Sleep quality and excessive daytime sleepiness in women with Premenstrual Syndrome.

OBJECTIVE: Examine the relationship between Premenstrual Syndrome (PMS) and sleep in different menstrual cycle phases. METHODS: Case-control survey conducted at the Primary Care Service and Clinical Research Center at Hospital de Clínicas de Porto Alegre with women aged between 18 and 45 years old. Women filled the Brazilian version of the Premenstrual Symptoms Screen Tool (PSST) for the screening of PMS; participants with positive screening completed the Daily Record of Severity of Problems (DRSP) to confirm PMS diagnosis. We applied the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) Brazilian versions in the luteal phase (LP) and follicular phase (FP). RESULTS AND CONCLUSION: 69 women were characterized with PMS and 52 without PMS. The risk of poor sleep quality (SQ) was two times higher in women with PMS (p = .006; OR = 3.057; IC95% 1.44-6.45). An interaction between no PMS and LP was found in ESS (p = .014; generalized estimating equation - GEE - adjusted for multiple comparisons by the Bonferroni test and adjusted by age); besides that, women with PMS had greater scores in ESS (p = .022; GEE adjusted by age).

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.

Food cue-elicited brain potentials change throughout menstrual cycle: Modulation by eating styles, negative affect, and premenstrual complaints.

BACKGROUND: While there is evidence for increased food intake and craving during the luteal phase, underlying mechanisms are incompletely understood. The present study investigated electrophysiological responses to food pictures as a function of menstrual cycle phase. In addition, the moderating effects of progesterone, eating behaviors (restraint, emotional, orthorexic), negative affect, and premenstrual complaints were explored. METHODS: Using a within-subject design, 35 free-cycling women watched and rated pictures of food (high and low caloric) and control items during the follicular, the ovulatory, and the luteal phase (counterbalanced), while EEG was recorded to examine the late positive potentials (LPP). Salivary gonadal hormones and affect were examined at each occasion. Eating behaviors and premenstrual complaints were assessed once. RESULTS: For parietal regions, average LPPs were comparable between cycle phases but slightly larger LPP amplitudes were elicited by high caloric food pictures as compared to the neutral category. Descriptively, both food categories elicited larger parietal LPPs than neutral pictures during the luteal phase. Analyses of LPPs for central-parietal regions showed no effect of picture category or cycle phase, except higher amplitudes in the right area during the luteal phase. During the luteal phase, progesterone and functional interference from premenstrual symptoms (but not age, BMI, picture ratings, affect, estradiol, or eating behaviors) significantly predicted larger parietal LPPs towards high caloric (but not low caloric) pictures. CONCLUSION: Our findings suggest a heightened food cue reactivity during the luteal phase, which may relate to higher ovarian hormone secretion and more functional impact of premenstrual symptoms. This research contributes to a better understanding of menstrual health and the identification of preventive strategies for premenopausal women.

Mood variations and personality traits in patients with epilepsy over the course of their menstrual cycle.

INTRODUCTION: The incidence of mood disorders and psychopathology is more frequent in patients with epilepsy (PWE) than in the general population. Also, it has been reported that PWE suffer more seizures during certain phases of their menstrual cycle (MC). Still, limited information exists regarding the relationship between the physical and emotional changes during the MC in PWE. Therefore, in this study, we aimed to evaluate the mood and personality traits of PWE during their MC and to compare them with controls. METHODS: A cohort of 22 PWE and nine controls was gathered. All the participants underwent psychiatric, electroencephalographic, and gynecological evaluations. RESULTS: Overall, PWE scored higher in depression compared with controls (p < 0.05), PWE also obtained higher scores for the personality traits of neuroticism and self-isolation (p < 0.05). During the evaluation of the symptoms of premenstrual syndrome (PMS), PWE were more symptomatic during the early follicular (EF) phase in comparison with the rest of the phases of their MC, whereas the control group showed the known premenstrual pattern of symptoms during the late luteal (LL) phase. The frequency of seizures (40.6%) and electroencephalographic abnormalities (34.8%) was also higher during the EF phase of the MC when compared with the other phases of the MC (p < 0.05). CONCLUSIONS: The results of this study suggest that unlike the PMS present in women without epilepsy, PWE appear to show a "menstrual syndrome" that consists of similar mood changes and physical symptoms. This arrangement of symptoms seems to have an impact on the increase in seizure activity.

