Premenstrual Syndrome In Women Research Articles

Frequency and severity of premenstrual syndrome in women diagnosed with brucellosis

Aim: Brucellosis is a zoonotic infectious disease caused by Brucella with 4 different subtypes, transmitted to humans mainly through undercooked meat, milk, and dairy products, leading to the involvement of many organs in the body. The purpose of this study is to investigate the frequency and severity of premenstrual syndrome in patients with brucellosis. Methods: The research was conducted at İdil State Hospital in Şırnak between 15.02.2024 and 15.03.2024. The premenstrual syndrome scale and sociodemographic data form were applied to female patients aged 18-50 years who presented to Idil State Hospital between 01.01.2022 and 01.01.2024 and were diagnosed with brucellosis. Results: The mean premenstrual syndrome score of women with brucellosis was 164.87 with a standard deviation of 31.58. In the control group of women who had not been exposed to brucellosis, the mean premenstrual syndrome score was 98.39 with a standard deviation of 40.31. The comparison between the two groups was significant at p<0.05, indicating a significantly higher frequency and severity of premenstrual syndrome in women who had experienced Brucellosis compared to those who had not. Conclusion: Our study investigated the relationship between the frequency and severity of premenstrual syndrome and brucella infection and found that Brucella infection significantly increased the frequency and severity of premenstrual syndrome.

Effect of nutritional interventions on the psychological symptoms of premenstrual syndrome in women of reproductive age: a systematic review of randomized controlled trials.

Premenstrual syndrome (PMS) affects approximately 48% of women of reproductive age worldwide. It can lead to functional impairment, lower quality of life, and decreased work productivity. Despite the availability of medical treatment options, women are seeking alternative interventions because of concerns of harmful side effects and limited evidence of efficacy associated with pharmacological treatments. To date, high-quality research investigating the effects of dietary and nutrient intervention on PMS is limited. This systematic review investigated the effect of nutritional interventions on the psychological symptoms of PMS. Five electronic databases were searched for randomized controlled trials (RCTs) published in English from inception to October 2022. Trials eligible for inclusion were nutritional intervention studies involving women of reproductive age that measured PMS-associated psychological outcomes. Articles were selected using prespecified inclusion criteria. Data screening and extraction and risk-of-bias assessments were conducted by 3 independent reviewers using article screening software and the Cochrane Risk of Bias 2 tool. Thirty-two articles reporting on 31 RCTs involving 3254 participants, ranging in age from 15 to 50 years were included and narratively reviewed. Only 1 of the included studies had a low risk of bias. Treatment with vitamin B6, calcium, and zinc consistently had significant positive effects on the psychological symptoms of PMS. There was insufficient evidence to support the effects of vitamin B1, vitamin D, whole-grain carbohydrates, soy isoflavones, dietary fatty acids, magnesium, multivitamin supplementation, or PMS-specific diets. There is some evidence to support the use of nutritional interventions for improving psychological symptoms of PMS. However, more research using consistent protocols, procedures to minimize risk of bias, intention-to-treat analysis, and clearer reporting is required to provide conclusive nutritional recommendations for improving PMS-related psychological outcomes. CRD42022369999.

Emerging Perspectives on the Impact of Diabetes Mellitus and Anti-Diabetic Drugs on Premenstrual Syndrome. A Narrative Review.

Diabetes mellitus (DM) and premenstrual syndrome (PMS) are global health challenges. Both disorders are often linked to a range of physical and psychological symptoms that significantly impact the quality of life of many women. Yet, the exact relation between DM and PMS is not clear, and the management of both conditions poses a considerable challenge. In this review, we aimed to investigate the interplay between DM, anti-diabetic drugs, and the different theories and symptoms of PMS. Female sex hormones are implicated in the pathophysiology of PMS and can also impair blood glucose control. In addition, patients with diabetes face a higher susceptibility to anxiety and depression disorders, with a significant number of patients experiencing symptoms such as fatigue and difficulty concentrating, which are reported in patients with PMS as well. Complications related to diabetic medications, such as hypoglycemia (with sulfonylurea) and fluid retention (with thiazolidinediones) may also mediate PMS-like symptoms. DM can, in addition, disturb the normal gut microbiota (GM), with a consequent loss of beneficial GM metabolites that guard against PMS, particularly the short-chain fatty acids and serotonin. Among the several available anti-diabetic drugs, those (1) with an anti-inflammatory potential, (2) that can preserve the beneficial GM, and (3) possessing a lower risk for hypoglycemia, might have a favorable outcome in PMS women. Yet, well-designed clinical trials are needed to investigate the anti-diabetic drug(s) of choice for patients with diabetes and PMS.

