The association of the severity of Omicron with menstrual and premenstrual syndrome among reproductive age women in China: a cross-sectional study.

This study aimed to investigate changes in menstruation and the association of the severity of Omicron with menstruation after the nationwide outbreak of COVID-19 in China. A cross-sectional study adopted an electronic questionnaire to conduct an anonymous online survey. The survey targeted women of reproductive age who had been infected with SARS-CoV-2, and were menstruating regularly in the six months prior to the infection, and experienced at least one menstrual cycle after the infection. The 737 included participants were divided into mild and severe groups based on the severity of the infection. Deviations in first menstrual cycle post-infection were reported in 46.4% of participants (mild group 40.1% vs. severe group 55.2%, P<0.05). Menstrual changes were predominantly a late menstrual period (mild group 25.3% vs. severe group 30.4%), a shorter duration of menstrual flow (mild group 10.4% vs. severe group 14.7%), and a decrease in menstrual flow volume (mild group 16% vs. severe group 21.6%). Premenstrual syndrome symptoms in a small number of women were worse compared with pre-infection, especially in the severe group. During the second menstrual period after infection, most participants reported their menstrual characteristics had returned to those of pre-infection (mild group 88% vs. severe group 80.2%, P<0.05). In this investigation, SARS-CoV-2 infection had a substantial effect on women's menstrual characteristics, and the changes were mostly transient. Women with more severe COVID-19 symptoms experienced more significant changes. The potential long-term effects of SARS-CoV-2 on female reproductive health require further observation and research.

Cette étude visait à étudier les changements dans la menstruation et l'association entre la gravité d'Omicron et la menstruation après l'épidémie nationale de COVID-19 en Chine. Une étude transversale a adopté un questionnaire électronique pour mener une enquête anonyme en ligne. L'enquête visait les femmes en âge de procréer qui avaient été infectées par le SRAS-CoV-2, qui avaient leurs règles régulièrement au cours des six mois précédant l'infection et qui ont connu au moins un cycle menstruel après l'infection. Les 737 participants inclus ont été divisés en groupes légers et sévères en fonction de la gravité de l'infection. Des écarts dans le premier cycle menstruel post-infection ont été signalés chez 46,4 % des participantes (groupe léger 40,1 % contre groupe sévère 55,2 %, P <0,05). Les changements menstruels étaient principalement une période menstruelle tardive (groupe léger 25,3 % contre groupe sévère 30,4 %), une durée plus courte du flux menstruel (groupe léger 10,4 % contre groupe sévère 14,7 %) et une diminution du volume du flux menstruel (groupe léger). 16 % contre groupe sévère 21,6 %). Les symptômes du syndrome prémenstruel chez un petit nombre de femmes étaient pires que ceux observés avant l'infection, en particulier dans le groupe sévère. Au cours de la deuxième période menstruelle après l'infection, la plupart des participantes ont déclaré que leurs caractéristiques menstruelles étaient revenues à celles d'avant l'infection (groupe léger 88 % contre groupe sévère 80,2 %, P <0,05). Dans cette enquête, l'infection par le SRAS-CoV-2 a eu un effet substantiel sur les caractéristiques menstruelles des femmes, et les changements ont été pour la plupart transitoires. Les femmes présentant des symptômes plus graves de la COVID-19 ont connu des changements plus importants. Les effets potentiels à long terme du SRAS-CoV-2 sur la santé reproductive des femmes nécessitent des observations et des recherches plus approfondies.

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.

Premenstrual exacerbation of underlying medical conditions is one of the variants of premenstrual disorders. This study aimed to assess the proportion of premenstrual exacerbation among patients attending a gynaecological clinic for premenstrual symptoms and to evaluate their mental health and quality of life. Women diagnosed with premenstrual disorder were divided into the core premenstrual disorder group and the premenstrual exacerbation group. We compared the mental health and quality of life scores calculated from the questionnaire between the two groups. Among the patients diagnosed with premenstrual disorders, about one-third were patients with premenstrual exacerbation. The premenstrual exacerbation group were more anxious and depressed than the core premenstrual disorder group, and had lower quality of life scores in almost all domains. The results underscore the importance that health care providers should always consider the possibility of premenstrual exacerbation when managing patients with premenstrual symptoms and provide appropriate care for these patients.