Associations between sleep habits and interference of premenstrual symptoms in athletic performance in Japanese adolescent athletes: a cohort study over a 2-year period.

Premenstrual symptoms are common problems among female high-school and college athletes. This prospective study investigated associations between sleep habits and interference of premenstrual symptoms in athletic performance among Japanese adolescent athletes. A school-based survey on menstruation and school life was conducted among 623 female high-school students in 2015 and 2016, and data from the two surveys were connected. In total, 262 students completed the questionnaire in both years. We recruited 108 of those students who were athletes with regular menstrual cycles. Participants completed a questionnaire about their premenstrual symptoms and lifestyle habits. The prevalence of short sleep duration (<8 h) was high (95.4%). The difference in premenstrual symptom severity in individual students between the first and second years was not significant (p > .05). Premenstrual symptoms were less associated with disturbance in 'athletic performance in training or competition' in the second year than the first. 'Longer sleeping time' in the first year was associated with lower risk of increased interference of premenstrual symptoms in athletic performance in the second year (odds ratio 0.982, 95% confidence interval: 0.970-0.994). Shorter sleep duration may therefore have an effect on premenstrual symptoms' interference with athletic performance among Japanese adolescents.

Altered exploratory behaviour and increased food intake in the spiny mouse before menstruation: a unique pre-clinical model for examining premenstrual syndrome.

STUDY QUESTION: Does the newly discovered menstruating spiny mouse exhibit behavioural and metabolic changes in correlation with premenstrual phases of the menstrual cycle? SUMMARY ANSWER: This is the first report of cycle variability in the exploratory and interactive behaviour, and food consumption in menstruating spiny mice, and demonstrates that physiological changes are also dependent on within-subject variation. WHAT IS KNOWN ALREADY: Premenstrual syndrome (PMS) is a prominent cyclic disorder that affects millions of women worldwide. More than 70% of women endure symptoms of impending menstruation, such as bloating, abdominal cramping and nausea to some degree. Consequently, ~8% of women experience recurrent physical and emotional symptoms which are extreme enough to disrupt daily life and seek intervention. Due to a lack of an appropriate animal model, the mechanisms underlying PMS are poorly understood, and subsequently, effective treatments are limited. STUDY DESIGN, SIZE, DURATION: This study analyses the changes in behavioural responses to the investigator during vaginal lavage (n = 14), exploratory behaviour (n = 11) and metabolism (n = 20) across the menstrual cycle in the spiny mouse (Acomys cahirinus). PARTICIPANTS/MATERIALS, SETTING, METHODS: We performed vaginal lavages on virgin spiny mice (6-8 months of age) and subjected each cohort of females to repeated measures for vaginal lavage, exploratory behaviour and metabolism. Stages of the menstrual cycle were designated as early follicular, late follicular, early luteal, late luteal, early menstrual and late menstrual, with the late luteal and early menstrual phases considered as premenstrual phases and analysed using generalized estimating equations. For vaginal lavage, the behavioural responses to researcher handling were scored on an increasing scale of severity during the lavage process (e.g. restraint, frequency of vocalizations, total handling time). For exploratory behaviour, exploration, memory and sociability were assessed through subjection to Open Field (OF), Novel Object Recognition (NORT), Social Novelty (SN) and Elevated Plus Maze (EPM) tests. For metabolism, physiological changes were measured over a 24-h period in metabolic cages. Results are mean ± SD with statistical significance set to P < 0.05. MAIN RESULTS AND THE ROLE OF CHANCE: Qualitative behavioural assessment showed that compared to early follicular controls, during premenstrual phases, cycling females had significantly increased probability of: manifesting difficulties during restraint (4×, P < 0.01), vocalizing (8×, P < 0.01) and exhibiting isolation in the cage (40×, P = 0.041). We saw significant increases in handling time during the premenstrual phase in cycling females (76 ± 16 s) compared to controls (55 ± 7 s, P < 0.001). For exploratory behaviour, cycling females in their early menstrual phase travelled significantly less distance in the outer zone of the OF arena (13.3 ± 9.0 m) than females in their early luteal phase (22.3 ± 9.9 m, P = 0.038) and at significantly reduced velocities (40.2 ± 10.5 mm/s and 78.8 ± 31.0 mm/s, respectively, P = 0.006). These females also had fewer entries into the EPM open arms during the same phases (9.6 ± 6.1 and versus 20.0 ± 7.2, respectively, P = 0.030) and travelled less distance (3.2 ± 2.8 m versus 7.0 ± 5.5 m, respectively, P = 0.026). No differences were observed in NORT or SN across the cycle. In the metabolism studies, spiny mice demonstrated a significant increase in food consumption (percentage of body weight) during the early follicular and late luteal phases (3.9 ± 2.4% and 3.8 ± 2.1%, respectively) compared to the late follicular phase (2.3 ± 2.6%, P = 0.015). LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: This is an observational study to determine fundamental changes in behaviour and metabolism in a novel species, and as such, lacks commercially available laboratory reagents and protocols specific to the spiny mouse. WIDER IMPLICATIONS OF THE FINDINGS: The timing of these behavioural and physiological changes suggests that spiny mice exhibit symptoms analogous to PMS in higher order primates, thus providing a pre-clinical model for testing novel interventions to alleviate premenstrual symptoms and overcoming many limitations associated with this research area. STUDY FUNDING/COMPETING INTEREST(S): N.B. is supported by a Research Training Program stipend through Monash University. J.E. is supported by a Fellowship awarded by the Peter Fielding Foundation. The Hudson Institute of Medical Research is supported by the Victorian Government Operational Research Infrastructure Support. The authors declare no conflicts of interest.