ShuYu capsule alleviates emotional and physical symptoms of premenstrual dysphoric disorder: Impact on ALLO decline and GABAA receptor δ subunit in the PAG area

Premenstrual dysphoric disorder (PMDD) is a severe subtype of premenstrual syndrome in women of reproductive age, with its pathogenesis linked to the heightened sensitivity of type A γ -aminobutyric acid receptors (GABAAR) to neuroactive steroid hormone changes, particularly allopregnanolone (ALLO). While a low dose of fluoxetine, a classic selective serotonin reuptake inhibitor, is commonly used as a first-line drug to alleviate emotional disorders in PMDD in clinical settings, its mechanism of action is related to ALLO-GABAA receptor function. However, treating PMDD requires attention to both emotional and physical symptoms, such as pain sensitivity. This study aims to investigate the efficacy of ShuYu capsules, a traditional Chinese medicine, in simultaneously treating emotional and physical symptoms in a rat model of PMDD. Specifically, our focus centres on the midbrain periaqueductal grey (PAG), a region associated with emotion regulation and susceptibility to hyperalgesia. Considering the underlying mechanisms of ALLO-GABAA receptor function in the PAG region, we conducted a series of experiments to evaluate and define the effects of ShuYu capsules and uncover the relationship between the drug's efficacy and ALLO concentration fluctuations on GABAA receptor function in the PAG region. Our findings demonstrate that ShuYu capsules significantly improved oestrous cycle-dependant depression-like behaviour and reduced stress-induced hyperalgesia in rats with PMDD. Similar to the low dose of fluoxetine, ShuYu capsules targeted and mitigated the sharp decline in ALLO, rescued the upregulation of GABAAR subunit function, and activated PAG neurons in PMDD rats. The observed effects of ShuYu capsules suggest a central mechanism underlying PMDD symptoms, involving ALLO_GABAA receptor function in the PAG region. This study highlights the potential of traditional Chinese medicine in addressing both emotional and physical symptoms associated with PMDD, shedding light on novel therapeutic approaches for this condition.

Associated Factors with Premenstrual Dysphoric Disorder among Undergraduate Medical Students of a Teaching Hospital

Introduction: Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome in women which adversely affects social, academic, or work performance. The mechanisms underlying PMDD are still insufficiently known, the findings indicate a multifactorial genesis. Prevalence data of PMDD and its potential associated risk factors is sparse in Nepal. This study aimed to determine the associated factors with PMDD among undergraduate medical students of a teaching hospital in Nepal. Methods: This was a cross sectional study conducted among unmarried female medical students at KIST medical college and teaching hospital from 1st June to 30th July, 2023. Students were assigned from each of the four MBBS years (First, Second, Third, and Final) through random sampling till the desired sample size was achieved. Questionnaires about socio-demographic, menstrual, lifestyle variables and questionnaire for diagnosis of PMDD were administered. PMDD was diagnosed from the Diagnostic and Statistical Manual – fifth edition (DSM-5) of the American Psychiatric Association (APA). Data Analysis was performed using SPSS version 16. Data calculated as frequencies, mean, standard deviation and chi square test, independent t test with p-value of < 0.05 was considered as statistically significant. Results: The prevalence of PMDD according to DSM-V criteria was 41 (36.28%). PMDD was significantly associated with dysmenorrhea (P=0.030) and with intake of caffeinated beverages (P=0.034). Conclusion: PMDD is prevalent among medical students in Nepal. The potential associated risk factors are dysmenorrhea and intake of caffeinated beverages.

