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Psychoneuroendocrinology Sep 2023Premenstrual Dysphoric Disorder (PMDD) is related to an abrupt drop in progesterone and impairments in the HPA axis that cause anxiety. Suffering persons report higher...
Premenstrual Dysphoric Disorder (PMDD) is related to an abrupt drop in progesterone and impairments in the HPA axis that cause anxiety. Suffering persons report higher daily-life stress and anxiety proneness that may contribute to developing PMDD, considered a chronic stress-related disorder. Here, we explored the effect of chronic unpredictable stress (CUS) in rats subjected to progesterone withdrawal (PW) and evaluated gene expression of HPA axis activation in the stress-vulnerable Wistar-Kyoto (WKY) rat strain that is prone to anxiety. Ovariectomized WKY rats were randomly assigned to CUS or Standard-housed conditions (SHC) for 30 days. To induce PW, animals received 2 mg/kg of progesterone on day 25th for 5 days; 24 h later, they were tested using the anxiety-like burying behavior test (BBT). After behavioral completion, rats were euthanized, and brains were extracted to measure Crh (PVN) and Nr3c1 (hippocampus) mRNA. Blood corticosterone and vasopressin levels were determined. Results showed that PW exacerbated anxiety-like behaviors through passive coping in CUS-WKY. PW decreased Crh-PVN mRNA and the Nr3c1-hippocampal mRNA expression in SHC. CUS decreased Crh-PVN mRNA compared to SHC, and no further changes were observed by PW or BBT exposure. CUS reduced Nr3c1-hippocampal gene expression compared to SHC animals, and lower Nr3c1 mRNA was detected due to BBT. The PW increased corticosterone in SHC and CUS rats; however, CUS blunted corticosterone when combined with PW+BBT and similarly occurred in vasopressin concentrations. Chronic stress blunts the response of components of the HPA axis regulation when PW and BBT (systemic and psychogenic stressors, respectively) are presented. This response may facilitate less adaptive behaviors through passive coping in stress-vulnerable subjects in a preclinical model of premenstrual anxiety.
Topics: Humans; Rats; Female; Animals; Rats, Inbred WKY; Progesterone; Corticosterone; Premenstrual Dysphoric Disorder; Hypothalamo-Hypophyseal System; Neurobiology; Pituitary-Adrenal System; Stress, Psychological; Vasopressins; RNA, Messenger
PubMed: 37437420
DOI: 10.1016/j.psyneuen.2023.106331 -
Journal of Obstetrics and Gynaecology :... Dec 2024The Menstrual Distress Questionnaire (MDQ) is a commonly used questionnaire that assesses various symptoms and distress associated with the menstrual cycle in women....
BACKGROUND
The Menstrual Distress Questionnaire (MDQ) is a commonly used questionnaire that assesses various symptoms and distress associated with the menstrual cycle in women. However, the questionnaire has not been completely translated into Chinese with rigorous reliability and validity testing.
METHODS
This study translated the Menstrual Distress Questionnaire Form Cycle (MDQC) from English into Chinese: MDQCC in two stages. First, it was translated forward and backward using Jones' model; second, to test the validity and reliability, 210 Chinese-speaking women were recruited through online announcements and posters posted between June 2019 and May 2020. Expert validity, construct validity, convergent validity, and factorial validity were determined using content validity index (CVI), intraclass correlation coefficient (ICC), composite reliability (CR), and exploratory factor analysis, respectively. For concurrent criterion validity, MDQCC score was compared with three existing pain scales. Reliability was evaluated using internal consistency across items and two-week test-retest reliability over time.
RESULTS
The CVI for content validity was .92. Item-CVI for expert validities among the 46 items ranged from .50 - 1; scale-CVI for the eight subscales, from .87 - 1; ICC, from .650 - .897; and CRs, from .303 - .881. Pearson correlation coefficients between MDQCC and short-form McGill pain questionnaire, present pain intensity, and visual analog scale scores were .640, .519, and .575, respectively. Cronbach's α for internal consistency was satisfactory (.932). ICC for test-retest reliability was .852 for the entire MDQCC.