Premenstrual syndrome is associated with altered cortisol awakening response.

Previous studies have revealed stress-induced dysregulation of hypothalamic-pituitary-adrenal (HPA) axis in women with premenstrual syndrome (PMS). So far, however, the results about the relationship between HPA axis dysregulation and PMS are mixed. To this end, it is necessary to investigate the basal activity of the HPA axis in women with PMS instead of only assessing a certain stressor. Therefore, this study evaluated the relationship between the cortisol awakening response (CAR) and PMS. Thirty-two women with PMS (mean age 22.47 ± 2.20 years) and 36 healthy controls (mean age 22.28 ± 2.43 years) were included in this study. Saliva samples of our participants were collected successively at 0, 30, 45, and 60 min after awakening to assess CAR during each of two phases of the menstrual cycle (the mid-follicular phase and the late luteal phase). The results showed a significantly attenuated CAR in women with PMS compared with the healthy controls, especially at 45 and 60 min after awakening, regardless of the menstrual cycle phases. Furthermore, there was a significant negative correlation between PMS severity as measured by PMS scale and AUCi (i.e. the Area Under the Curve with respect to increase) in the mid-follicular phase. Our findings suggested that an attenuated CAR activity profile may be an important risk factor for the development of PMS.

The impact of menstrual symptoms on everyday life: a survey among 42,879 women.

BACKGROUND: Menstrual symptoms such as dysmenorrhea, heavy menstrual bleeding, and perimenstrual mood disorders are known to be widespread among the general population. From studies in patients with endometriosis and premenstrual disorder, it has been shown that these symptoms can have a large impact on women's quality of life and account for substantial health care use. Furthermore, it is estimated that many women initially do not consult a doctor while facing menstrual symptoms. Consequently, the impact of menstrual symptoms on daily activities in the general population is unknown. OBJECTIVE: To obtain a nationwide overview of menstrual symptoms and their impact on everyday activities. STUDY DESIGN: Nationwide, cross-sectional, internet-based survey among 42,879 women aged 15-45 years, conducted from July to October 2017. OUTCOME MEASURES: presence of menstrual symptoms, pain or intensity score, impact on daily activities. RESULTS: Dysmenorrhea was the most common symptom, with a prevalence of 85%, followed by psychological complaints (77%), and tiredness (71%). During their menstrual period, 38% of all women reported not to be able to perform all their regular daily activities. From the women that had to skip tasks because of their symptoms, only 48.6% told their family that menstrual symptoms were the reason for the transfer of tasks. CONCLUSION: Menstrual symptoms are widespread among the general population. One in 3 women quit daily activities owing to menstrual symptoms. Half of all women did not mention menstrual complaints being the reason for transferring tasks in a family setting. These results must be interpreted with caution owing to the potential for selection bias. However, considering the impact of menstrual symptoms on daily activities in a large group of women, it is time to open the societal dialogue and improve education for both patients and doctors.

Menstrual characteristics, disorders and associated risk factors among female international students in Zhejiang Province, China: a cross-sectional survey.