Effect of pranayama on sympatho-vagal imbalance and cognitive deficit in premenstrual syndrome.

Premenstrual syndrome (PMS) is a prevalent and often neglected condition that affects around 80% of women of reproductive age. In PMS, abnormal fluctuations in gonadal hormones cause altered homeostasis, resulting in sympatho-vagal imbalance and poor cognition. To compare autonomic function parameters and cognitive performance between PMS and control groups, and to study the effect of pranayama on the above parameters in PMS women. It was a randomized control trial. We recruited 40 women of reproductive age who fit the inclusion criteria. They were asked to complete the Premenstrual Syndrome Screening Tool (PSST) questionnaire and were categorized as having PMS (n = 20) or not having PMS (n = 20). All study participants had their baseline CAFT, HRV, BRS, P300, and MOCA values recorded. Following that, participants in the PMS group were divided into two groups of ten at random. For 8 weeks, one group received pranayama training. Following that, all baseline data were recorded again in both the pranayama and no-intervention groups. SPSS version 20 was used to analyze the data. For parametric data, the unpaired t test was used to compare between the PMS and no PMS groups, whereas the Mann-Whitney U test was employed for non-parametric data. To compare the parameters before and after intervention, the Students paired 't' test for parametric data and the Wilcoxan-signed rank test for non-parametric data were used. According to the findings, autonomic function and cognition were considerably affected in the PMS group and improved significantly in the PMS group following pranayama intervention. Pranayama is an effective and safe non-pharmacological method for treating PMS and improving women's quality of life.

Relationship Between Steroid Hormone Profile and Premenstrual Syndrome in Women Consulting for Infertility or Recurrent Miscarriage

To determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a retrospective cross-sectional study on women attending a hospital-based clinic for fertility concerns and/or recurrent miscarriage. All participants were assessed with a women’s health questionnaire which also included evaluation of premenstrual symptoms. Day of ovulation was identified based on the peak mucus symptom assessed by the woman after instruction in a fertility awareness-based method (FABM). This enabled reliable timing of luteal-phase serum hormone levels to be taken and analysed. Between 2011 and 2021, 894 of the 2666 women undertaking the women’s health assessment had at least one evaluable serum luteal hormone test. Serum progesterone levels were up to 10 nmol/L lower for symptomatic women compared with asymptomatic women. This difference was statistically significant (p < 0.05) for the majority of PMS symptoms at ≥ 9 days after the peak mucus symptom. A similar trend was observed for oestradiol but differences were generally not statistically significant. ROC curves demonstrated that steroid levels during the luteal phase were not discriminating in identifying the presence of PMS symptoms. Blood levels for progesterone were lower throughout the luteal phase in women with PMS, with the greatest effect seen late in the luteal phase.

Online positive-oriented counseling, taking vitamin D3 tablet, online lifestyle modification training on premenstrual syndrome: a 3-armed randomized clinical trial

