Premenstrual Syndrome Patients Research Articles

Relation between metabolic syndrome and psychiatric symptoms severity in women with premenstrual syndrome

BackgroundPremenstrual syndrome (PMS) is a clinical condition characterized by recurrent moderate-to-severe affective, physical, and behavioral symptoms during the menstrual cycle. The present study aimed to assess the relation between metabolic syndrome (MetS) and symptoms severity in patients with premenstrual syndrome (PMS). This multicentric propensity score matched analysis included 300 women with PMS. They comprised 150 women with MetS and 150 women without MetS. Diagnosis of PMS was based on the validated Arabic version of Premenstrual Symptoms Screening Tool (PSST). For the diagnosis of MetS, we adopted the Harmonized Joint Scientific Statement (HJSS) on metabolic syndrome recommendations.ResultsThe present study included 300 patients with PMS. They comprised 150 patients with MetS and 150 patients without MetS. Comparison between the studied groups regarding the demographic and clinical data showed that patients with MetS had significantly higher BMI (30.5 ± 3.0 versus 25.2 ± 3.5 kg/m2, p < 0.001) and longer symptoms duration (4.4 ± 0.9 versus 3.3 ± 1.1 days, p < 0.001). Patients with MetS included higher frequency of moderate-to-severe PMS (35.3% versus 20.7%, p = 0.005). In patients with MetS, it was found that patients with moderate-to-severe PMS have significantly higher BMI, younger age at menarche and longer symptoms duration. Multivariate logistic regression analysis identified age at menarche [OR (95% CI): 0.7 (0.55–0.9), p = 0.005], PMS symptoms duration [OR (95% CI): 4.45 (3.0–6.6), p < 0.001] and MetS [OR (95% CI): 1.67 (1.34–2.53), p = 0.017] as significant predictors of moderate-to-severe PMS.ConclusionsMetS is related to symptoms severity in PMS patients.

Efficacy and Tolerability Evaluation of a Nutraceutical Composition Containing Vitex agnus-castus Extract (EVX40™), Pyridoxine, and Magnesium in Premenstrual Syndrome: A Real-World, Interventional, Comparative Study.

Background Pre-menstrual syndrome (PMS) is a condition associated with altered hormone levels during the menstrual phase of females and is characterised by physical, emotional, and behavioural symptoms that have a negative impact on the quality of life of females. The symptoms of PMS may vary between individuals, but the major complication is pain, especially during menstrual days. The current treatment strategy involves the use of hormonal therapies and analgesics for symptomatic relief, but these therapies have a risk of potential side effects. The use of herbal and nutraceutical supplements in PMS conditions is increasing due to their long-term safety and proven efficacy. The current real-world study aimed to evaluate the efficacy and tolerability of Ezedayz® tablets containing Vitex agnus-castus extract (EVX40™), vitamin B6, and magnesium in PMS subjects. Methodology A real-world, open-label study was conducted involving 64 participants with varied severity of PMS symptoms. Participants were categorised into Group A (N=23) receiving standard therapies, Group B (N=20) receiving Ezedayz®tablets, or Group C (N=21) receiving standard and Ezedayz®therapy. Standard therapies were provided as per physician supervision, and Ezedayz® tablets were given for 90 days. All subjects were evaluated on core symptoms of PMS like menstrual backache, menstrual cramps, joint or muscle pain, and headache using the numerical rating scale (NRS), and quality-of-life (QoL) was evaluated using a QoL questionnaire. A spontaneous reporting methodology was used to evaluate the tolerability of the therapies provided. Statistical analysis was performed as per the statistical plan. A p-value of <0.05 was considered statistically significant. Results Out of 64 participants, five were lost to follow-up, and the data of 59 participants were included in the final analysis. All groups showed improvement in all evaluated parameters, but Group B and Group C showed greater improvement at the end of the study in all evaluated parameters. The quality-of-life assessment revealed greater improvement in Group B and Group C participants compared to Group C in all evaluated QoL parameters. No serious side effects were observed in any subjects. Conclusion The results of the current study conclude that the nutraceutical composition of Vitex agnus-castus extract, vitamin B6, and magnesium is effective in reducing the severity of PMS symptoms and improving the quality of life of PMS subjects. The nutraceutical therapy provided greater relief from PMS symptoms compared to standard therapy alone, and this effect was augmented when the nutraceutical therapy was provided in combination with standard therapies. Similarly, the improvement in quality-of-life parameters was greater in subjects treated with nutraceuticals alone or in combination therapy. Despite the limitations of the study, the results of the current study are promising, and the nutraceutical composition (Ezedayz®) can be effectively used in clinical settings to control symptoms and improve the quality of life of PMS patients.