CONCLUSION
MDQCC was valid and reliable for Mandarin Chinese-speaking women. It can be used to evaluate female psychiatric symptoms related to the menstrual cycle in future work.
Topics: Female; Humans; Asian People; Correlation of Data; Factor Analysis, Statistical; Menstrual Cycle; Reproducibility of Results
PubMed: 38466187
DOI: 10.1080/01443615.2024.2320844 -
Psychiatric Research and Clinical... 2023While premenstrual dysphoric disorder (PMDD) as defined in DSM has become an established diagnosis, and a formal indication for drug treatment, the relative impact of...
OBJECTIVE
While premenstrual dysphoric disorder (PMDD) as defined in DSM has become an established diagnosis, and a formal indication for drug treatment, the relative impact of the disparate symptoms named in the criteria, and to what extent they indeed constitute parts of one syndrome, remains insufficiently clarified. We have therefore explored the frequency, impact, and inter-relationship of different PMDD symptoms.
METHOD
Using a web survey, 10,457 Swedish women of fertile age were asked to retrospectively assess if they experience reduced functioning due to symptoms clearly associated with the premenstrual phase. Those responding affirmatively reported presence, severity, and impact of each symptom named in the PMDD criteria.
RESULT
Nine percent reported impairing premenstrual symptoms. Whereas irritability was reported to cause impairment in 77% of those passing the gate questions, somatic symptoms were common but seldom causing impairment. A vast majority reported presence of at least 5 different symptoms, as required to meet the PMDD criteria, but few reported each of 5 different symptoms to be severe or impairing. An analysis of the association between symptoms revealed clear-cut clustering of somatic and mood symptoms, respectively.
CONCLUSION
While retrospective account suggested irritability to be the clinically most important premenstrual symptom, some of the complaints named in the PMDD criteria were not or only weakly associated with mood symptoms and also reported to be of limited clinical significance. It is concluded that regarding all symptoms listed in the DSM criteria as clinically relevant manifestations of one and the same syndrome may be questioned.
PubMed: 37711753
DOI: 10.1176/appi.prcp.20220007 -
International Journal of Reproductive... Feb 2024Physical and emotional manifestations of premenstrual disorder cause increased absenteeism, decreased productivity, and decreased work-related quality of life.
BACKGROUND
Physical and emotional manifestations of premenstrual disorder cause increased absenteeism, decreased productivity, and decreased work-related quality of life.
OBJECTIVE
Due to the relatively high prevalence of premenstrual disorders in Iran and limited studies on its work-related problems, this study investigated the relationship between premenstrual disorders and work performance in working women.
MATERIALS AND METHODS
This cross-sectional study was conducted on 358 working women (teachers and industrial workers) in Yazd, Iran, from July 2019 to January 2020. Data were collected using premenstrual symptom screening tool, the work productivity and activity impairment (a modified version), and functional work capacity questionnaires. Women were classified into 2 groups: women with and without premenstrual disorders. Productivity, functional capacity, and ability to perform activities of daily living were compared between groups.
RESULTS
Among 358 participants, 121 women (33.8%) had premenstrual disorders. The prevalence of premenstrual disorders was significantly higher in teachers than workers (0.41% vs. 24.7%, respectively) (p = 0.002). The work results showed a worse score in the group with premenstrual disorder than the other group and teachers compared to workers (p 0.001).
CONCLUSION
This study showed a significant association between premenstrual disorders and worse work productivity, functional work capacity, and ability to perform activities of daily living. Teachers had a higher prevalence of premenstrual disorders and worse work performance than workers, which can be due to higher education levels, work stress, more complex tasks, and increased work responsibility in teachers.
PubMed: 38628782
DOI: 10.18502/ijrm.v22i2.15712 -
Heliyon Mar 2024Premenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine...
PURPOSE
Premenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine nursing schedules and activities is limited. This study aims to identify the prevalence of PMS among female nursing staff and to examine the relationship between PMS and missed nursing care (MNC).