Lack of absolute treatment for premenstrual syndrome (PMS), its cyclic nature, considerable prevalence (70–90%), and its mental and physical burden imply necessity of effectiveness comparison of various treatments. Although antidepressant and hormonal drugs are well-known medications for PMS, in affected women who can’t tolerate, or don’t have compatibility or compliance with these drugs, other effective treatments have always been important concern. This study aimed to compare effectiveness of online positive-oriented counseling, taking vitamin D3 tablet, and online lifestyle modification training on alleviating PMS. 3-armed parallel randomized clinical trial was performed on 84 20–40-year-old eligible women with PMS. 84 women were randomly (www.random.org/sequenc) allocated into three groups, but data of 77 women (1, n = 25) online positive-oriented counseling group (6 sessions), (2, n = 27) vitamin D3 tablet group (one vitamin D3 tablet weekly for 6 weeks), and (3, n = 25) online lifestyle training group (6 sessions) were analyzed. Vitamin D3 was measured at baseline, week6 and fallow up week10. Primary outcome variable PMS was measured with Premenstrual Symptoms Screening Tool (PSST) at baseline, week 6, and follow-up week 10. Primary outcome satisfaction with intervention method was measured using satisfaction scale at week 6 and follow-up week 10. ANOVA, Repeated Measures, and Paired samples t-test were used for statistical analysis. There was no statistically significant difference in PMS at baseline between three groups respectively (33 ± 5.8, 34.1 ± 7.1, & 35.2 ± 6.4, P = 0.500). However, at follow-up week 10, there was statistically significant difference between three groups (22.3 ± 4.3, 25.4 ± 6.5, & 31.8 ± 6.5; P < 0.001), with greatest improvement in online positive-oriented counseling group (P < 0.001). Satisfaction differed significantly among three groups at week 6 (51 ± 6.8, 46.4 ± 12, & 42.3 ± 6.3, P = 0.001) and follow-up week 10 (55.7 ± 11.6, 51.4 ± 12; & 43 ± 3.3, P < 0.001), with most satisfaction in positive-oriented counseling group (P < 0.001). All three interventions alleviated PMS, but online positive-oriented counseling was more effective and satisfying. Superiority of positive-oriented counseling implies mechanism of adaptation, better relationships, forgiveness, self-mood-regulation, and feasibility of its skills that could be continued individually by women after counseling completion. It is recommended health providers, health policymakers and managers support use of these interventions in treatment program and clinical guidelines.Trial registration: RCT registration number: IRCT20191231045967N1, Registration date:11/02/2020, Registration timing: prospective (IRCT | Survey the effect of vitamin D3 tablet intake, positivism group consulting with changing in life style in the treatment of premenstrual syndrome in women).

Dietary intake of micronutrients are predictor of premenstrual syndrome, a machine learning method

Background & Aims Premenstrual syndrome (PMS) is a common disorder affecting 30-40% of women of reproductive age. Many of the modifiable risk factors associated with PMS involve nutrition and poor eating habits. This study aims to explore the correlation between micronutrients and PMS in a group of Iranian women and to build a predictor model showing the PMS using nutritional and anthropometric variables. Methods This is a cross-sectional which was conducted on 223 females in Iran. Anthropometric indices including Body Mass Index (BMI) and skinfold thicknesses were measured. For assessing the dietary intakes of participants, Food Frequency Questionnaire (FFQ) and for analyzing the data, machine learning methods were used. Results After applying different variable selection techniques, we’ve created machine learning models such as KNN. KNN achieved 80.3% accuracy rate and 76.3% F1 score indicating that our model is a curate and valid proof to show a strong relationship between input variables (sodium intake, Skin fold thickness of suprailiac, irregular menstruation, total calorie intake, total fiber intake, trans fatty acids, painful menstruation (dysmenorrhea), total sugar intake, total fat intake, and biotin) and the output variable (PMS). We sorted these effective variables based on their ‘Shapley values’ and we figured out Na intake, suprailiac skinfold thickness, biotin intake, total fat intake and total sugar intake have major impact on having PMS. Conclusions Dietary intakes and anthropometric measurements are highly associated with occurrence of PMS and in our model these variables can predict PMS in women with a high accuracy rate. Premenstrual syndrome (PMS) is a common disorder affecting 30-40% of women of reproductive age. Many of the modifiable risk factors associated with PMS involve nutrition and poor eating habits. This study aims to explore the correlation between micronutrients and PMS in a group of Iranian women and to build a predictor model showing the PMS using nutritional and anthropometric variables. This is a cross-sectional which was conducted on 223 females in Iran. Anthropometric indices including Body Mass Index (BMI) and skinfold thicknesses were measured. For assessing the dietary intakes of participants, Food Frequency Questionnaire (FFQ) and for analyzing the data, machine learning methods were used. After applying different variable selection techniques, we’ve created machine learning models such as KNN. KNN achieved 80.3% accuracy rate and 76.3% F1 score indicating that our model is a curate and valid proof to show a strong relationship between input variables (sodium intake, Skin fold thickness of suprailiac, irregular menstruation, total calorie intake, total fiber intake, trans fatty acids, painful menstruation (dysmenorrhea), total sugar intake, total fat intake, and biotin) and the output variable (PMS). We sorted these effective variables based on their ‘Shapley values’ and we figured out Na intake, suprailiac skinfold thickness, biotin intake, total fat intake and total sugar intake have major impact on having PMS. Dietary intakes and anthropometric measurements are highly associated with occurrence of PMS and in our model these variables can predict PMS in women with a high accuracy rate.

