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Frontiers in Neuroendocrinology Jul 2021Women's increased risk for depression during reproductive transitions suggests an involvement of the hypothalamic-pituitary-ovarian (HPO) axis. This is the first... (Meta-Analysis)
Meta-Analysis Review
Women's increased risk for depression during reproductive transitions suggests an involvement of the hypothalamic-pituitary-ovarian (HPO) axis. This is the first systematic review and meta-analysis of HPO functioning in female mood disorders. Inclusionary criteria were: i) women suffering from premenstrual dysphoric disorder (PMDD) or a depressive disorder, ii) assessment of HPO-axis related biomarkers, iii) a case-control design. Sixty-three studies (N = 5,129) were included. There was evidence for PMDD to be paralleled by lower luteal oestradiol levels. Women with depression unrelated to reproductive transition showed lower testosterone levels than healthy controls and there was some evidence for lower dehydroepiandrosterone sulfate levels. There were no differences in HPO-related parameters between women with pregnancy, postpartum, and perimenopausal depression and controls. Women with PMDD and depression unrelated to reproductive transitions exhibit specific changes in the HPO-axis, which potentially contribute to their symptoms. Further research into reproductive mood disorders characterised by extreme endocrine changes is warranted.
Topics: Female; Hormones; Humans; Mood Disorders; Pregnancy; Premenstrual Dysphoric Disorder; Premenstrual Syndrome
PubMed: 34171352
DOI: 10.1016/j.yfrne.2021.100929 -
Antioxidants (Basel, Switzerland) Apr 2021Premenstrual syndrome (PMS) is a cyclically occurring combination of various symptoms, leading to decreased life quality among approximately 30% of women of childbearing... (Review)
Review
Premenstrual syndrome (PMS) is a cyclically occurring combination of various symptoms, leading to decreased life quality among approximately 30% of women of childbearing age. PMS etiology remains unknown; however, there are some suggestions that inappropriate inflammatory response and oxidative stress are involved. This study aimed to systematically review case-control and cross-sectional studies investigating inflammation markers, oxidative stress, and antioxidant status among women with PMS and controls. The study protocol was registered with PROSPERO (no. CRD42020178545), and the authors followed the guidelines for performing a systemic review recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). By searching PubMed and Scopus databases (up to 8 January 2021), six case-control studies and five cross-sectional studies of medium or high quality were classified to the review. The systematic review included 652 women with PMS and 678 controls, for whom 36 eligible markers were determined. Limited evidence indicates increased levels of inflammatory parameters and suggests decreased antioxidant status in PMS women. Insufficient data with inconsistent results made it impossible to formulate a firm conclusion on the contribution of oxidative stress in PMS occurrence. To acknowledge the role of inflammation, oxidative stress, and antioxidant status in the pathophysiology of PMS, further research with case-control design and large study groups is needed.
PubMed: 33919885
DOI: 10.3390/antiox10040604 -
Evidence-based Complementary and... 2020Premenstrual syndrome (PMS) is a common disturbance among women of childbearing age. Aromatherapy is a commonly used form of complementary and alternative medicine (CAM)... (Review)
Review
Premenstrual syndrome (PMS) is a common disturbance among women of childbearing age. Aromatherapy is a commonly used form of complementary and alternative medicine (CAM) to treat PMS. The purpose of this study is to quantify and summarize the effects of aromatherapy on premenstrual syndrome symptoms. . PubMed, Scopus, and Cochrane Library databases were searched through relevant search terms until October 2020. The effect sizes were pooled as weighted mean difference (WMD) and 95% confidence interval (CI) using the random effect model. Egger tests and visual inspection of the funnel plot were performed to identify the existence of publication bias. The -squared ( ) test was applied to measure heterogeneity. . Eight studies ( = 8) were included in this analysis. The quantitative synthesis of evidence found that aromatherapy decreases PMS scores (WMD -13.83; 95% CI (-22.04, -5.63), = 94.5%), total psychological symptoms of PMS (WMD -3.51; 95% CI (-4.84, -2.18), = 82.6%), anxiety of PMS (WMD-1.78; 95% CI (-3.17, -0.38), = 94.2%), depression of PMS (WMD-2.0; 95% CI (-3.65, -0.34), = 93.7%), and fatigue of PMS (WMD - 1.44; 95% CI (-2.44, -0.44), = 89.7%) compared to the control group. . Aromatherapy is an effective tool for the relief of PMS symptoms. Additional randomized controlled clinical trials with different durations and essential oils should be conducted to confirm our findings.
PubMed: 33414837
DOI: 10.1155/2020/6667078 -
Frontiers in Psychiatry 2020Results of basic science studies demonstrate shared actions of endogenous neuroactive steroid hormones and drugs of abuse on neurotransmission. As such, premenstrual...