Altered functional connectivity density and structural covariance networks in women with premenstrual syndrome.

Premenstrual syndrome (PMS) is a menstrual-related disorder, characterized by physical, emotional, behavioral and cognitive symptoms. However, the neuropathological mechanisms of PMS remain unclear. This study aimed to investigate the frequency-specific functional connectivity density (FCD) and structural covariance in PMS. Functional and T1-weighted structural data were obtained from 35 PMS patients and 36 healthy controls (HCs). This study was a cross-sectional and prospective design. The local/long-range FCD (LFCD/LRFCD) across slow-4 (0.027-0.073 Hz) and slow-5 (0.01-0.027 Hz) bands were computed, and two-way analysis of variance (ANOVA) was performed to ascertain the main effects of group and interaction effects between group and frequency band. Receiver operating characteristic (ROC) curve was performed to investigate reliable biomarkers for identifying PMS from HCs. Based on the ROC results, characterized the changes of whole-brain structural covariance patterns of striatum subregions in two groups. Correlation analysis was applied to examine relationships between the clinical symptoms and abnormal brain regions. Compared with HCs, PMS patients exhibited: (I) aberrant functional communication in the middle cingulate cortex and precentral gyrus; (II) significant frequency band-by-group interaction effects of the striatum, thalamus and orbitofrontal cortex; (III) the better classification ability of the LFCD in the striatum in ROC analysis (slow-5); (IV) decreased gray matter volumes in the caudate subregions and decreased structural associations of between the caudate subregions and frontal cortex; (V) the LFCD value in thalamus were significantly negatively correlated with the sleep problems (slow-5). Based on multi-modal magnetic resonance imaging (MRI) analysis, this study might imply the aberrant emotional regulation and cognitive function related to menstrual cycle in PMS and improve our understanding of the pathophysiologic mechanism in PMS from novel perspective.

Brain Activation During Processing of Depression Emotion in College Students With Premenstrual Syndrome in China: Preliminary Findings.

BackgroundThis study aimed to investigate the neural substrates of processing depression emotion in premenstrual syndrome (PMS) and healthy subjects of college students using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI).MethodsDuring BOLD-fMRI scanning, 13 PMS patients and 15 healthy controls (HC) performed a picture visual stimulation task during luteal and follicular phases, in which participants and HC were asked to see pictures containing depression and non-depression emotions. Simultaneously, self-rating depression scales (SDS) were employed to evaluate the emotional status of participants.ResultsCompared to HC, right inferior occipital gyrus, right middle occipital gyrus, right lingual gyrus, right fusiform gyrus, right inferior temporal gyrus, cerebelum_crus1_R, cerebelum_6_R, culmen, the cerebellum anterior lobe, tuber, and cerebellar tonsil of PMS patients showed enhanced activation. In contrast, sub-lobar, sub-gyral, extra-nuclear, right orbit part of superior frontal gyrus, right middle temporal gyrus, right orbit part of inferior frontal gyrus, limbic lobe, right insula, bilateral anterior and adjacent cingulate gyrus, bilateral caudate, caudate head, bilateral putamen, and left globus pallidus exhibited decreased activation.ConclusionThe findings indicate that abnormal functional regulation of brain regions such as occipital lobe and cerebellum leads to abnormal changes in emotional regulation, cognitive ability, and attention distribution in PMS patients, implying significant central pathogenesis.