Prevalence of premenstrual syndrome in adolescent girls.

BACKGROUND: Premenstrual syndrome (PMS) is characterized by physical, cognitive, emotional, and behavioral symptoms that appear during the luteal phase of the menstrual cycle, disappear after menstruation, and are recurrent in every cycle. PMS significantly affects the social and academic lives of adolescents, and historically, it has been neglected by healthcare professionals. We aimed to evaluate the current point prevalence of PMS in Turkish adolescents presented to a tertiary adolescent medicine clinic. MATERIAL AND METHOD: Adolescent girls between the ages of 12 and 18 and who had regular menstrual cycles for at least three months without any mental or chronic illness were assessed. A clinic information form and the 'Premenstrual Syndrome Scale' (PMSS) questionnaire were completed. Those with a PMSS total score of more than 50% of the total score (>110 out of 220) were classified as PMS (+). Those classified as PMS were further classified as mild-moderate (score: 110-150) and severe (>150). RESULTS: The study included 417 adolescents. The point prevalence of PMS was found to be 61.2% (n:255). Of those with PMS, 49.4% had mild-moderate and 50.6% had severe PMS. The mean PMSS score was 154.56 ± 30.43 in the PMS group and 76.17 ± 20.65 in the non-PMS group (p<0.001). The mean age was 15.41 ± 1.3 years in the PMS group and 14.88 ± 1.35 years in the non-PMS group (p=0.029). None of the youth in our study applied to our clinic due to any premenstrual complaints. CONCLUSION: PMS is frequently observed in youth, as indicated by our study. Adolescents have little awareness of PMS and their need for healthcare services. During the evaluation of adolescents, it is important for health care providers to acquire knowledge regarding the features of menstrual cycles and conduct a comprehensive psychosocial assessment.

Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual's life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS. METHODOLOGY: A case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire. RESULTS: The study's findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI). CONCLUSION: The study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.

Prevalence and determinant factors of premenstrual syndrome among secondary and preparatory school students in Dessie city administration, Northeast Ethiopia.

BACKGROUND: In Ethiopia, premenstrual syndrome (PMS) was predominantly studied among university students who were in their early 20s; as a result, little is known about the prevalence of premenstrual syndrome among adolescent girls. Therefore, this study aimed to determine the prevalence of premenstrual syndrome and identify factors associated with premenstrual syndrome among secondary school female students in the Dessie city administration, 2023. METHODS: An institutional-based cross-sectional study was conducted involving a sample of 630 participants. A structured self-administered data collection tool was used to gather the necessary information. To ensure data quality, the pretesting and training of the data collectors and supervisors were conducted. The collected data were entered into Epi-data software and analyzed using SPSS version 25. Frequency tables, graphs, means, and medians were used to describe the characteristics of the study participants. Binary logistic regression was employed to identify significant factors. Variables with a p-value ≤ 0.05 with 95% confidence interval (CI) of adjusted odds ratio (AOR) in the final multivariable logistic regression were reported as statistically significant factors associated with PMS. Model fitness was evaluated using the Hosmer and Lemeshow goodness-of-fit test. RESULTS: In the present study, the prevalence of PMS was 22%, 95% CI = 19-26%. FACTORS: Age ≥ 18 years (AOR = 0.54; 95% CI: 0.34, 0.86), duration of menstruation ≥ 7 days (AOR = 3.61; 95% CI: 1.25, 10.37), presence of chronic illness (AOR = 2.08; 95% CI:1.04, 4.16), coffee intake (AOR = 6.05; 95% CI: 2.05, 17.87), alcohol intake (AOR = 0.49; 95% CI: 0.28, 0.86), use of pain medication (AOR = 2.06; 95% CI:1.10, 3.86), use of hormonal contraceptives (AOR = 3.9; 95% CI:1.58, 9.62), sleep disturbance (AOR = 3.82; 95% CI: 2.29, 6.42) and physical exercise (AOR = 0.50; 95% CI: 0.28, 0.87) were significantly associated with PMS. CONCLUSION: A significant number of students in this study were affected by premenstrual syndrome. Age, duration of menstruation, presence of chronic illness, coffee intake, use of pain medication, use of hormonal contraceptives, and sleep disturbance were significantly associated with PMS. Students should avoid excessive use of alcohol, coffee intake and use of pain medication without prescription.