BACKGROUND: Until now, no previous study has addressed the menstrual patterns among female international students in China. In this present study, our objectives are to ascertain the menstrual characteristics and address the menstrual problems together with their associated risk factors among international students in China. METHODS: A cross-sectional survey was carried out with 500 previously piloted self-structured questionnaires which were administered to female international students enrolled in 15 universities in Zhejiang Province, China from May 2-August 31, 2016. Participants were required to provide answers to a semi-structured questionnaire which asked questions about their socio-demographics and their menstrual characteristics while in their home countries. Relevant changes in their menstrual pattern in terms of amount of flow and duration, regularity, length and suggestive symptoms for premenstrual syndrome in the months after coming to reside in China were also inquired. Respondents indicated changes in eating habits and selected stressors relevant to them from a given list. Their stress levels were assessed and further categorized with the help of the Perceived Stress Scale (PSS). Measurements for the main outcomes included the characteristics of menstrual patterns after arrival in China, stress levels, stressors and new lifestyle patterns. RESULTS: Four hundred and nine (81.8%) out of the 500 questionnaires met the criteria and constituted the population for this study. The respondents' mean age was 21.405 years. Almost half of our respondents (49.1%) reported varying changes in their menstrual pattern after arrival to China. Although, menstrual regularity, normal menstrual length (21-35 days) and duration of flow (3-7 days) remained fairly normal among most of the respondents, disorders like premenstrual symptoms (PMS) (33.82%); abnormal amount (17.97%) and dysmenorrhea (16.38%) were prevalent. There was a significant association between high stress (PSS > 20) and menstrual change 0R = 1.636, 95% CI 1.051-2.547, p = 0.029) and dysmenorhea (p = 0.037). Common stressors included language barrier 81(25.88%), food 64(20.45%), and loneliness 56(17.89%). CONCLUSION: Menstrual disorders are high among international students in China. We established premenstrual symptoms as the most common menstrual disorder. High levels of stress (PSS > 20) emanating from factors including the language barrier, diet and loneliness was significantly related to the disruptions in their menstruation.

Changing the perception of premenstrual dysphoric disorder - An online-experiment using the Stereotype Content Model.

Women with Premenstrual Dysphoric Disorder (PMDD) are often faced with prejudices about the premenstrual phase. The aim of this study was to investigate whether providing information (psychoeducation) could improve study participants' perception of a PMDD-patient and whether experimentally-induced prejudices about PMDD resulted in stigmatization. Two hundred sixteen students (50% female; aged 18-42 years) from Philipps University Marburg participated in January 2014. Participants were randomly assigned to one of two experimental groups (EG1, EG2) or to a control group (CG). EG1 read a text informing about PMDD. EG2 read a text with stereotypic PMDD-information. CG received a text with information unrelated to PMDD. Then, all participants watched a video of a woman reporting about her PMDD. Finally, participants appraised the woman on the cognitive dimensions warmth and competence as well as on PMDD-related attributes (depressive symptoms, emotional regulation). Participants of EG1 rated the woman as warmer (p <  .001), more competent (p =  .006), and with less depressive symptoms (p < .001) than the CG. The results by study group did not differ by gender. Stereotypic information did not differ significantly among the study groups. Psychoeducation can facilitate the understanding of PMDD-patients and should be integrated in future research on PMDD-treatments.

Negative cognitive styles as risk factors for the occurrence of PMS and PMDD.

Background: The purpose of our study is to verify whether elements of cognitive vulnerability to affective disorders may enhance the occurrence of PMS/PMDD. Methods: In total, 293 women with regular cycles took part in the study. The subjects were exposed to failure during the follicular phase or luteal phase, as appropriate, and the attributional style of failure, cognitive triad inventory (CTI) and presence of biased information processing were determined. The mood of the subjects before and after failure was measured, and the depressive mood was screened by CES-D. The occurrence of PMS/PMDD was assessed on the basis of PSST. Results: The women suffering from PMS/PMDD differed from those without PMS in terms of the cognitive triad, the use of positive and negative adjectives when describing themselves and biased information processing. In the luteal cycle phase, considerably greater sadness and irritation were observed in women with PMS/PMDD after experiencing failure, but only in those from the group not taking oral contraceptives. Conclusions: Negative cognitive styles are an important factor in the development of PMS/PMDD. PMDD is similar to major depression regarding cognitive vulnerability. Only in the case of PMDD was biased information processing in the luteal cycle phase recorded.

ASSOCIATION OF ACE GENE POLYMORPHISM WITH THE DEVELOPMENT OF PREMENSTRUAL SYNDROME.