The Concentration of 8-Hydroxy-2'-Deoxyguanosine in Plasma During the Menstrual Cycle in Young Japanese Women.

Background: The exact pathophysiology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is still unknown. This study aimed to investigate the concentration of 8-hydroxy-2′-deoxyguanosine (8-OHdG) in plasma in relation to the menstrual cycle and the severity of premenstrual symptoms in young Japanese women.Methods: The study included 21 healthy Japanese women 19–24 years of age. Fourteen women had no or mild PMS [PMS (−)], while five women had moderate to severe PMS and two women exhibited PMDD [PMS (+)]. The concentration of 8-OHdG in plasma was measured by means of high-performance liquid chromatography–electrochemical detector. The Center for Epidemiologic Studies Depression (CES-D) scale was used to evaluate the depressive tendency.Results: The concentration of 8-OHdG before menstruation was significantly higher than that after menstruation in total subjects (p = 0.04). In the PMS (+) group, the 8-OHdG concentration before menstruation was higher than that after menstruation (p = 0.02). Moreover, the PMS (+) group showed a higher 8-OHdG concentration compared with the PMS (−) group before menstruation (p < 0.01), as well as higher CES-D scores compared with the PMS (−) group both before and after menstruation (p < 0.01).Conclusions: These results suggested that the oxidation of DNA occurred before menstruation in PMS. The depression was associated with PMS symptoms both before and after menstruation in patients with PMS. Oxidation of DNA due to oxidative stress and depression in PMS patients may be involved in the pathogenesis of PMS. Clinical Trial Registration number 15-02-011.

Altered resting-state functional networks in patients with premenstrual syndrome: a graph-theoretical based study.

Premenstrual syndrome (PMS) is a menstrual cycle-related disorder. Previous studies have indicated alterations of brain functional connectivity in PMS patients. However, little is known about the overall organization of brain network in PMS patients. Functional magnetic resonance imaging data deriving from 20 PMS patients and 21 healthy controls (HCs). Pearson correlation between mean time-series was used to estimate connectivity matrix between each paired regions of interest, and the connectivity matrix for each participant was then binarized. Graph theory analysis was applied to assess each participant's global and localtopological properties of brain functional network. Correlation analysis was performed to evaluate relationships between the daily rating of severity of problems (DRSP) and abnormal network properties. PMS patients had lower small-worldness values than HCs. PMS-related alterations of nodal properties were mainly found in the posterior cingulate cortex, precuneus and angular gyrus. The PMS-related abnormal connectivity components were mainly associated with the thalamus, putamen and middle cingulate cortex. In the PMS group, the DRSP score werenegatively correlated with the area under the curves of nodal local efficiency in the posterior cingulate cortex. Our study suggests that the graph-theory method may be one potential tool to detect disruptions of brain connections and may provide important evidence for understanding the PMS from the disrupted network organization perspective.

Increased Incidence of Premenstrual Syndrome in Females with Palmar Hyperhidrosis.

Background: Premenstrual syndrome (PMS) is a common disorder affecting the quality of life of women of reproductive age. In a previous study, sex hormone imbalances and alterations in autonomic function were present in PMS, with parasympathetic dysfunction and sympathetic overactivity during the late luteal phase. Palmar hyperhidrosis (PH) presents with oversweating, heat and emotional stimulation, sympathetic hyperactivity and parasympathetic hypofunction. We hypothesized that the incidence of PMS is increased in females with PH. Methods: Data were retrieved from the Taiwanese National Health Insurance Database. The patients with PH were identified by the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) disease code 780.8. Female patients matched by age and index day were used as the control group. The incidence of PMS was considered an outcome by the ICD-9-CM disease code 625.4. The factors related to PMS were analyzed by Cox regression. Results: The adjusted hazard ratio for the incidence of PMS was 1.276 (95% confidence interval: 1.05–1.488) in females with PH. Conclusions: This study found a positive correlation between PMS and female PH patients. Patients and physicians must understand the relationship of PMS with autonomic function alterations and other risk factors to prevent this problematic disorder.