Association between physical activity and risk of premenstrual syndrome among female college students: a systematic review and meta-analysis.

BACKGROUND: This study aimed to analyze the relationship between physical activity and the risk of premenstrual syndrome among college students. METHODS: Eligible studies were searched from the PubMed, Web of Science, and Embase databases. The link between physical activity and the risk of premenstrual syndrome was evaluated using odds ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was tested and their sources were explored by subgroup analysis. A sensitivity analysis was performed to assess the effect of a single study on the pooled results. The included studies were evaluated for publication bias. Five moderate-quality studies were included in this meta-analysis. RESULTS: Physical activity levels were negatively associated with risk of premenstrual syndrome among college students (OR [95%CI] = 1.46 [1.09, 1.96], P = .011). The pooled results were not influenced after being stratified by the study region and whether multi-factor correction was performed or not. Publication bias was not observed in the included studies. CONCLUSION: A high level of physical activity is dramatically associated with a reduced risk of premenstrual syndrome among female college students.

Prevalence of premenstrual syndrome and its associations with dietary and other lifestyle factors among university female students in Dubai: A cross-sectional study.

BACKGROUND: Premenstrual syndrome is a relatively prevalent condition that affects a significant number of menstruating women worldwide. It can range from mild to severe and may interfere with daily activities. OBJECTIVE: This study aims to investigate the prevalence of premenstrual syndrome and its associated factors among female university students in Dubai. DESIGN: This study was designed as a cross-sectional study. METHODS: The analysis for this study involved 217 female university students (aged ⩾18 years old) who completed a self-reported online questionnaire. Participants were recruited through simple random sampling, and the study received ethical approval from the Zayed University Ethical Committee. RESULTS: All participants reported that they experienced at least one premenstrual syndrome symptom with different levels of severity. The prevalence rate of psychological, physical, and behavioral symptoms was 83.0%, 79.4%, and 76.6%, respectively. The most frequently reported premenstrual psychological symptoms were loss of control (69.6%). Most reported physical premenstrual symptoms included lethargy/fatigue/decreased energy (56.7%); premenstrual syndrome symptoms interfered with participants' daily routines (45.2%). Normal body mass index, no smoking, milk consumption, cruciferous vegetables, fruits, animal foods, fish oil supplements, and no fast-food consumption were all significant factors associated with decreasing premenstrual syndrome. CONCLUSIONS: Premenstrual syndrome is a common menstrual disorder among university students that interferes with their daily routines. Dietary habits and other lifestyle factors were highly related to premenstrual syndrome. Therefore, health promotion programs are highly recommended to encourage healthy diets and lifestyles for females as early as adolescence at the school level.

Mortality Risk Among Women With Premenstrual Disorders in Sweden.

Importance: Premenstrual disorders (PMDs) adversely affect the quality of life of millions of women worldwide, yet research on the long-term consequences of PMDs is limited, and the risk of mortality has not been explored. Objective: To estimate the associations of PMDs with overall and cause-specific mortality. Design, Setting, and Participants: This nationwide, population-based, matched cohort study used data from population and health registers in Sweden. Participants included women of reproductive age with a first diagnosis of PMDs between January 1, 2001, and December 31, 2018. Data analysis was performed from September 2022 to April 2023. Exposures: PMDs were identified through inpatient and outpatient diagnoses and drug dispensing. Main Outcomes and Measures: Dates of death and underlying causes were ascertained from the National Cause of Death Register. Conditional Cox regression was used to estimate the hazard ratios (HRs) of overall and cause-specific death (eg, death due to natural or nonnatural cause, suicide, or cardiovascular events), adjusting for age, socioeconomic status, and somatic and psychiatric comorbidities; in a separate sibling comparison, models were also adjusted for all factors that sisters share. Results: A total of 67 748 women with clinically diagnosed PMDs and 338 740 matched unaffected women were included, for a total of 406 488 women. Women with PMDs received a diagnosis at a mean (SD) age of 35.8 (8.2) years. During a mean (SD) follow-up of 6.2 (4.6) years (range, 1-18 years), 367 deaths were observed among women with PMDs (rate, 8.4 deaths per 10 000 person-years; 95% CI, 7.6-9.3 deaths per 10 000 person-years), and 1958 deaths were observed among women without PMDs (rate, 9.1 deaths per 10 000 person-years; 95% CI, 8.7-9.6 deaths per 10 000 person-years). Compared with unaffected women, women with PMDs had increased risk of death due to nonnatural causes (HR, 1.59; 95% CI, 1.25-2.04), particularly suicide (HR, 1.92; 95% CI, 1.43-2.60), but they did not have increased risk of overall mortality (adjusted HR, 0.91; 95% CI, 0.82-1.02). Notably, women who received a diagnosis before the age of 25 years experienced higher all-cause mortality (HR, 2.51; 95% CI, 1.42-4.42) and death from both suicide (HR, 3.84; 95% CI, 1.18-12.45) and natural causes (HR, 2.59; 95% CI, 1.21-5.54). Conclusions and Relevance: The findings of this matched cohort study suggest that women with PMDs are not at increased risk of early death overall. However, the risk was elevated among young women and for death by suicide. This supports the importance of careful follow-up for young patients and highlights the need to develop suicide prevention strategies for all women with PMDs.