Results of basic science studies demonstrate shared actions of endogenous neuroactive steroid hormones and drugs of abuse on neurotransmission. As such, premenstrual syndrome (PMS) may be associated with smoking, however, results from studies examining this relationship have been mixed. Following PRISMA guidelines, we extracted unique studies examining the relationship between smoking and PMS. We used the escalc () function in R to compute the log odds ratios and corresponding sampling variance for each study. We based quality assessment on the nature of PMS diagnosis and smoking estimation, confounding adjustment, participation rate, and specification of target population. Our final sample included 13 studies, involving 25,828 study participants. Smoking was associated with an increased risk for PMS [OR = 1.56 (95% CI: 1.25-1.93), < 0.0001]. Stratified by diagnosis, the effect size estimate was higher for Premenstrual Dysphoric Disorder (PMDD) [OR = 3.15 (95% CI: 2.20-4.52), < 0.0001] than for PMS [OR = 1.27 (95% CI: 1.16-1.39), < 0.0001]. We review some of the basic mechanisms for the observed association between smoking and PMS. Given nicotine's rewarding effects, increased smoking behavior may be a mechanism to alleviate affective symptoms of PMS. However, smoking may lead to worsening of PMS symptoms because nicotine has effects on neurocircuitry that increases susceptibility to environmental stressors. Indeed, prior evidence shows that the hypothalamic-pituitary-adrenal (HPA) axis is already sub-optimal in PMS, hence, smoking likely further deteriorates it. Combined, this complicates the clinical course for the treatment of both PMS and Tobacco Use Disorder in this population.
PubMed: 33324253
DOI: 10.3389/fpsyt.2020.575526 -
International Journal of Preventive... 2020Since premenstrual syndrome (PMS) is one of the most common and debilitating disorders in women, risk factor modification is an urgent health priority. Therefore, this... (Review)
Review
Since premenstrual syndrome (PMS) is one of the most common and debilitating disorders in women, risk factor modification is an urgent health priority. Therefore, this systematic review aimed to summarize and discuss the outcomes of observational and interventional studies in humans regarding the relationship between Calcium and PMS. PubMed, Scopus, ISI web of sciences and Google scholar were searched up to January 2019 to identify relevant studies. The Newcastle-Ottawa and Jadad scales were used for quality assessment. A total of 14 studies (8 interventional and 6 observational) met our inclusion criteria. Majority of the studies showed that not only serum calcium levels are lower in PMS subjects, but also calcium supplementation could significantly improve the incidence of PMS and its related symptoms. This systematic review suggests a beneficial role for calcium in PMS subjects. However, in order to draw a firm link between calcium and PMS, further dose-response clinical trials with larger sample size and better methodological design are warranted.
PubMed: 33312465
DOI: 10.4103/ijpvm.IJPVM_243_19 -
PloS One 2020Premenstrual syndrome is a clinical condition characterised by the cyclic occurrence of physical and emotional symptoms, which can interfere with normal activity. It... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Premenstrual syndrome is a clinical condition characterised by the cyclic occurrence of physical and emotional symptoms, which can interfere with normal activity. It significantly affects the health-related quality of life and can result in decreased work productivity. The prevalence of premenstrual syndrome varies widely in different countries and different regions of the same country. Thus, this study was aimed to estimate the pooled prevalence of premenstrual syndrome and its associated factors among women in Ethiopia.
MATERIALS AND METHODS
Published studies searched from electronic databases such as PubMed/Medline, google scholars, HINARI, Science Direct, Cochrane Library, and EMBASE were used. All studies done among women of the reproductive age group in Ethiopia and reported in the English language were included. The current study was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two authors extracted the data independently by using Microsoft excel extraction format and transported to STATA 14 software for analysis. I2 test was used to assess heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence and associated factors of premenstrual syndrome. The prevalence and odds ratio with 95% confidence interval (CI) were presented using a forest plot.
RESULTS
After careful screening of 33 studies, nine studies were included in our systematic review and meta-analysis. The pooled prevalence of premenstrual syndrome in Ethiopia was found to be 53% (95% CI: 40.64, 65.36). Subgroup analysis by university versus high school showed a pooled prevalence of 53.87% (95% CI: 40.97, 67.60) and 56.19% (95% CI: 6.80, 105.58), respectively. The pooled odds ratio shows that age at menarche, menstrual pattern and hormonal contraceptive use had no statistically significant association with premenstrual syndrome.
CONCLUSION
More than half of the women under reproductive age group were experiencing premenstrual syndrome in Ethiopia.