Regulated aberrant amygdala functional connectivity in premenstrual syndrome via electro-acupuncture stimulation at sanyinjiao acupoint（SP6）

Background: Acupuncture is an effective therapy for premenstrual syndrome (PMS). However, the mechanisms behind this method are still unclear. Our previous study found that aberrant amygdala resting-state functional networks were involved in PMS. Thereby, a deep investigation on the alterations of amygdala resting-state functional networks induced by acupuncture stimulation might contribute to a better understanding of the intricate mechanisms of acupuncture treatment on PMS. Methods: Twenty three PMS patients were recruited in this study. All patients received a 6-minute electro-acupuncture stimulation (EAS) at Sanyinjiao acupoint (SP6) and underwent two 6-minute resting-state fMRI scannings before and after EAS. With amygdala as the seed region, functional connectivity (FC) method was adopted to examine EAS-related modulation of intrinsic connectivity in PMS patients by comparing pre-EAS. Results: The results showed that EAS at SP6 induced increased FC between the left amygdala and brainstem, right hippocampus, and decreased FC between the left amygdala and left thalamus, bilateral supplementary motor area (SMA). Moreover, the results also showed that EAS at SP6 induced increased FC between the right amygdala and brainstem, right hippocampus, right orbitofrontal cortex, bilateral anterior cingulate cortex (ACC), and decreased FC between the right amygdala and right SMA. Conclusions: Based on the results of our previous study, our findings might improve our understanding of neural mechanisms behind acupuncture effects on PMS.

Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial

Women with premenstrual syndrome (PMS) often complain about depression when their menstrual cycle begins. This study investigated the effects of yoga on women with PMS suffering from depression during menstrual cycle. MethodsThis randomized controlled clinical trial was conducted from April to October 2015 in Tabriz, Iran. All subjects (20–45 years old), who were frequently referred to the private obstetrics and gynecology clinics, were initially monitored for PMS and depression. Subjects completed the demographic and Beck Depression Inventory-II (BDI-II) questionnaires before and after intervention. In addition, subjects were monitored for eligible and ineligible criteria. In this study 62 subjects were randomly selected for the yoga group and control groups. Subjects practiced yoga over two months in three sessions, the duration of each session was 60 min. ResultsThe general score of the depression after yoga intervention was statistically significant compared to the control group (P < 0.036) and yoga group before intervention (P < 0.001). The diastolic pressure decreased significantly after yoga intervention (P < 0.029). Yoga decreased the state of depression and diastolic pressure of the subjects with PMS complaining from depression. ConclusionWe conclude that yoga has strong effects on depression symptoms and blood pressure, therefore it can be used as a complementary or alternative remedy for PMS patients.

Remote intervention using smartphone for rural women suffering from premenstrual syndrome: A propensity score matched analysis.

Timely treatment of premenstrual syndrome (PMS) is not always available for rural women, because the local medical resources are insufficient. The efficacy of remote intervention by smartphone on PMS has not been confirmed.A retrospective analysis was performed on rural PMS patients between January 2014 and December 2015. After a propensity score matched analysis, 60 patients were enrolled and evenly divided into remote group and outpatient group. Multidisciplinary therapy including cognitive-behavioral therapy (CBT), oral medication, and physical exercise education was used individually, in accordance with their symptoms evaluated by Daily Record of Severity of Problems (DRSP) questionnaire. Patients in remote group utilized WeChat software by smartphone for therapy guidance, while those in outpatient group attended face-to-face interview. Their DRSP scores in 5 new menstrual cycles after therapy were recorded. Then, they were followed up for 1 year.Total DRSP scores of the cases in both groups after initial intervention were less than those before therapy (P < .001), without group difference (P > .05). However, patients in remote group indicated a higher satisfactory rate than the outpatient group (P = .03). On the 1-year follow up, patients in both groups demonstrated similar DRSP scores (P = .07), but the satisfactory rate in remote group was encouragingly higher than that in the outpatient group (P = .02).The efficacy of remote intervention using smartphone on PMS is noninferior to traditional outpatient visits. Nevertheless, high-quality trials are needed.