Menstrual irregularity and premenstrual syndrome in women with diabetes in the reproductive age group: a comparative study

Menstrual irregularity and premenstrual syndrome in women with diabetes in the reproductive age group: a comparative study

Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis.

To date, no definitive results have been reported on the effect of omega-3 fatty acids on premenstrual syndrome (PMS). Therefore, this systematic review and meta-analysis aimed to determine the effect of omega-3 fatty acids on PMS. In this systematic review and meta-analysis, the databases were searched. In this regard, randomized clinical trials investigating the effect of omega-3 fatty acids on PMS were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias tool. Meta-analysis was done based on random effects model and calculation of standardized mean difference (SMDs). The results of meta-analysis showed that omega-3 fatty acids were efficient in reducing the severity of PMS in women (SMD=-0.968, 95% confidence interval [CI]: -1.471 to -0.464). In addition, the results showed that the studies were heterogeneous (I2 =89.11%, p <0.001). Based on meta-regression analysis, aging (β=-0.150, 95% CI -0.202 to -0.098, p <0.001) and increasing the duration of intervention (β=-0.579, 95% CI -0.781 to -0.378, p <0.001) had a significant effect on the severity of PMS. We also found that omega-3 fatty acids could significantly reduce the somatic (SMD=-0.800, 95% CI: -1.126 to -0.474) and psychological (SMD=-0.373, 95% CI: -0.686 to -0.061) symptoms of PMS. Omega-3 fatty acids could reduce the severity of PMS. However, we should caution in the conclusion in affirming the beneficial effects of n-3 PUFAs on PMS, since the heterogeneity is evident in the analysis. The efficacy of the treatment was enhanced by increase of the treatment duration.

Cognitive function evaluation in premenstrual syndrome during the follicular and luteal phases using near-infrared spectroscopy

BackgroundMany adult females experience periodic mental and physical symptoms associated with premenstrual syndrome (PMS). Diagnosis of PMS is generally based on self-reported symptoms over several menstrual cycles, but there are concerns about its accuracy and duration. It is well known that decreased cognitive function is one of the symptoms of PMS. Near-infrared spectroscopy (NIRS) is one of the methods for imaging brain activity, similar to magnetic resonance imaging (MRI), electroencephalography (EEG), and positron emission tomography (PET). NIRS has been used to assess cognitive function decline demonstrated by decline in brain activity. However, to the best of our knowledge, there have been no report characterizing brain activity pattern in females with PMS during the luteal and follicular phases separately. ObjectiveWe aimed to characterize the cognitive function of females with PMS during the follicular and luteal phases using NIRS. MethodsThe level of brain activity in the prefrontal cortex was detected with NIRS while PMS women were performing cognitive tasks. NIRS detected brain activity by measuring the oxy-hemoglobin and deoxy-hemoglobin levels. Participants were females between the ages of 20 and 25 with PMS (n = 11) and without PMS (n = 11). During the participants’ follicular and luteal phases, the participants were asked to perform the cognitive task; an N-back task (0-, 1-, and 2-back tasks), which is widely used for assessing cognitive function. We also calculated the oxyhemoglobin integral value during the N-back task using the NIRS signal; this value represented the total amount of change in cerebral oxyhemoglobin and the brain activation level. ResultsThe correct response rate on the 2-back task was significantly lower during both the follicular and luteal phases in females with PMS compared to that in females without PMS (P = 0.01; P = 0.02, during the follicular and luteal phases, respectively). During the luteal phase, brain activation was significantly lower in participants with PMS than in that in females without PMS (P = 0.04). In addition, during the luteal phase, the participants with PMS also had higher negative mood than those without PMS. ConclusionThe cognitive decline during the luteal phase in participants with PMS was detected by NIRS with significant differences from participants without PMS. The difference was observed only during the luteal phase, not in the follicular phase and were related to the increase in negative mood. These results may provide an objective method for diagnosing PMS based on brain activity. We believe that the use of instruments (e.g., NIRS, MRI, EEG … etc.) to detect cognitive function decline will lead to rapid and reliable diagnosis of PMS and premenstrual dysphoric disorder.