Global, regional, and national burden of premenstrual syndrome, 1990-2019: an analysis based on the Global Burden of Disease Study 2019.

STUDY QUESTION: What is the burden of premenstrual syndrome (PMS) at the global, regional, and national levels across 21 regions and 204 countries and territories? SUMMARY ANSWER: Over the past few decades, the global prevalent cases of PMS have grown significantly from 652.5 million in 1990 to 956.0 million in 2019, representing a 46.5% increase. WHAT IS KNOWN ALREADY: PMS, which affects almost half of reproductive women worldwide, has substantial social, occupational, academic, and psychological effects on women's lives. However, no comprehensive and detailed epidemiological estimates of PMS by age and socio-demographic index (SDI) at global, regional, and national levels have been reported. STUDY DESIGN, SIZE, DURATION: An age- and SDI-stratified systematic analysis of the prevalence and years lived with disability (YLD) of PMS by age and SDI across 21 regions and 204 countries and territories has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: The prevalence and YLD of PMS from 1990 to 2019 were retrieved directly from the Global Burden of Diseases (GBD) 2019 study. The number, rates per 100 000 persons, and average annual percentage changes (AAPCs) of prevalence and YLD were estimated at the global, regional, and national levels. MAIN RESULTS AND THE ROLE OF CHANCE: Globally, the prevalent cases of PMS increased by 46.5% from 652.5 million in 1990 to 956.0 million in 2019; in contrast, however, the age-standardized prevalence rate was approximately stable at 24 431.15/100 000 persons in 1990 and 24 406.51/100 000 persons in 2019 (AAPC, 0[95% CI: -0.01 to 0.01]). Globally, the YLD was 8.0 million in 2019 and 5.4 million in 1990, with a sizable increase over the past 30 years. The age-standardized YLD rate was stable (AAPC 0.01, P = 0.182), at 203.45/100 000 persons in 1990 and 203.76/100 000 persons in 2019. The age-standardized burden estimates were the highest in the low-middle SDI regions and the lowest in the high SDI regions. Peaks in burden rate estimates were all observed in the 40-44 years age group. Regional age-standardized burden estimates were the highest in South Asia and the lowest in Western Sub-Saharan Africa. The national age-standardized burden estimates were the highest in Pakistan and the lowest in Niger. LIMITATIONS, REASONS FOR CAUTION: The accuracy of the results depended on the quality and quantity of the GBD 2019 data. Fortunately, the GBD study endeavoured to retrieve data globally and applied multiple models to optimize the completeness, accuracy, and reliability of the data. In addition, the GBD study took the country as its basic unit and neglected the influence of race. Further study is warranted to compare differences in PMS burden associated with race. Finally, no data are available on the aetiology and risk information related to PMS, which might help us to better understand the trends and age distribution of PMS and help local governments formulate more detailed policies and comprehensive interventions. WIDER IMPLICATIONS OF THE FINDINGS: Although the age-standardized prevalence/YLD rate has been stable over the past 30 years, the absolute number of prevalent cases and YLD grew significantly worldwide from 1990 to 2019. Public health-related policies should be implemented to reduce the prevalence and alleviate the symptoms of PMS. Lifestyle changes and cognitive-behavioral therapy are critical in helping to reduce the burden of PMS. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the National Key Research and Development Program of China (grant number 2022YFC2704100) and the National Natural Science Foundation of China (No. 82001498, No. 82371648). The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.