Premenstrual syndrome (PMS) is a common problem of women in reproductive age. Genetic aspects of this pathology are not completely clear. The aim of the article is devoted to the study of the frequency of ID polymorphism of angiotensin-converting enzyme gene ACE in patients with premenstrual syndrome. The object of the study were 50 women in reproductive age with the diagnosis of PMS, 25 of them had mild form of the disease, 25 - severe one. 25 persons without PMS were controls. Polymerase chain reaction was used to study ACE gene polymorphism. We determined an equal distribution of ACE gene genotypes between women with PMS and without this pathology (DD genotype was established in 24% of controls and 30% women with PMS, ID genotype - 60% and 46% respectively, II genotype - 16% and 24%). However, DD genotype was found in 2.17 times more often in patients with severe form of the disease (52%) compared to healthy persons. Thus, women with DD genotype of ACE gene have the tendency to the development of severe PMS (χ2=3.06, p=0.08; OR=3.43, 95% CI 1.02-11.47, p=0.045).

Perimenstrual exacerbation of symptoms in borderline personality disorder: evidence from multilevel models and the Carolina Premenstrual Assessment Scoring System.

BACKGROUND: Individuals with a borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder. METHODS: Fifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS), a protocol for evaluating clinically significant cycle effects on symptoms. RESULTS: Most symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (⩾30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD). CONCLUSIONS: Females with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.

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

PURPOSE: To investigate differences in hippocampal activity between premenstrual syndrome (PMS) patients and healthy controls, to elucidate the neural mechanisms of PMS. MATERIALS AND METHODS: 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: 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. CONCLUSION: Altered spontaneous neural activity and connectivity of left HIPP may be involved in PMS. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:545-553.

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

OBJECTIVES: To assess structural and functional changes of the amygdala due to premenstrual syndrome (PMS) using magnetic resonance imaging (MRI). METHODS: 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. RESULTS: 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. CONCLUSIONS: Our findings may improve our understanding of the neural mechanisms involved in PMS. KEY POINTS: • 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.

Investigation of auditory potentials and cognitive impairment in premenstrual syndrome.

Premenstrual syndrome is a term which is used for describing of somatic, cognitive, emotional, and behavioral symptoms that occur during the luteal phase of menstrual cycle in women of reproductive age; symptoms rapidly improve at the onset of menstruation. In this study, we aimed to reveal if cognitive functions are affected or not in PMS and if the subjects are affected, we try to explain this situation by an objective diagnostic test. Ethical committee approval was taken for this project on 09.03.2012 and numbered 050.99-60. In this study, in order to determine premenstrual syndrome, "Premenstrual Syndrome Scale" that is developed by Gençdogan (2006) with 44 items, Likert type, and 9 subgroups was used. Sample size was calculated using simple random sampling with a confidence level of 95% and confidence interval of 0.05. A total of 60 participants were included in the study (calculated sample size was 30 for each group). Each group was recorded in the ENMG-UP laboratory using the OIP auditory warning and the "oddball two-tone discrimination task" method. Latency measurements were taken from the highest point of the peak, and amplitude measurements were taken from peak to peak with a cursor. Comparisons of P300 wave latencies obtained via sparse auditory stimulus in PMS and non-PMS groups were made and findings were summarized in one of the tables. Recordings are taken from three scalp regions: parietal and central, respectively. PMS women have longer P300 wave latencies in all regions compared to non-PMS group, whereas there is no significant difference between P300 amplitude.

Premenstrual symptoms interference and equol production status in Japanese collegiate athletes: A cross-sectional study.

AIM: Consumption of soy isoflavones reduces the risk of estrogen-related diseases, such as menopausal symptoms, osteoporosis, and cardiovascular disease. Equol is metabolized from the isoflavone daidzein by intestinal bacteria and has higher bioavailability than other isoflavones. Equol producers are believed to benefit from soybean consumption to a greater extent than non-producers. Recently, we showed that equol non-producers were at significant risk of premenstrual syndrome (PMS). Previously, we reported that PMS is a common menstrual problem in female athletes, and almost half of the studied athletes felt a negative effect of premenstrual symptoms on their athletic performance. This study was conducted to evaluate the relation between PMS and equol production status in Japanese collegiate athletes. METHODS: This was a cross-sectional, observational study that included 88 Japanese female collegiate athletes. Equol production status was determined using urine samples collected after a soy challenge test. The subjects also completed a questionnaire about their premenstrual symptoms and their competitive career. RESULTS: The prevalence of equol producers was 29.5% in Japanese collegiate athletes. The athletic performance of 54.5% of athletes was found to suffer in competition or in practice due to premenstrual symptoms. In multivariate analysis, equol non-producers (odds ratio, 3.34; 95% confidence interval, 1.03-12.20) and restriction of bodyweight (odds ratio, 4.94; 95% confidence interval, 1.47-20.00) were shown to be significant risk factors for poor athletic performance. CONCLUSION: This study showed a relation between athletic performance and equol production status in Japanese collegiate athletes.