Estrous cycle modulates the anxiogenic effects of caffeine in the elevated plus maze and light/dark box in female rats

Caffeine is a commonly used stimulant of the central nervous system that reduces fatigue, increases alertness, and exerts positive effects on emotion through actions on various brain structures. High doses of caffeine can cause headaches, heart palpitations, hyperactivity, and anxiety symptoms. Consequently, reducing the consumption of stimulant substances, such as sugar and caffeine, is proposed to ameliorate symptoms of premenstrual syndrome in women. The administration of steroid hormones has been suggested to modulate the effects of caffeine, but unknown is whether endogenous hormone variations during the estrous cycle modulate the pharmacological effects of caffeine. The present study evaluated the effects of caffeine (10, 20, and 40 mg/kg) during metestrus-diestrus and proestrus-estrus of the ovarian cycle in rats on anxiety-like behavior using the elevated plus maze and light/dark box. During metestrus-diestrus, all doses of caffeine increased anxiety-like behavior, indicated by the main variables in both behavioral tests (i.e., higher Anxiety Index and lower percent time spent on the open arms in the elevated plus maze and less time spent in the light compartment in the light/dark box). During proestrus-estrus, only 20 and 40 mg/kg caffeine increased these parameters of anxiety-like behavior, albeit only slightly. In conclusion, caffeine increased anxiety-like behaviors in metestrus-diestrus, with an attenuation of these effects of lower doses of caffeine in proestrus-estrus. These effects that were observed in metestrus-diestrus and proestrus-estrus may be associated with low and high concentrations of steroid hormones, respectively, that naturally occur during these phases of the ovarian cycle.

Is Premenstrual Syndrome Associated with Inflammation, Oxidative Stress and Antioxidant Status? A Systematic Review of Case-Control and Cross-Sectional Studies.

Premenstrual syndrome (PMS) is a cyclically occurring combination of various symptoms, leading to decreased life quality among approximately 30% of women of childbearing age. PMS etiology remains unknown; however, there are some suggestions that inappropriate inflammatory response and oxidative stress are involved. This study aimed to systematically review case–control and cross-sectional studies investigating inflammation markers, oxidative stress, and antioxidant status among women with PMS and controls. The study protocol was registered with PROSPERO (no. CRD42020178545), and the authors followed the guidelines for performing a systemic review recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). By searching PubMed and Scopus databases (up to 8 January 2021), six case–control studies and five cross-sectional studies of medium or high quality were classified to the review. The systematic review included 652 women with PMS and 678 controls, for whom 36 eligible markers were determined. Limited evidence indicates increased levels of inflammatory parameters and suggests decreased antioxidant status in PMS women. Insufficient data with inconsistent results made it impossible to formulate a firm conclusion on the contribution of oxidative stress in PMS occurrence. To acknowledge the role of inflammation, oxidative stress, and antioxidant status in the pathophysiology of PMS, further research with case–control design and large study groups is needed.