Altered Brain Regional Homogeneity Following Electro-Acupuncture Stimulation at Sanyinjiao (SP6) in Women With Premenstrual Syndrome.

Background: Premenstrual syndrome (PMS) is a menstrual cycle-related disorder which causes physical and mood changes prior to menstruation and is associated with the functional dysregulation of the brain. Acupuncture is an effective alternative therapy for treating PMS, and sanyinjiao (SP6) is one of the most common acupoints used for improving the symptoms of PMS. However, the mechanism behind acupuncture’s efficacy for relieving PMS symptoms remains unclear. The aim of this study was to identify the brain response patterns induced by acupuncture at acupoint SP6 in patients with PMS.Materials and Methods: Twenty-three females with PMS were enrolled in this study. All patients underwent resting-state fMRI data collection before and after 6 min of electroacupuncture stimulation (EAS) at SP6. A regional homogeneity (ReHo) approach was used to compare patients’ brain responses before and after EAS at SP6 using REST software. The present study was registered at http://www.chictr.org.cn, and the Clinical Trial Registration Number is ChiCTR-OPC-15005918.Results: EAS at SP6 elicited decreased ReHo value at the bilateral precuneus, right inferior frontal cortex (IFC) and left middle frontal cortex (MFC). In contrast, increased ReHo value was found at the bilateral thalamus, bilateral insula, left putamen and right primary somatosensory cortex (S1).Conclusions: Our study provides an underlying neuroimaging evidence that the aberrant neural activity of PMS patients could be regulated by acupuncture at SP6.

Thalamocortical dysconnectivity in premenstrual syndrome.

Premenstrual syndrome (PMS) is a menstrual cycle-related disorder. Although the precise pathophysiology is not fully understood, it is increasingly believed that the central nervous system plays a vital role in the development of PMS. The aim of this study is to elucidate specific functional connectivity between the thalamus and cerebral cortex. Resting-state functional magnetic resonance imaging (fMRI) data were obtained from 20 PMS patients and 21 healthy controls (HCs). Seed-based functional connectivity between the thalamus and six cortical regions of interest, including the prefrontal cortex (PFC), posterior parietal cortex, somatosensory cortex, motor cortex/supplementary motor area, temporal and occipital lobe, was adopted to identify specific thalamocortical connectivity in the two groups. Correlation analysis was then used to examine relationships between the neuroimaging findings and clinical symptoms. Activity in distinct cortical regions correlated with specific sub-regions of the thalamus in the two groups. Comparison between groups exhibited decreased prefrontal-thalamic connectivity and increased posterior parietal-thalamic connectivity in the PMS patients. Within the PMS group, the daily record of severity of problems (DRSP) score negatively correlated with the prefrontal-thalamic connectivity. Our findings may provide preliminary evidence for abnormal thalamocortical connectivity in PMS patients and may contribute to a better understanding of the pathophysiology of PMS.