The effect of perceived stress on menstrual complaints in university students.

Studies have examined the effect of stress on dysmenorrhea and premenstrual syndrome. For this reason in this study, it was aimed to determine the impact of stress on menstrual symptoms (adverse effects, abdominal pain, and coping methods). This descriptive and correlational study was conducted with 351 university students in Turkey by sharing the link to the questionnaire on online social media platforms. It was determined that those whose income was equal to their expenses had lower menstrual symptoms, having a chronic disease and smoking increased menstrual symptoms (F = 3.19/p = .04; t = 2.33/p = .02; t = 3.96/p = .00). The study identified that there was a positive low-level correlation (r: 0.25, p < .01) between the Perceived Stress Scale-14 and the Menstruation Symptom Questionnaire, and the 6.5 percent change in menstrual symptoms was explained by perceived stress. In the study, it is thought that stress affects the experience of menstrual symptoms. Therefore, it is believed that by providing training on stress and effective coping methods by midwives and nurses, menstrual symptoms can be reduced, contributing to women's health. For future studies, it is recommended to examine the effects of stress coping methods training on stress and menstrual complaints.

Network structure of complex interactions of premenstrual syndrome and influencing factors in young adult women.

BACKGROUND: In the transition phase from adolescence to adulthood, premenstrual syndrome (PMS) occurs more commonly, with a variety of symptoms. The occurrence of PMS may be the result of a combination of demographic, physiological, psychological and sociological factors. This study aimed to identify the central symptoms of PMS, and explored the complex influencing factors especially the one-to-one inter-relationships factors with specific symptoms. METHOD: This is a cross-sectional study conducted in mainland China. 3458 young adult women were assessed. Using the Premenstrual Syndrome Scale (PSS) to assess the PMS, and PSS score was over 6 divided into PMS group, and vice versa. Influencing factors were assessed by a set of self-reported questionnaire. Network analysis was used to examined the interplay of PMS, whilst also considering the influencing factors of PMS. RESULTS: In summary, 1479 participants were in PMS group. Anxiety had the highest strength centrality (1.12/1.09), shown higher centrality in the both network. Swelling of the hands or feet also shown higher strength centrality (0.89) in PMS group. PMS is associated with a higher history of dysmenorrhea, and neurotic personality. Neurotic personality - depressed mood/nervousness (0.27/0.23), history of dysmenorrhea - abdominal distension (0.21), had significantly higher weight than other edges in PMS group. CONCLUSION: Anxiety was the most central symptom in the network, and was closely associated with other symptoms like depressed mood, which provided additional evidence for the centrality of emotional features in PMS. Moreover, the influencing factors of PMS combined demographic, physiological, psychological, and sociological factors. According to the central symptoms and factors affecting the specific PMS symptoms in young adult women, targeted intervention is helpful to prevent and alleviate PMS. LIMITATION: Cross-sectional design cannot infer the directionality of the associations between variables. All data is self-reported with recall bias and the edge weights across the constructs of influencing factors and PMS were fairly small.

Association between dietary patterns and premenstrual disorders: a cross-sectional analysis of 1382 college students in China.

Premenstrual disorders (PMDs) are common among young women and have been linked to metabolic dysfunction. Limited evidence exists regarding the associations between dietary patterns and PMDs. This cross-sectional study involved young female adults recruited from the Care of Premenstrual Emotion (COPE) cohort study in China to examine the relationship between dietary patterns and PMDs in young adulthood. PMDs were assessed using the Calendar of Premenstrual Experiences, and the consumption frequency of 12 common food groups was evaluated using a Food Frequency Questionnaire. We used principal component analysis to identify the dietary patterns and employed logistic regression to investigate the association between dietary pattern adherence and PMDs. The study included 1382 participants, of whom 337 (24.4%) reported having PMDs. Three dietary patterns were identified and named based on regional food preferences: the Traditional North China Diet (TNCD), the Traditional South China Diet (TSCD), and the Lacto-ovo Vegetarian Diet (LVD). The TSCD, characterized by high consumption of rice, red meat, and poultry, showed a significant inverse association with PMDs. This pattern held good for both premenstrual syndrome and premenstrual dysphoric disorder. These findings suggest that targeted dietary modifications could serve as a localized strategy for PMDs prevention.

Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults.

INTRODUCTION: Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome. METHODS: This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable. RESULTS: The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p < 0.001), neglect (Beta = 0.02; p = 0.017), physical (Beta = 0.19; p < 0.001) and sexual (Beta = 0.20, p < 0.001) child abuse were significantly associated with higher suicidal ideation, which was significantly associated with the presence of PMS (Beta = 0.38, p = 0.001; Beta = 0.57, p < 0.001; Beta = 0.45, p < 0.001; and Beta = 0.50, p < 0.001) respectively. Finally, higher psychological (Beta = 0.17, p < 0.001), physical (Beta = 0.11, p = 0.024), but not sexual (Beta = 0.07, p = 0.198) child abuse was directly and significantly associated with the presence of PMS, whereas higher neglect (Beta = -0.06, p = 0.007) was significantly associated lower odds of having PMS. CONCLUSION: This study highlights the mediating role of suicidal ideation in the complex association between different types of childhood abuse and premenstrual symptoms. The findings emphasize the need for trauma-informed care and tailored interventions to address the diverse impact of these factors. Recognizing the intricate relationships between child abuse, suicidal ideation, and PMS can aid healthcare providers in comprehensively addressing young women's mental and reproductive well-being. Trauma-informed care, tailored interventions and awareness of potential connections between childhood maltreatment are essential in managing these complex challenges.

The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis.

BACKGROUND: Premenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective monitoring of symptoms over two cycles, otherwise the diagnosis is provisional. We aimed to measure the point prevalence of premenstrual dysphoric disorder. METHODS: We searched for studies of prevalence using MEDLINE, EMBASE, PsycINFO and PubMed. For each study, the total sample size and number of cases were extracted. The prevalence across studies was calculated using random effects meta-analysis with a generalised linear mixed model. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Pre-registration was with PROSPERO (CRD42021249249). RESULTS: 44 studies with 48 independent samples met inclusion criteria, consisting of 50,659 participants. The pooled prevalence was 3.2 % (95 % confidence intervals: 1.7 %-5.9 %) for confirmed and 7.7 % (95 % confidence intervals: 5.3 %-11.0 %) for provisional diagnosis. There was high heterogeneity across all studies (I2 = 99 %). Sources of heterogeneity identified by meta-regression were continent of sample (p < 0.0001), type of sample (community-based, university, high school) (p = 0.007), risk of bias (p = 0.009), and method of diagnosis (p = 0.017). Restricting the analysis to community-based samples using confirmed diagnosis resulted in a prevalence of 1.6 % (95 % confidence intervals: 1.0 %-2.5 %), with low heterogeneity (I2 = 26 %). LIMITATIONS: A small number of included studies used full DSM criteria in community settings. CONCLUSIONS: The point prevalence of premenstrual dysphoric disorder using confirmed diagnosis is lower compared with provisional diagnosis. Studies relying on provisional diagnosis are likely to produce artificially high prevalence rates.

Global burden and trends in female premenstrual syndrome study during 1990-2019.