Determine of the Prevalence of Premenstrual Syndrome and Related Factors

Aim: Premenstrual syndrome is the periodic recurrence of a group of psychological, behavioral and physical symptoms related to the menstrual cycle. These symptoms arise especially in the middle of the luteal phase of the menstrual cycle and disappear when menstruation starts. The objective of this study was to determine the prevalence of premenstrual syndrome in women in reproductive age between 15 and 49 years old, and to investigate the relationship between premenstrual syndrome and sociodemographic variables. Method: A cross-sectional design was employed. The study was carried out on 500 women. The face to face interview, sociodemographic data form and Premenstrual Syndrome Scale were applied to the women for data collection. As for data analysis, percentage tests, chi-square test and logistic regression analysis were utilized. Results: PMS prevalence of women included in this study was found to be 47%. Premenstrual syndrome symptoms in order of severity are pain, bloating, fatigue, change in appetite, irritability, and anxiety. It was found that being in the age group between 15-46, being single, smoking, having dysmenorrhea, and familial premenstrual syndrome history have direct effect on PMS. Conclusion: It was observed that the prevalence of PMS in women is quite high. Greater importance should be attached to the issue and necessary precautions should be taken for risk groups in order to decrease PMS prevalence and improve women’s quality of life.

Yoga a Therapy to Improve Anxiety in Premenstrual Syndrome Women

Yoga a Therapy to Improve Anxiety in Premenstrual Syndrome Women

Comparison of Vegetable Intake in Nurses with and without Premenstrual Syndrome: A Case-Control Study

Objectives: Premenstrual syndrome (PMS) is a common cyclic disorder in women, which is characterized by multiple emotional or physical symptoms. The protective effect of vegetable intake against PMS was not completely investigated. Thus, in the current study, we compared vegetable intake in nurses with and without PMS. Methods: In this case-control study, 307 female nurses with PMS (n = 156) and without PMS (n = 151) were participated from eight hospitals affiliated to the Tehran University of Medical Sciences, Iran. This study was performed from March to October 2014. Anthropometric measurements were performed for all nurses using standard methods. International physical activity questionnaire (IPAQ) was used for the physical activity assessment. The premenstrual symptoms screening tool (PSST) was applied to identify women who suffer from PMS. A validated semi-quantitative food frequency questionnaire (FFQ) was used for dietary intake measurement during the past years. Results: Across increasing total vegetable quartiles, individuals had a significantly higher energy intake (P < 0.001). A significant difference was found in job duration, working shift, and physical activity, according to quartiles of total vegetable intakes (P < 0.05). A significant difference was observed in the mean intake of cruciferous vegetables between cases and controls (P = 0.001). Healthy women had significantly more cruciferous vegetable intakes compared to PMS women (6.8 ± 3.9 vs 4.0 ± 3.3). After adjusting for the confounders such as total vegetables, cruciferous vegetables, green leafy vegetables, dark yellow vegetables, and other vegetables, subjects in the highest quartile of cruciferous vegetables had lower odds (ratio OR) of PMS compared with those in the lowest-quartile (P = 0.002; OR = 0.33; CI = 0.16 - 0.67). Conclusions: Our findings showed that higher consumption of cruciferous vegetables might be associated with a lower OR of PMS.

Current evidence for the identification and management of premenstrual syndrome in women with intellectual disabilities: a systematic review

PurposeIntellectual disability (ID) is prevalent in 1 per cent of the population. Premenstrual syndrome (PMS) affects up to 5 per cent of the general population of adult women. Identification of PMS is challenging in women with ID due to differences in communication. Management of PMS in the ID population requires careful consideration of baseline function, co-existing mental and physical health problems, drug interactions as well as complex ethical considerations. The paper aims to discuss this issue.Design/methodology/approachProspero-registered systematic review (CRD42019119398) of papers exploring the diagnosis and management of patients with PMS and ID (n=414). In total, 35 relevant titles were identified and 27 full text papers were assessed for eligibility, resulting in 10 studies for final qualitative analysis.FindingsTen original research papers were included. There are no standardised symptom criteria for diagnosis of PMS in women with ID. Studies relied on observer-reported data. All papers demonstrated higher rates of PMS in women with ID compared with the general adult population. Management was not standardised and varied between centres. Mainstays of treatment included non-steroidal anti-inflammatories, combined oral contraceptive pills and intramuscular progesterone. Newer evidence suggests levonorgestrel intrauterine systems may be appropriate. There was no quantitative method of establishing success of management.Practical implicationsA modified symptom diary should be used for diagnosis in this population. Differentiation between cyclical behavioural change due to pain vs mood disturbance remains challenging. Conservative, psychological and medical management should be the mainstay of treatment, with surgery considered in exceptional cases.Originality/valueThis paper demonstrates the current limited evidence for the management of PMS in women with a diagnosis of ID and offers an overview of the current options for managing these patients’ symptoms.