Altered brain structure in women with premenstrual syndrome

BackgroundFunctional brain abnormalities have been noted in premenstrual syndrome (PMS). However, the brain structural alterations related to PMS remain unclear. This study aimed to identify possible abnormalities in gray matter (GM) volumes and structural covariance patterns among PMS patients. MethodsStructural magnetic resonance imaging data were obtained from 20 PMS patients and 20 healthy controls. Voxel-based morphometry (VBM) analysis was applied to examine GM volumes changes between the two groups. Receiver operating characteristic (ROC) curve was used to investigate the most reliable biomarker for distinguishing PMS patients from health controls based on the intergroup differences. Correlation analysis was then performed to assess relationships between the daily rating of severity of problems (DRSP) and abnormal brain regions. Finally, the regions identified from VBM analysis were served as seeds to characterize the whole-brain structural covariance patterns. ResultsCompared with healthy controls, PMS patients showed increased GM volumes in the precuneus/posterior cingulate cortex (precuneus/PCC) and thalamus, and decreased GM volumes in the insula. The precuneus/PCC exhibited the highest classification power by ROC analysis and positively correlated with the DRSP. Moreover, different patterns of structural covariance in the two groups were mainly located in the dorsolateral prefrontal cortex, anterior cingulate cortex, angular gyrus and hippocampus. LimitationsThis study is limited by a small sample and narrow age range of participants. ConclusionsOur findings may provide preliminary evidence for brain morphology alterations in PMS patients and contribute to a better understanding of the pathophysiology of PMS.

Larger volume and different functional connectivity of the amygdala in women with premenstrual syndrome.

To assess structural and functional changes of the amygdala due to premenstrual syndrome (PMS) using magnetic resonance imaging (MRI). Twenty PMS patients and 21 healthy control (HC) subjects underwent a 6-min resting-state fMRI scan during the luteal phase as well as scanning high-resolution T1-weighted images. Subcortical amygdala-related volume and functional connectivity (FC) were estimated between the two groups. Each subject completed a daily record of severity of problems (DRSP) to measure the severity of clinical symptoms. Greater bilateral amygdalae volumes were found in PMS patients compared with HC subjects, and PMS patients had increased FC between the amygdala and certain regions of the frontal cortex (e.g. medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), right precentral gyrus), the right temporal pole and the insula, as well as decreased FC between the bilateral amygdalae and the right orbitofrontal cortex and right hippocampus. The strength of FC between the right amygdala and right precentral gyrus, left ACC and left mPFC were significantly and positively correlated with DRSP scores in PMS patients. Our findings may improve our understanding of the neural mechanisms involved in PMS. • Functional and structural MRI used to explore amygdala in PMS patients. • Aberrant amygdala structural and functional connectivity were found in PMS patients. • Amygdala strength FC was positively correlated with individual clinical symptom scores.

Hippocampal fractional amplitude of low-frequency fluctuation and functional connectivity changes in premenstrual syndrome.

To investigate differences in hippocampal activity between premenstrual syndrome (PMS) patients and healthy controls, to elucidate the neural mechanisms of PMS. Twenty female patients with PMS (PMS group) and 21 healthy controls (HC group) underwent a single-shot gradient-recalled echo planar imaging (EPI) sequence scan during the luteal phase in 3.0 Tesla MRI. Spontaneous neural activity in hippocampus (HIPP) was measured by fractional amplitude of low-frequency fluctuation (fALFF). Functional connectivity (FC) was used to examine the neural networks of PMS patients by selecting the abnormal HIPP as the seed region. All participants completed a daily record of severity of problems (DRSP) questionnaire to measure the severity of clinical symptoms. Results from a two-sample t-test showed increased left HIPP fALFF in the PMS group compared with the HC group (P = 0.042), while there was no between-group difference of fALFF in the right HIPP (P = 0.1011). A secondary analysis using a two-sample t-test with the left HIPP as the seed region, the results revealed that the PMS group exhibited increased FC between the left HIPP and left medial prefrontal cortex (mPFC), left posterior cingulate cortex (PCC), right middle cingulate cortex (MCC), and bilateral precentral cortex (PC), while decreased FC between the left HIPP and right orbitofrontal cortex (OFC). Moreover, the PMS group exhibited higher DRSP scores, which were positively correlated (r = 0.64, P = 0.003) with FC between the left HIPP and mPFC during the luteal phase. Altered spontaneous neural activity and connectivity of left HIPP may be involved in PMS. 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:545-553.