PURPOSE: Premenstrual syndrome (PMS) is prevalent worldwide and considered a crucial issue regarding women's health. In the present study, the Global Burden of Disease (GBD) Study 2019 dataset was utilized to assess the distributional trends in PMS burden and prevalence in regional, national, and sociodemographic index (SDI) categories. METHODS: The analytical methods and approaches used in the 2019 GBD study were adopted to investigate the incidence rates and disability-adjusted life years (DALY) related to PMS in 204 countries or regions. Age-standardized incidence rates (ASIR), 95% uncertainty intervals (95% UI), and annual percentage changes (EAPC) were calculated from the data. RESULTS: The global incidence and disability-adjusted life years of PMS exhibited a declining trend in the year 2019. Regions with medium-low SDI had the greatest burden of PMS, with the regions of South Asia (ASR = 7337.9 per 10,000) exhibiting the greatest Age-standardized incidence rates, while the high-income North American states presented the fastest upward trends in Age-standardized disability-adjusted life year rates. At the national level, 107 nations exhibited a decreasing trend in PMS incidence ASR, while 97 nations exhibited an increasing trend, with the United States presenting the greatest increase. CONCLUSIONS: The present study highlighted that even though the global PMS incidence and disability-adjusted life years have decreased from the year 1990 to 2019, PMS remains a prevalent health concern for women worldwide. While addressing preventive measures and treatment, it is also important to consider the regional and national differences in PMS to develop further effective and targeted health policies.

Menstrual and psychosocial characteristics associated with high-risk of premenstrual dysphoric disorder among university students: a cross-sectional study.

Up to 92 percent of Chinese women of reproductive age have pre-menstrual syndrome (PMS). The severe form of PMS (i.e. pre-menstrual dysphoric disorder [PMDD]) negatively affects women's everyday functioning and reproductive health. This study examined the relationships between menstrual, psychosocial characteristics and the risk of PMDD among young Chinese women. A cross-sectional online survey was conducted among Chinese university students in Hong Kong. Logistic regression was used to compute adjusted odds ratio (aOR) for the association of high-risk PMDD with menstrual and psychosocial characteristics. A total of 541 Chinese university students were recruited. Approximately 53 percent of female students were at high risk of developing PMDD. The high-risk PMDD group was significantly associated with a heavy volume of menstrual flow (aOR = 2.17, 95 percent CI 1.06-4.45), irregular menstrual cycle (1.72, 1.17-2.52), high dysmenorrhea (2.80, 1.95-4.04) and older ages of menarche (0.67, 0.45-0.98) in the menstrual characteristics. In the psychosocial characteristics, high-risk PMDD was significantly associated with symptoms of anxiety (2.19, 1.48-3.32) and depression (2.22, 1.48-3.32), high loneliness (1.94, 1.34-2.79) and low resilience (2.21, 1.52-3.23) levels. Additionally, resilience had a potential moderating effect on the associations between the high risk of PMDD and anxiety, depression and loneliness. The development and delivery of interventions that can enhance resilience and manage psychological distress would be beneficial for young Chinese women's reproductive health.

Perimenstrual Asthma and Premenstrual Disorders in Adolescents with Asthma.

BACKGROUND: Asthma is a common chronic disease in pediatric patients, and perimenstrual asthma (PMA), refers to the worsening of asthma symptoms during the perimenstrual period, mainly reported in adult women. However, there is limited information regarding the exacerbation of symptoms in the presence of premenstrual disorders (PMDs) in adolescents. The aim of this pilot observational study was to investigate the frequency and potential association of PMA and PMDs in a clinical sample of adolescents with asthma. PATIENTS AND METHODS: The study included 50 adolescents (aged 12-18 years, mean 16.08 ± 2.35) with asthma and at least 2 years of gynecological age. The participants completed the Asthma Control Test (ACT) to assess asthma control (considered pathological if ACT score < 20) and the modified Premenstrual Symptoms Screening Tool for Adolescents (PSST-A) to evaluate PMDs. RESULTS: A total of 75.5% of adolescents reported PMA. The prevalence of premenstrual symptoms did not significantly differ between the PMA and no-PMA group. Among the study sample, 38.7% experienced symptoms indicative of moderate/severe premenstrual syndrome, and 8.1% exhibited symptoms of premenstrual dysphoric disorder. Compared with the no-PMA group, patients with PMA showed a significant impairment in daily and home activities (P = .03 and P = .02, respectively) and exhibited a difference in the frequency of asthma symptoms (P < .001) and medication use (P ≤ .01). CONCLUSION: Perimenstrual worsening of asthma symptoms may be common in adolescents with a severe form of asthma. Prospective data collection through menstrual diaries is necessary to further explore the association between PMA and PMDs. Identifying early risk factors for PMA could facilitate the development of preventive strategies and early interventions for adolescents with asthma.

The impact of comorbid premenstrual syndrome or premenstrual dysphoric disorder on the clinical characteristics of bipolar disorder among Han Chinese women.