METHOD
Between November 1, 2022, and April 30, 2023, this study was conducted among female nursing staff working in nine inpatient departments at Sun Yat-sen University Cancer Center. This study used a cross-sectional design. The participants were recruited through convenience sampling. Data were collected using the standardized Menstrual Distress Questionnaire, the Oncology Missed Nursing Care self-rating scale, and a sociodemographic questionnaire. One-way analysis of variance, Fisher's least significant difference test for post-hoc comparisons, and Spearman's correlation coefficient were utilized for data analysis. A trend test was also performed to explore patterns in the severity of PMS and MNC over time.
RESULTS
We collected a total of 224 questionnaires, with 154 (68.7%) female nursing staff reporting PMS. The most common symptoms were low back pain (91.1%), abdominal discomfort (90.6%), cold hands and feet (87.1%), and lethargy (87.1%). Moreover, 91.5% of the 224 female nursing staff reported at least one MNC activity. The nursing activities most frequently missed or left incomplete were liquid intake and output monitoring as ordered (43.3%), medication administration within 30 min before or after the scheduled time (43.3%), and electrocardiogram monitoring as ordered (42.9%). "Abdominal discomfort" from the Menstrual Distress Questionnaire was significantly correlated with the majority of MNC activities ( < 0.001).
CONCLUSIONS
This study provides evidence for a strong association between PMS and MNC among female nursing staff, suggesting that administrators should take the premenstrual conditions of female nursing staff into consideration. It is necessary to provide appropriate understanding and support to mitigate the impact on patient care and safety.
PubMed: 38486753
DOI: 10.1016/j.heliyon.2024.e27609 -
Cureus Feb 2024Introduction Premenstrual syndrome (PMS) is a regular clinical condition that affects most women during their reproductive years. Its related symptoms may be linked to a...
Introduction Premenstrual syndrome (PMS) is a regular clinical condition that affects most women during their reproductive years. Its related symptoms may be linked to a decrease in women's quality of life. Female nurses may be more susceptible to PMS due to the demanding nature of their job. The importance of nurses' jobs and how their quality of life will affect patients and themselves in parallel make female nurses a population that is worth investigating. Our objective is to estimate the level of PMS among Jordanian nurses and assess the potential impact of PMS on work-related quality of life among them. Methods A cross-sectional study was conducted on 210 nurses who completed a questionnaire regarding demographic data, menstrual characteristics, the Premenstrual Symptoms Screening Tool (PSST), and the Work-Related Quality-of-Life Scale (WRQoL). The nurses were classified as having or not having PMS according to the PSST. Results The prevalence of PMS was 60.5%, the results showed a significantly lower mean WRQoL score for nurses with PMS (mean = 65.47, SD = 15.38) compared to nurses without PMS (mean = 70.54, SD = 14.47). The multivariable regression model revealed that the adjusted odds ratios for age, combined oral contraceptive pill (COCP) use, family history, severe dysmenorrhea, job and career satisfaction, and stress at work were 0.90 (95% CI = 0.84, 0.96), 5.18 (95% CI = 1.33, 20.17), 2.52 (95% CI = 1.23, 5.18), 11.78 (95% CI = 2.48, 56.02), 0.92 (95% CI = 0.85, 0.99), and 1.20 (95% CI = 1.01, 1.42), respectively. Conclusion PMS is quite prevalent among Jordanian nurses, with a negative impact on their work-related quality of life. Healthcare managers might implement special regulations for female nurses with PMS to improve their work-related quality of life. This research suggests that PMS is a substantial factor in the low work-related quality of life among Jordanian nurses.
PubMed: 38435204
DOI: 10.7759/cureus.53427 -
BJPsych Bulletin Oct 2023We aimed to describe the clinical characteristics of female patients presenting with premenstrual disorders to a tertiary service in the UK. We conducted a retrospective...
AIMS AND METHOD
We aimed to describe the clinical characteristics of female patients presenting with premenstrual disorders to a tertiary service in the UK. We conducted a retrospective case-note review of referrals to the National Female Hormone Clinic from April 2014 to August 2020. Based on clinical assessment, we determined whether the patient met criteria for premenstrual dysphoric disorder or premenstrual exacerbation of an underlying psychiatric disorder.