Premenstrual syndrome and fibromyalgia: the frequency of the coexistence and their effects on quality of life

Objective: We aimed to investigate the association between Premenstrual syndrome (PMS) and fibromyalgia syndrome (FMS), to assess common symptoms and quality of life (QOL) of them.Methods: Patients with PMS formed the PMS group and age-matched healthy normal controls were included in the control group. The diagnosis of the FMS and PMS were based on new American College of Rheumatology FMS criteria and DSM-IV PMS criteria. FMS-related symptoms assessed by visual analog scale and number of tender points (TePs) were analyzed. QOL, PMS severity and FMS severity were assessed with SF-36, fibromyalgia impact questionnaire (FIQ) and premenstrual assessment form (PAF), respectively. Patients with PMS were divided into two subgroups according to coexistence of FMS or not.Results: The frequency of FMS in PMS and control group were 20 and 0%, respectively (p = 0.002). FMS-related symptoms, number of TePs in the PMS group were higher than those in the control group. The mean mental component summary (MCS) score of SF-36 was low in the PMS group. The mean PAF score in PMS with FMS subgroup was higher than those in without FMS subgroup. The mean physical component summary of SF-36 was low in the PMS patient with FMS. There was correlation between PAF score and FIQ score (r = 0.476, p < 0.001).Conclusion: FMS was common among the patients with PMS and frequently seen in the PMS patients having severe premenstrual complaints. Mental QOL was distressed in the patients with PMS but while FMS accompanied to PMS, the physical QOL was decreased.

Abnormal Spontaneous Brain Activity in Women with Premenstrual Syndrome Revealed by Regional Homogeneity.

Background: Previous studies have revealed that the etiologies of premenstrual syndrome (PMS) refer to menstrual cycle related brain changes. However, its intrinsic neural mechanism is still unclear. The aim of the present study was to assess abnormal spontaneous brain activity and to explicate the intricate neural mechanism of PMS using resting state functional magnetic resonance imaging (RS-fMRI).Materials and Methods: The data of 20 PMS patients (PMS group) and 21 healthy controls (HC group) were analyzed by regional homogeneity (ReHo) method during the late luteal phase of menstrual cycle. In addition, all the participants were asked to complete a daily record of severity of problems (DRSP) questionnaire.Results: Compared with HC group, the results showed that PMS group had increased ReHo mainly in the bilateral precuneus, left inferior temporal cortex (ITC), right inferior frontal cortex (IFC) and left middle frontal cortex (MFC) and decreased ReHo in the right anterior cingulate cortex (ACC) at the luteal phase. Moreover, the PMS group had higher DRSP scores, and the DRSP scores positively correlated with ReHo in left MFC and negatively correlated with ReHo in the right ACC.Conclusion: Our results suggest that abnormal spontaneous brain activity is found in PMS patients and the severity of symptom is specifically related to the left MFC and right ACC. The present findings may be beneficial to explicate the intricate neural mechanism of PMS.

Comparison of serum zinc concentrations and body antioxidant status between young women with premenstrual syndrome and normal controls: A case-control study

Premenstrual syndrome (PMS) is one of the important health problems with high incidence in young women. The exact cause of this syndrome is not clear and some theories have been declared from hormonal factors to nutritional disorders. We investigated the correlation between serum zinc and antioxidant status with PMS. In this case-control study, forty eight young girls were selected from a total sample of 110 students residing at university dormitories including PMS (n=23) and healthy (n=25) groups based on PMS questionnaire. Dietary intake questionnaire and blood samples were collected from all participants. Serum total antioxidant capacity (TAC) and zinc concentrations were also measured. Serum TAC and zinc concentrations were lower in PMS patients compared with healthy groups (p<0.01 and p<0.05, respectively). Healthy controls consumed lower servings of hydrogenated oils (p<0.05). There were significant differences in terms of muscle mass between the PMS and healthy groups (p<0.05). Both serum TAC and zinc levels were negatively correlated to PMS scores (r=-0.39, p<0.05 and r= -0.36; p<0.05, respectively). This study shows that higher TAC and zinc serum levels are associated with lower risk of PMS. PMS cases have more hydrogenated oils than their normal counterparts.

