associated with both trait anger and pessimistic attributional style, as well as with trauma and stress. The correlations were moderate to strong, ranging from rho = 0.57 (pessimistic attributional style and trauma) to rho = 0.85 (stress and premenstrual symptoms). Both anger and pessimistic attributional style partially mediated the relationship between trauma and premenstrual symptoms and between stress and premenstrual symptoms. Conclusion Although the design of the study does not allow to infer causality, it demonstrates strong, positive relationship between the symptoms of premenstrual disorders, trauma, stress, attributional style, and anger. The results of mediation analyses may point to some practical implications (e.g. for psychotherapeutic interventions) but further studies employing prospective methods are needed.