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).

Comparison of performance-related responses to an endurance running training between untrained men and women / Comparación de respuestas relacionadas con el rendimiento a un entrenamiento de carrera de resistencia entre hombres y mujeres no entrenados

INTRODUCTION: The adherence on endurance running events is increasing exponentially around the World in both previously untrained men and women, thus the incorporation of more appropriate and individualized training approaches are required. It is not known if male and female untrained runners differ in the responses to endurance running training on performance-related variables. OBJECTIVE: We aimed to compare performance-related responses to an endurance running training program between untrained men and women. MATERIAL AND METHOD: Sixteen participants (8 men and 8 women) were paired in the baseline by age, body mass index, and percentage in which time to complete 5 km (t5km) represented from the average of best 50 runners t5km in the greatest regional race for each gender. They completed an 11-week training protocol alternating high-intensity interval training and moderate-intensity continuous running, three times per week, in a running track. In the week 1 and 11 of the protocol (baseline and post-training weeks), peak running velocity at treadmill (Vpeak), time limit (tlim) at 100% Vpeak, t5km, and the index rMSSD of heart rate variability (HRV ) were measured for cardiac autonomic function. Baseline gender-differences were accounted in the analysis. RESULTS: Male and female significantly improved Vpeak (9.4 ± 1.7% and 7.2 ± 1.7%, respectively) and t5km (-13.0 ± 1.8% for both), and no gender-related differences for the adaptations in these two variables were observed. The tlim at 100% Vpeak and rMSSD did not change across the training period in both groups. Percentage of change for men was "moderately" higher than for women for rMSSD (33.4 ± 40.7% vs. 13.9 ± 21.4%), although statistically non-significant. CONCLUSION: Men and women responses to training were similar with regards to their running performance and cardiac autonomic function. With regards to practical application, Vpeak and its tlim can be applied in exercise settings for the prescription of moderate- to high-intensity running training with similar benefits regardless of the biological gender

INTRODUCCIÓN: La adherencia a los eventos de carreras de resistencia está aumentando exponencialmente en el mundo entre hombres y mujeres no entrenados, y por eso es necesaria la incorporación de un entrenamiento individualizado y apropiado. No se sabe si los hombres y mujeres desentrenados en carrera difieren en las respuestas al entrenamiento de carrera de resistencia en relación a las variables relacionadas con el rendimiento. OBJETIVO: Nuestro objetivo fue comparar las respuestas del rendimiento durante un programa de entrenamiento de carrera de resistencia entre hombres y mujeres no entrenados. MATERIAL Y MÉTODO: Dieciséis participantes (8 hombres y 8 mujeres) fueron emparejados en la línea de base por edad, índice de masa corporal y porcentaje del tiempo para completar los 5 km (t5km) representados por el promedio de los t5km de los 50 mejores corredores obtenidos en las mejores carreras regionales (para cada género). Los participantes completaron un protocolo de entrenamiento de 11 semanas alternando entrenamiento de intervalos de alta intensidad con entrenamiento continuo de intensidad moderada, tres veces por semana, en una pista de atletismo. En las semanas 1 y 11 del protocolo (línea de base y semana posterior al entrenamiento), se midieron la velocidad máxima de carrera en la cinta (Vpeak), el tiempo límite (tlim) en Vpeak, t5km y el índice rMSSD de la variabilidad de la frecuencia cardíaca (VFC) para la función cardíaca autónoma. En los análisis se consideraron las diferencias entre géneros en la línea de base. RESULTADOS: Hombres y mujeres mejoraron significativamente la Vpeak (9,4 ± 1,7% y 7,2 ± 1,7%, respectivamente) y el t5km (-13,0 ± 1,8% para ambos), y se observaron diferencias relacionadas con el género para las adaptaciones en estas dos variables. El tlim en Vpeak y el rMSSD no han cambiado durante el período de entrenamiento en ambos grupos. El porcentaje de cambio en los hombres fue moderadamente superior al de las mujeres para la rMSSD (33,4 ± 40,7% vs. 13,9 ± 21,4%), aunque no fue significantemente diferente. CONCLUSIÓN: Las respuestas de hombres y mujeres al entrenamiento fueron similares considerando el rendimiento de carrera y la función cardíaca autónoma. En relación con la aplicación práctica, Vpeak y su respectivo tlim se pueden aplicar en programaciones de ejercicio para prescribir intensidades de entrenamiento de carrera con intensidades moderadas a altas y con beneficios similares, independientemente del género

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.