Relation between premenstrual syndrome and equol-production status.

Consumption of isoflavones, which are predominantly derived from soybeans, reduces the risk of estrogen-related diseases, such as menopausal symptoms, breast cancer, osteoporosis, and cardiovascular disease. Equol is more bioavailable than other soy isoflavones, and equol producers are believed to benefit to a greater extent. This study was conducted to evaluate the relation between premenstrual syndrome (PMS) and equol-production status in Japanese reproductive-age women. This was a cross-sectional, observational study. The study included 144 Japanese women aged 20-45 years. PMS patients (n=46) were recruited at three obstetrics and gynecology clinics. Control group women (n=98) who were not receiving therapy for PMS were recruited from the local area by advertisement. The participants' equol-production status was determined using urine samples collected after a soy challenge test. The prevalence of equol producers was 41.8% in the control group and 23.9% in the patient group (P=0.042). Using univariate analysis, significant risk factors for equol non-producers were being a PMS patient and being younger. In multivariate analysis with a step-wise model, being a PMS patient (odds ratio, 2.342; 95% confidence interval, 1.021-5.698) was shown to be a significant risk factor for being an equol non-producer. This study showed a relation between PMS and equol-production status in Japanese women.

Premenstrual syndrome knowledge and attitude among women attending family medicine clinics, King Khalid Military Hospital, Tabuk city

Background: Research on premenstrual syndrome (PMS) is generally lacking in the Gulf countries, a region with unique cultural features that might influence expectations and self-perception of the disease. Little, if any, is known about the knowledge and attitude among women in Tabuk toward PMS. The shortage of such data in the general female Saudi population, too, emphasizes this concept, and hence the need to research on it. Objective: To study knowledge and attitude of women attending Primary Health Care Centers, Ministry of Health toward PMS, as well as to identify factors affecting them. Materials and Methods: A cross-sectional study was conducted consists of Saudi female aged 13–50 years attending family medicine clinics, King Khalid military hospital, Tabuk (nine clinics), throughout the period of study (October–November, 2014). Simple random sampling technique was adopted to select nine women every day to fill in the study questionnaire. Thus, approximately 25 working days were required to complete the field work. An Arabic self-administered questionnaire was used. It consisted of four sections. The first section is on the sociodemographic and reproductive characteristic of the participants. The second section covered the medical and reproductive history. The third section addressed PMS diagnostic criteria, as developed by the University of California at San Diego and the National Institute of Mental Health. The fourth section of the questionnaire involved their knowledge about PMS. Results: The study included 225 females. Their age ranged between 13 and 45 years (mean 26.7 ± 7.2 years). Almost one-third of the participants (30.2%) reported family history of PMS. The prevalence rate of PMS among them was 56%. Only 8.9% of women recognized correctly that PMS is a gynecological disease while 30.2% recognized that it necessitates medical consultation. When women asked if they were PMS patients, what they will do, 21.3% of them answered that they will use medical treatment directly from pharmacy, 11.6% will consult physician, and 21.8% will use traditional therapy. Almost one-third of them (35.6%) responded that they will do nothing. Majority of participated women (89.3%) responded positively that they will benefit others in this regard. Conclusion: PMS is a common problem in Tabuk, Saudi Arabia, affecting more than half of women. The number of women who will seek medical advice or treatment for PMS if they were PMS patients is not very promising since the disorders of the menstrual cycle and its associated complications are considered as normal phenomenon in Saudi society.