Vitamin D and Premenstrual Syndrome in Healthy Women with Regular Cycles (P18-056-19)

ObjectivesVitamin D levels have been associated with premenstrual syndrome (PMS) and symptom severity, but data are mixed. Our aim was to assess the relationship between serum vitamin D and PMS in women with regular menstrual cycles. MethodsWe looked at vitamin D and PMS using two cohorts of healthy women with regular cycles. BioCycle followed 76 women, for up to 2 menstrual cycles prospectively and EAGeR followed 1191 women with 1–2 prior pregnancy losses. 25(OH)D was measured in serum at baseline in both cohorts, with PMS assessed via questionnaire evaluating the presence and severity of 14 psychological and physical menstrual symptoms the week before and after menses. EAGeR assessed symptoms over the past year, and BioCycle assessed symptoms prospectively over the next cycle. We used status and PMS associations adjusting for age, BMI, race, smoking, income, physical activity, and season of blood draw. Results54% and 47% of women had sufficient 25(OH)D (≥30 ng/mL) and 33% and 40% exhibited PMS in BioCycle and EAGeR, respectively. Vitamin D status was not associated with risk of PMS in either cohort (BioCycle: D insufficiency was associated with risk of breast fullness/tenderness (RR 1.27, 95% CI 1.03, 1.55) and generalized aches and pains (RR 1.33, 95% CI 1.01, 1.78), compared to women with vitamin D sufficiency. Similar associations were observed in BioCycle though confidence intervals were wide. No associations were observed between vitamin D status and psychological symptoms. ConclusionsAmong women with regular menses, 25(OH)D was not associated with PMS, though it may be associated with individual symptoms. Additional studies are needed to understand these relationships in women with irregular menstrual. Funding SourcesIntramural Research Program, Division of Population Health Research, NICHD. NIH Medical Research Scholars Program. Doris Duke Charitable Foundation.

Short-term, low-dose fluoxetine prevents oestrous cycle-linked increase in anxiety-like behaviour in female rats.

We sought a robust behavioural test that evoked increased anxiety-like behaviour during the late dioestrus phase of the oestrous cycle (similar to the premenstrual period in women) and tested whether this could be prevented by acute low-dose fluoxetine (FLX). Female Wistar rats in different stages of their cycle were exposed to four different tests of anxiety-like behaviour. No oestrous cycle differences were detected in fear potentiated startle or conditioned freezing to an aversive context. In a light switch-off test where rats move from one compartment of a shuttle-box to the other to turn off an aversive light, females displayed enhanced responding in late dioestrus. During isolation restraint stress females in late dioestrus emitted three times more 22 kHz ultrasound vocalisations (USV) than at other cycle stages. Using the USV test, short-term administration of low-dose FLX (1.75 mg kg-1, i.p.) designed to blunt the sharp fall in brain allopregnanolone concentration during late dioestrus but without affecting 5-HT systems, prevented the increase in isolation stress-evoked USVs. The light switch-off and isolation restraint-induced USV tests evoke unconditioned adverse emotional responses that are ethologically relevant and sensitive to oestrous cycle stage. The USV test fulfils many criteria required of a model for premenstrual syndrome in women. Using the USV test, short-term administration of FLX to increase brain allopregnanolone concentration without affecting 5-HT systems prevented the increased USV responding in late dioestrus. Short-term low-dose FLX treatment may have potential to alleviate development of adverse premenstrual symptoms in women.