Hormonal Contraception and Depression: Updated Evidence and Implications in Clinical Practice.

Hormonal contraceptives are used worldwide by more than 100 million women. Some studies have been published about the possible appearance of depressive symptoms when using hormonal contraceptives, but this link is still a matter of debate. The purpose of this review is to provide an update of the literature on this issue, and to investigate the possible explanations of this problem based on animal and human studies. The main pathway responsible for menstrual cycle-related mood changes is the γ-aminobutyric acid pathway, which is sensitive to changes in the levels of progesterone and of its metabolites, the neurosteroids. In particular, allopregnanolone is a potentiating neurosteroid with anxiolytic and anti-convulsant effects whose levels change during a normal menstrual cycle together with progesterone levels. Progestins have different effects on allopregnanolone, mainly owing to their diverse androgenicity. Moreover, they might affect brain structure and function, even though the meaning of these changes has yet to be clarified. It is important to define the groups of women in which negative mood disorders are more likely to occur. Adolescence is a critical period and this age-specific vulnerability is complex and likely bidirectional. Moreover, women with a history of mood affective disorders or premenstrual dysphoric syndrome are at a higher risk when taking contraceptives. In this review, we aim to provide clinicians with advice on how to approach these difficult situations.

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.

A Pilot Randomized Treatment-Controlled Trial Comparing Vitamin B6 with Broad-Spectrum Micronutrients for Premenstrual Syndrome.

Objective: Premenstrual syndrome (PMS) affects 20%-30% of women but current medical treatments are limited in their efficacy. The objective of this study was to compare efficacy of a broad-spectrum micronutrient formula (consisting mainly of minerals and vitamins) to a single vitamin (B6) for treatment of PMS, for which B6 has already been shown to be efficacious. Methods: This double-blind, randomized, treatment-controlled trial allocated 78 (72 completed) regularly menstruating women with PMS to consume micronutrients or vitamin B6 (80 mg/day) daily following a two-cycle baseline period, for three menstrual cycles. The primary outcome measure, Daily Record of Severity of Problems (DRSP), established PMS as well as tracked change in five PMS symptoms: psychological, somatic, total symptoms, impact ratings, and worst day ratings. Results: Linear-mixed model analyses indicated both treatments produced comparable reduction in PMS symptoms with medium effect sizes (ES) across all PMS variables as measured by the DRSP (micronutrient ES = 0.50-0.56; B6 ES = 0.43-0.56), with 72% of the micronutrient and 60% of the vitamin B6 group identified as in full remission in PMS symptoms after three cycles. The micronutrient-treated participants showed greater improvement than the B6 group (between group d = 0.51, p < 0.05) in health-related quality of life. For those women (n = 28) who met criteria for premenstrual dysphoric disorder (PMDD), the DRSP ES were larger for those who had been in the micronutrient condition (ES = 1.28-1.67) as compared with those on B6 (ES = 0.50-0.75), although the group differences were not statistically reliable. There were no group differences in side effects, nor any serious adverse effects reported. Conclusions: Both treatments provided similar benefit for reducing PMS symptoms, with greater effect of micronutrients on quality of life as well as potential clinical benefit of micronutrients for PMDD. This study provides further efficacy data on B6 and also identifies the nutritionally broader spectrum intervention as possibly having specific advantages for those whose symptoms are more severe. As this is the first study to investigate these treatments for PMDD, systematic replication is required.

Effects of a social-media-based support on premenstrual syndrome and physical activity among female university students in South Korea.

Introduction: This study examined the effects of social-media-based support on premenstrual syndrome (PMS) and physical activity among female South Korean university students.Methods: This quasi-experimental study with an equivalent-control-group pretest-posttest design randomly assigned 64 female students with PMS to the experimental or control group. The experimental group received social-media-based support through a smartphone application, text messaging, and e-mail for one menstrual cycle between September and December, 2016. Descriptive and inferential statistics included a Chi-square test and independent and paired t-tests.Results: Significant differences emerged between the experimental and control groups in total PMS scores (p = .003), 14 premenstrual symptoms, and physical activity (p = .010).Conclusions: Female university students with PMS experienced decreased premenstrual symptoms and increased physical activity with social-media-based support, which could be an efficacious, accessible, and widely available nursing intervention to manage PMS and physical activity.

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).

Increased sensitivity to social exclusion during the luteal phase: Progesterone as resilience factor buffering against ostracism?