Topics: Confidence Intervals; Ethiopia; Female; Humans; Odds Ratio; Premenstrual Syndrome; Prevalence; Quality of Life; Software
PubMed: 33156860
DOI: 10.1371/journal.pone.0241702 -
Archives of Women's Mental Health Apr 2021Previous research has identified how menstruation is an important factor in both attempted and completed suicides for women. The purpose of this review was to outline... (Review)
Review
Previous research has identified how menstruation is an important factor in both attempted and completed suicides for women. The purpose of this review was to outline (a) the risk profile for suicidality in women who were identified to experience Premenstrual Dysphoric Disorder (PMDD), a condition characterized by severe physical and psychological changes that occur during the luteal menstrual phase, and (b) the implications of these findings for clinical practice. A systematic literature review was conducted using five databases to identify any peer-reviewed articles published between 1989 and 2019. Ten papers eligible for inclusion were identified: three pertaining to suicide cognitions, five to suicide attempts and two to both cognitions and attempts. Findings showed that suicidal thoughts, ideation, plans and attempts were strongly associated with experiences of PMDD and that these findings were independent of psychiatric co-morbidities. However, women with PMDD did not present with more severe risk profiles for suicide attempts (in terms of frequency, impulsivity and lethality) or make more frequent attempts during the luteal menstrual phase compared with suicide attempters without PMDD. Women with PMDD should be considered a high risk group for suicidality; thus, identifying and treating symptoms are vital in reducing suicide attempts. Implications for clinical practice are outlined in the discussion.
Topics: Female; Humans; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Suicidal Ideation; Suicide; Suicide, Attempted
PubMed: 32936329
DOI: 10.1007/s00737-020-01054-8 -
BJGP Open Aug 2020Exercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.
BACKGROUND
Exercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.
AIM
To systematically review the evidence for the effectiveness of exercise as a treatment for PMS.
DESIGN & SETTING
This systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.
METHOD
Randomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.
RESULTS
A total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion ( = 717). Seven trials contributed data to the primary outcome meta-analysis ( = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity ( = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.
CONCLUSION
Based on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.
PubMed: 32522750
DOI: 10.3399/bjgpopen20X101032 -
Obstetrics & Gynecology Science Mar 2020[This corrects the article on p. 73 in vol. 62, PMID: 30918875.].
[This corrects the article on p. 73 in vol. 62, PMID: 30918875.].
PubMed: 32206663
DOI: 10.5468/ogs.2020.63.2.213 -
BMC Women's Health Feb 2020Pictorial blood loss assessment charts (PBACs) represent the most widely used method to assess menstrual blood loss (MBL) in clinical trials. The aims of this review...
BACKGROUND
Pictorial blood loss assessment charts (PBACs) represent the most widely used method to assess menstrual blood loss (MBL) in clinical trials. The aims of this review were to: (1) determine the diagnostic accuracy of PBACs that have been validated against the reference alkaline hematin technique; (2) categorize the pitfalls of using obsolete and nonvalidated charts; (3) provide guidelines for development of a new PBAC or use of an existing chart to measure MBL in clinical trials; and (4) consider the feasibility of using pictorial charts in primary care.
METHODS
A literature review was conducted using Embase and MEDLINE databases. The review identified reports of women with self-perceived or actual heavy menstrual bleeding (HMB), bleeding disorders, abnormal uterine bleeding, leiomyomata (uterine fibroids) or endometriosis, and women undergoing treatment for HMB, as well as those with normal menstrual periods. Data were reviewed from studies that focused on the development and validation of PBACs and from those that used derivative noncertified charts to assess HMB.
RESULTS
Nine studies reported validation of PBAC scoring systems against the alkaline hematin technique. Across these studies, the sensitivity was 58-97%, the specificity was 7.5-95.5%, the positive and negative likelihood ratios were 1.1-13.8 and 0.14-0.56, respectively, and the diagnostic odds ratio was 2.6-52.4. The cut-off score above which the diagnosis of HMB was made ranged from 50 to 185. Several modifications of these PBACs were used in other studies; however, objective confirmation of their validity was not reported. Overall, there was widespread inconsistency of chart design, scoring systems, diagnostic cut-off limits and post-treatment outcome measures.
CONCLUSIONS
PBACs are best suited to the controlled and specific environment of clinical studies, where clinical outcome parameters are defined. The current lack of standardization precludes widespread use of the PBAC in primary care.
REVIEW REGISTRATION NUMBER
PROSPERO international prospective register of systematic reviews: CRD42016030083.
Topics: Adult; Clinical Trials as Topic; Diagnostic Techniques, Obstetrical and Gynecological; Female; Humans; Menorrhagia; Menstruation; Odds Ratio; Sensitivity and Specificity; Visual Analog Scale
PubMed: 32041594
DOI: 10.1186/s12905-020-0887-y