Hormonal contraceptive use and prevalence of premenstrual symptoms in a multiethnic Canadian population.

BACKGROUND: Hormonal contraceptive use may be associated with a reduction in some premenstrual symptoms, however, the evidence remains equivocal. The objectives of the present study were to investigate the associations between ethnicity and hormonal contraceptive use with premenstrual symptoms. METHODS: One thousand one hundred two women participating in the Toronto Nutrigenomics and Health Study provided data on their premenstrual symptoms and hormonal contraceptive use. Severity of symptoms was classified as none, mild, moderate, or severe. Prevalence of premenstrual symptoms was determined in the total population and among major ethnic groups. Logistic regressions were used to determine the association between ethnicity and prevalence of premenstrual symptoms. Logistic regressions were used to determine the associations between hormonal contraceptive use, and premenstrual symptoms, adjusting for ethnicity and other covariates. RESULTS: Prevalence of individual symptoms varied, and the most commonly reported were cramps (75%), bloating (75%), mood swings (73%), increased appetite (64%), and acne (62%). Prevalence of cramps differed between ethnic groups with East Asians reporting a lower prevalence than Caucasians and South Asians (p < 0.05). Use of hormonal contraceptives was associated with a lower RR (95% CI) of experiencing moderate/severe: cramps (0.82, 0.72-0.93), clumsiness (0.22, 0.07-0.73), confusion (0.22, 0.09-0.54) and desire to be alone (0.45, 0.28-0.73). Hormonal contraceptive use was not associated with the risk of premenstrual symptoms at mild severity. Hormonal contraceptive use was not associated with symptoms of anxiety, bloating, mood swings, increased appetite, acne, fatigue, sexual desire, depression, nausea, headache and insomnia. CONCLUSION: This study demonstrates that East Asians may be at a lower risk of experiencing premenstrual cramps and that hormonal contraceptive use is associated with a lower risk of experiencing many, but not all, premenstrual symptoms at moderate/severe severity.

The cytokine-hormone axis - the link between premenstrual syndrome and postpartum depression.

Premenstrual syndrome (PMS) and related disorders, and postpartum depression (PPD) can affect women to the extent that their quality of life and that of their near ones can be severely impaired. This review focuses on the different theories regarding the etiologies of PMS and PPD, and attempts to draw a link between the two. Theories focus mainly on hormonal and cytokine factors throughout different phases in the female reproductive cycle. Changes in this symptomatology during pregnancy are also reviewed, as are changes in hormones and cytokine levels. Hypotheses are thus developed as to why the symptoms experienced in PMS often subside during pregnancy yet may recur and be exacerbated after birth, giving rise to the symptoms experienced in PPD.

Factors associated with the severity of premenstrual syndrome among Iranian college students.

AIM: Premenstrual syndrome (PMS) is characterized by physical, cognitive, and behavioral symptoms that occur cyclically, from several days to 2 weeks before menses, which resolve either quickly or during the early days of menstruation. The aim of this study was to determine the factors associated with the severity of PMS in Iranian college students. METHODS: The cross-sectional study was performed among 298 college students (aged 18-35 years) with PMS, of whom, 271 college students completed the Iranian version of the Premenstrual Symptoms Screening Tool questionnaire to determine the severity of PMS. Factors associated with PMS severity were identified using linear regression analysis with a stepwise method. RESULTS: Factors associated with severity of PMS were age (years), family income (low vs high income), marital status (unmarried vs married), and familial history of dysmenorrhea or PMS after adjustment for dysmenorrheal severity with ß (95% confidence interval) of 0.31 (0.45-0.57), 11.6 (1.2-23.54), 3.2 (0.4-5.2), and 2.22 (0.04-4.4), respectively. CONCLUSION: In this study, factors associated with severity of PMS were age, marital status, family income, and familial history of PMS. We observed that some outcomes were consistent with some previously reported results, which indicates the need for further studies.