A woman's social behaviour reportedly varies across the menstrual cycle. In this study, we estimated changes in sensitivity to social exclusion across the menstrual cycle and scrutinized the related role of progesterone. Forty-nine naturally cycling women played a virtual ball-tossing game (Cyberball) to manipulate social inclusion. All participants underwent inclusion and exclusion conditions during the late follicular and the luteal phase. We assessed salivary progesterone concentrations at each cycle phase. After each Cyberball session we measured positive/negative mood using the Multidimensional Mood State Questionnaire (MDMQ). Multilevel analyses indicated that women showed worse mood following exclusion as compared to inclusion conditions (p = 0.014). Notably, this exclusion effect was more pronounced during the luteal phase than the late follicular phase (p = 0.029). As expected, progesterone concentrations were higher during the luteal phase as compared to the late follicular phase, but interestingly, progesterone concentrations were negatively associated with exclusion effects. When accounting for mediation via progesterone, direct cycle-phase related differences in social exclusion effects even increased as compared to the model without mediator. These findings suggest that progesterone may function as buffer against negative feelings that result from being socially excluded. The relevance of these findings for Premenstrual Dysphoric Disorder (PMDD) are discussed, and we conclude that social exclusion may represent an important research domain criterion (RDoC) of relevance for PMDD, with progesterone pointing to new potential pharmacological targets.

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.

Can menstrual health apps selected based on users' needs change health-related factors? A double-blind randomized controlled trial.

OBJECTIVE: Most healthcare providers are reluctant to use health apps for healthcare because there is no rigorous way of choosing the best app for their patient or consumer. Accordingly, we developed a new method of app selection that fully considers target users' needs. This study verified whether health apps selected based on target users' needs can influence health-related factors. MATERIALS AND METHODS: We conducted a randomized control trial of women with dysmenorrhea and premenstrual syndrome using App A (the best app selected using the new method) and App B (the app with the highest number of users worldwide). The intervention was performed over 4 months to include at least 3 menstrual cycles. RESULTS: Sixty-one app users completed the 16-week intervention. While users rated both apps as higher in quality than previously used menstrual apps, only App A users showed significant improvements in overall satisfaction, app outcome expectancy, the number of days with records, app social influence, intent to recommend, and the possibility of behavioral or cognitive changes in their symptom management. The number of menus used increased over time. While the app self-efficacy and the number of relief methods did not significantly differ between groups, they still showed an increase in App A users. CONCLUSIONS: When a menstrual app reflected users' needs, they recorded their symptoms more often and reported higher app quality, satisfaction, and intention to recommend. This study can not only benefit the selection of menstrual apps, but also confirm that mobile health apps can improve health-related factors.

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.

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.

Changes in trunk veins of the lower limbs in women with premenstrual leg heaviness and swelling.

BACKGROUND: The aim of this study was to investigate vein changes during the menstrual cycle in parous women with premenstrual leg heaviness. METHODS: А total of 39 women with heavy legs before menstruation were examined. Great saphenous vein (GSV) in the groin, femoral vein (FV) and popliteal vein (PV) were examined with ultrasound scanning before 10 a.m. and after 6 p.m. on days 1 to 4 (menstrual phase) and 25 to 28 (secretory phase). To characterize biophysical features of veins we used: 1) interphase gradient of the diameter (IGd), i.e. the difference in vein diameters during the secretory and menstrual phases; 2) orthostatic gradient of the diameter (OGd), i.e. the difference in vein diameters measured in the evening and in the morning. RESULTS: Diameter changings for GSV, FV and PV were similar. GSV diameter increased from the morning during the menstrual phase to the evening during the secretory phase on average by 26.2%. OGd was 0.73 mm (95% CI: 0.59-0.87) during the menstrual phase and 0.62 mm (95% CI: 0.54-0.71) during the secretory phase. IGd was 0.73 mm (95% CI: 0.61-0.86) already in the morning. During the secretory phase 43.6% patients had the GSV reflux. During the whole menstrual cycle GSV diameter in the reflux zone increased on average by 40.6%. IGd of GSV in this zone reached 1.25 mm (95% CI: 1.02-1.48) in the morning and 1.30 mm (95% CI: 1.25-1.35) in the evening. CONCLUSIONS: Women with premenstrual leg heaviness have a minimal vein diameter in the morning during the secretory phase. The maximal diameter is revealed in the evening during the secretory phase. Clinically manifested expansion of veins, including GSV refluxes, is found during the secretory phase due to increased expansibility of veins. However, because of increased creeping ability one observes expansion of veins during the whole menstrual cycle in these women.

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.

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.

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.