Bipolar disorder (BD) is commonly comorbid with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). However, little is known about their relationship. This study aimed to assess the impact of comorbid PMS or PMDD on the clinical characteristics of BD. A cross-sectional study was conducted on 262 women with BD. PMS and PMDD were screened with the Premenstrual Symptoms Screening Tool (PSST). Symptomatic features were assessed with Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS), and atypical features by the depressive episode section of SCID-I/P. The rates of PMS and PMDD among BD were 57.6% and 20.6% according to PSST. No significant difference in the rates of PMS and PMDD was found between BD I, BD II, and BD-NOS. Compared to BD patients without PMS or PMDD, patients with comorbid BD and PMS or PMDD were younger, more educated, had a higher risk of OCD, had an earlier age of onset, scored higher on HAMD-17 and its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and were more likely to have increased appetite and leaden paralysis. In addition, patients with comorbid BD and PMDD were less likely to experience traumatic life events, more likely to have family history of mental disorders and have inflammatory or autoimmune disease, scored higher on HMAD-17, particularly in its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and sleep disturbance. Compared with BD without PMS or PMDD, BD with PMS or PMDD might be a specific subtype of BD characterized with earlier onset age, heavier genetic load, increased symptom severity, and atypical features.

Prevalence and correlates of premenstrual syndrome and premenstrual dysphoric disorder among women aged 18-25 in Turkey.

OBJECTIVE: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are experienced in the luteal phase among women of reproductive age and are known to affect quality of life. This study sought to determine the prevalence and correlates of PMS and PMDD in women aged 18-25 in Turkey. METHOD: A cross-sectional study was conducted between December 2022 and May 2023, which recruited 1125 female college students. A personal information form, the International Physical Activity Questionnaire, and the Premenstrual Syndrome Scale (PMSS) were administered. Participants who met criteria for PMS during three consecutive menstrual cycles based on the ACOG and PMSS scores were diagnosed as having PMS. Participants who met the criteria for PMDD during three consecutive menstrual cycles based on the DSM-V were diagnosed as having PMDD. Logistic regression analysis was used to determine correlates of PMS and PMDD. FINDINGS: PMS was found in 49.2% and PMDD in 48.0% of the participants. Women having a blood group type B compared to those with blood group type A were more likely to have PMS (OR = 151.8, 95% CI = 54.5-422.6). In addition, women with PMS were less likely to be physically active based on the metabolic equivalent of task score (OR = 0.99, 95% CI= 0.98-0.99). Menstrual cycle duration was also longer among those with PMDD (OR = 1.47, 95% CI= 1.25-1.72), as was daily caffeine intake (OR = 1.01, 95% CI= 1.00-1.01). PMDD score was also found to be associated with major depressive disorder (OR = 1.06,95% = 1.05-1.07). CONCLUSIONS: PMS and PMDD among young women in Turkey were associated with blood groups, MET scores, and other clinical characteristics that may help clinicians to identify these conditions.

The Association between the Severity of Dysmenorrhea and Psychological Distress of Women Working in Central Tokyo-A Preliminary Study.

This study aims to clarify the association between the severity of dysmenorrhea and psychological distress among working women in central Tokyo and examine the effect modification of job stressors. The participants in this cross-sectional study were 312 women who had undergone health check-ups in the "Marunouchi Hokenshitsu" project. The severity of dysmenorrhea was defined as the degree of daily life disturbance with menstrual pain, and the outcome variable was the K6 scores. To assess the association of psychological distress with the severity of dysmenorrhea, multiple regression analyses were performed. The results revealed that 18.3% of the 289 working women were in the moderate/severe group of dysmenorrhea. In multiple regression analysis, moderate/severe dysmenorrhea was significantly associated with higher levels of psychological distress, but the significance disappeared after adjusting for gynecology such as premenstrual syndrome (PMS) and workplace-related factors. The degree of job control was significantly associated with lower levels of psychological distress and may modify psychological distress caused by dysmenorrhea. Moderate/severe dysmenorrhea may be associated with higher levels of psychological distress in working women, and psychological symptoms of PMS) and the degree of job control were possible effect factors, and there may be effect modification by the degree of job control.