RESULTS
Of 146 patients seen in clinic for premenstrual disorders, an ICD-10 psychiatric diagnosis was made in 130 (89.0%); a minority 16 (11.0%) did not have a psychiatric diagnosis. Following assessment, 94 patients (64.4%) met criteria for premenstrual dysphoric disorder and 67 (45.6%) had exacerbation of a psychiatric disorder.
CLINICAL IMPLICATIONS
Patients presenting to this specialist service had complex psychiatric comorbidity; almost half presented with exacerbation of a psychiatric disorder.
PubMed: 36239445
DOI: 10.1192/bjb.2022.63 -
BMC Women's Health Apr 2024Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote...
BACKGROUND
Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity.
METHODS
In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time.
RESULTS
During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism.
CONCLUSION
Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information.
TRIAL REGISTRATION
UMIN Clinical Trials Registry number: UMIN000038917.
Topics: Female; Humans; Adult; Checklist; Japan; Work Performance; Follow-Up Studies; Premenstrual Syndrome
PubMed: 38622575
DOI: 10.1186/s12905-024-03067-2 -
Frontiers in Nutrition 2023Premenstrual syndrome disorder (PMS) is a condition that affects health-related quality of life (HRQoL) and encompasses a variety of symptoms, including psychological,...
Does an alternate-day modified fasting diet improve premenstrual syndrome symptoms and health-related quality of life in obese or overweight women with premenstrual syndrome? A randomized, controlled trial.
BACKGROUND
Premenstrual syndrome disorder (PMS) is a condition that affects health-related quality of life (HRQoL) and encompasses a variety of symptoms, including psychological, physical, and behavioral symptoms. Some evidence suggests that an increase in body mass index (BMI) can reduce both HRQoL and menstrual quality. This is because the body fat tissue can affect menstrual cycles by changing the estrogen/progesterone ratio. This study investigated the impact of two diets alternate-day modified fasting (ADMF) and daily calorie restriction (DCR) - on PMS syndrome and HRQoL.
METHODS
The study was a randomized controlled, open-label trial that lasted for 8 weeks and involved 60 obese/overweight women. Participants were recruited from the Health Service Centers of Kashan University of Medical Sciences using simple random sampling. The study compared the impact of the ADMF and DCR diets on HRQoL and PMS symptoms. Patients were classified based on their BMI and age and then allocated to either the intervention (ADMF) or control (DCR) group using a random numbers table. The study measured HRQoL, PMS severity, weight, BMI, body fat mass, waist circumference, fat-free mass, and skeletal muscle mass before and after the study. The study had an almost 18% dropout rate.
RESULTS
Significant improvements were observed in mood lability ( = 0.044) and expressed anger ( < 0.001) in relation to PMS symptoms. However, no significant differences were detected in the changes of other COPE subscales. The ADMF diet had a significant impact on the 12-item Short-Form Health Survey (SF-12) total score ( < 0.001) and physical function subscales ( = 0.006) as well as mental health ( < 0.001) when compared to the control diet. This implies that the ADMF diet increased both SF-12 total score and its subscales. The intervention led to improvements in HRQoL, physical function, and mental health. Additionally, significant improvements in BMI and weight were observed between the two groups pre- and post-study ( < 0.001). Anthropometric data, including body fat mass and waist circumference, showed a significant improvement ( < 0.001 and = 0.029, respectively) before and after the study. However, there were no significant changes in fat-free mass ( = 0.936) and skeletal muscle mass ( = 0.841) between the two groups.
CONCLUSION
The study suggested that ADMF can improve HRQoL, mood lability, and expressed anger. It also showed that ADMF can reduce waist circumference, weight, and body fat mass in obese/overweight women.
CLINICAL TRIAL REGISTRATION
The Iranian Registry of Clinical Trials (IRCT20220522054958N1).
PubMed: 38268675
DOI: 10.3389/fnut.2023.1298831 -
BMC Women's Health Feb 2024Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated...
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.
Topics: Adult; Humans; Female; Child; Suicidal Ideation; Cross-Sectional Studies; Child Abuse; Emotions; Premenstrual Syndrome
PubMed: 38326825
DOI: 10.1186/s12905-024-02949-9