Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan.

BACKGROUND: Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity. METHODS: In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time. RESULTS: During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism. CONCLUSION: Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information. TRIAL REGISTRATION: UMIN Clinical Trials Registry number: UMIN000038917.

Effects of Laughter Yoga on Premenstrual Symptoms.

Context: Premenstrual syndrome (PMS) is associated with a group of emotional, behavioral, and somatic symptoms that occur during the menstrual cycle. Laughter yoga involves a combination of laughter exercises and breathing techniques derived from more traditional yoga practice. No previous studies have examined the effects of laughter yoga on the symptoms of PMS. Objective: The study intended to assess the effectiveness of laughter yoga in coping with the premenstrual symptoms of women. Design: The research team performed a pretest and posttest, quasi-experimental study. Setting: The study took place in the nursing and midwifery departments at Marmara University, a state university located in Istanbul, Turkey. Participants: Participants were 80 female students in those departments at the university between February 2019 and May 2020 who had PMS. Intervention: The research team divided participants into two groups based on their departments: (1) an intervention group, the laughter yoga group, with 32 participants who took part in a twice-weekly laughter yoga program that included a weekly 30-min group session consisting of laughter and deep breathing, and (2) a control group with 48 participants. Outcome Measures: The research team collected the data using the Demographic and Descriptive Information Form (DDIF), Premenstrual Syndrome Symptom Scale (PMSS), and Visual Analogue Scale (VAS). Results: Between baseline and postintervention, the laughter yoga group's mean scores for the PMSS subdimensions depressive affection (P = .00), anxiety (P = .04), fatigue (P = .00), irritability (P = .01), depressive thoughts (P = .03), pain (P = .002), changes in sleep (P = .004), and bloating (P = .001) significantly decreased. The laughter yoga group's scores for fatigue (P = .03) and pain (P = .001) were significantly lower than those of the control group postintervention. Conclusions: Laughter yoga is a noninvasive complementary therapy that clinicians can use to reduce the PMS symptoms.

The effects of yoga and progressive muscle relaxation exercises on premenstrual syndrome: a randomized controlled trial.

In this study, university students with premenstrual syndrome (PMS) were evaluated for their responses to the practices of yoga and progressive muscle relaxation (PMR) to combat PMS, and the depression, anxiety, and stress associated with it. A total of 68 students participated in a randomized controlled trial. They were divided into four parallel groups: a yoga intervention group (n = 17), a PMR intervention group (n = 17), a yoga and PMR intervention group (n = 17), and a control group (n = 17). Data were collected between April 2022 and June 2022, from students who practiced only yoga, who practiced only PMR, and who practiced both yoga and PMR. A Personal Information Form, the PMS Scale, and the Depression, Anxiety, and Stress Scale were used as measurement tools. The yoga and yoga + PMR groups had lower scores for the PMS Scale in the posttest than the other groups (p < .05). Depression, anxiety, and stress sub-dimension mean scores were lower in the yoga, PMR + yoga, and PMR groups compared to the control group (p < .05). The results suggest that yoga and PMR interventions are beneficial non-pharmacological treatments for PMS, depression, anxiety, and stress.Clinical Registration Name, Registration Number, Registration Date: The Effects of Yoga and Progressive Muscle Relaxation Exercises on Premenstrual Syndrome, NCT05396976, April 5, 2022.

Effectiveness of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of students with premenstrual syndrome.

BACKGROUND: Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS. METHODS: A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff's Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P < 0.05 was considered for the analysis. RESULTS: The results of the study showed that the SIT interventions decreased the PMS severity and most psychological factors so in the intervention group, SIT was able to significantly reduce anxiety, depression, perceived stress, and Sheehan's disability after intervention (P < 0.001). Based on multiple linear regression analysis, the most predictors of HADS were the PSS and SDS (ß = 0.285, p = 0.009 and ß = 0.236, p = 0.024, respectively). CONCLUSION: The computer-based SIT counseling approach could reduce the severity of symptoms and psychological factors in students. Therefore, SIT intervention is recommended to manage their PMS. TRIAL REGISTRATION: IRCT20230130057274N2.

[Premenstrual syndrome and premenstrual dysphoric disorder-Overview on pathophysiology, diagnostics and treatment]. / Prämenstruelles Syndrom und prämenstruelle dysphorische Störung ­ Übersicht zu Pathophysiologie, Diagnostik und Therapie.

Premenstrual syndrome and premenstrual dysphoric disorder become episodically manifest during the second half of the female menstrual cycle and are characterized by psychological and physical symptoms causing relevant functional and social impairments. Mood swings, depression and dysphoria are associated depressive symptoms. Therefore, affective disorders should be considered as a differential diagnosis. Of women in reproductive age 3-8% suffer from premenstrual syndrome and 2% of women are affected by premenstrual dysphoric disorder. Genetic and sociobiographical risk factors are discussed. Furthermore, genetic polymorphisms of specific hormone receptors are considered to be genetic risk factors. From a pathophysiological perspective premenstrual syndrome and premenstrual dysphoric disorder are caused by a complex interaction between cyclic changes of ovarian steroids and central neurotransmitters. An imbalance of estrogen and progesterone in the luteal phase is believed to cause the symptoms. Therefore, the first treatment approach consists of regulation of the menstrual cycle or luteal support with progesterone or synthetic progestins even if their effectiveness has not yet been proven in randomized controlled studies and meta-analyses. The administration of combined oral contraceptives is also an option. Especially treatment with selective serotonin reuptake inhibitors (SSRI) represent an evidence-based approach. In severe cases the administration of gonadotropin releasing hormone (GnRH) agonists with add back treatment can also be considered. In the field of affective disorders premenstrual syndromes represent clinically relevant differential diagnoses and comorbidities, which confront the treating physician with particular clinical challenges. Therefore, this literature review gives the readership a clinical orientation for dealing with these disorders.

Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity.

Most women who menstruate experience various physical, psychological, and behavioral changes during the period between ovulation and menstruation. This study focuses on defining and diagnosing premenstrual disorders, distinguishing between premenstrual symptoms (PS), PMS, and premenstrual dysphoric disorder (PMDD). It highlights the prevalence of these conditions and their impact on women's quality of life, including social, occupational, and psychological aspects. Furthermore, the study examines the role of physical activity, particularly aerobic exercise, in managing premenstrual symptoms. Several systematic reviews are cited, suggesting that regular physical activity can effectively reduce both physical and psychological symptoms associated with PMS. In conclusion, the management of PMS involves a multifaceted approach, with exercises, dietary modifications, stress management, cognitive-behavioral therapy, and medications all playing roles. Physical activity, especially aerobic exercise, has been found to be an effective non-pharmacological therapy for alleviating PMS symptoms and improving overall well-being. However, more research is needed to determine the optimal type and dosage of exercise for individual women with PMS.

Pre-menstrual Syndrome and Pre-menstrual Dysphoric Disorder in Female Medical Students of Nepal.

Background Pre-menstrual Syndrome and Pre-menstrual Dysphoric Disorder can have negative impact on medical students and remains mostly underdiagnosed. Different treatment modalities like medications (doctor-prescribed or self-medicated), and alternative therapies are used by students to cope with pre-menstrual symptoms. Objective To estimate the prevalence and severity of Premenstrual Syndrome and Premenstrual Dysphoric Disorder among medical students in Nepal along with its impact in their quality of life, their health seeking behavior and treatment modalities used to cope with these disorders. Method A cross-sectional study was conducted among female medical students studying MBBS in various medical colleges in Nepal using a self-administered questionnaire from September 2020 to March 2021. Result The prevalence of Premenstrual Syndrome and Premenstrual Dysphoric Disorder among female medical students in Nepal was 64% and 36.3% respectively as per this study. Among the areas impacted by premenstrual symptoms, concentration in class was the most affected (68.1%), followed by distress (64.6%). Only 7.3% of the responding participants sought medical consultation for their symptoms. Among those who suffered from at least one symptom for any length of time, 34.8% of participants reported of using at least one medication (either prescribed or selfmedication). Similarly, alternative remedies were used by 44.4% of the participants. Conclusion Premenstrual syndrome and premenstrual dysphoric disorder were found to be common in female medical students of Nepal. However, very few students sought medical consultation despite a significant impact in their academic and other activities. Self-medication and traditional therapies were common modalities used for treatment of premenstrual symptoms.

The Effect of Cognitive-behavioral Counseling on the Resilience of Female Adolescents with Premenstrual Syndrome: A Randomized Controlled Trial.

Background: Premenstrual syndrome (PMS) is one of the causes of poor performance in women, with direct and indirect adverse effects on their marital, family, and social life. This study aimed to examine the effect of cognitive-behavioral counseling on resilience in adolescent girls with PMS. Methods: This randomized clinical trial was conducted from February to May 2018 on 15-17-year-old girl adolescents in Hamadan high schools. Using the block randomization method and the block size of 10, we randomly assigned 120 participants with moderate to severe PMS into intervention (N=60) and control groups (N=60). Participants in the intervention group received eight 60-minute cognitive-behavioral counseling sessions for 8 weeks, and the control group received no intervention. Data were gathered using demographic questionnaire, Premenstrual Symptoms Screening Tool, and the Connor-Davidson resilience scale. Statistical analysis was performed using SPSS version 16. The Chi-square, independent-samples t-test, and paired t-tests were used to analyze the data. P values <0.05 were considered significant. Results: The mean total resilience score and all its dimensions increased in the intervention group 3 months after the intervention (P<0.05). Mean scores of total resilience and all subscales except spiritual influences showed statistically significant differences between the intervention and control groups 3 months after the intervention (P<0.05). Conclusion: Cognitive-behavioral counseling can improve resilience in female adolescents with moderate to severe PMS. It is recommended that school counselors can use cognitive-behavioral counseling to improve the resilience of girls with moderate to severe PMS.Trial Registration Number: IRCT2015052615341N6.

Online positive-oriented counseling, taking vitamin D3 tablet, online lifestyle modification training on premenstrual syndrome: a 3-armed randomized clinical trial.

Lack of absolute treatment for premenstrual syndrome (PMS), its cyclic nature, considerable prevalence (70-90%), and its mental and physical burden imply necessity of effectiveness comparison of various treatments. Although antidepressant and hormonal drugs are well-known medications for PMS, in affected women who can't tolerate, or don't have compatibility or compliance with these drugs, other effective treatments have always been important concern. This study aimed to compare effectiveness of online positive-oriented counseling, taking vitamin D3 tablet, and online lifestyle modification training on alleviating PMS. 3-armed parallel randomized clinical trial was performed on 84 20-40-year-old eligible women with PMS. 84 women were randomly ( www.random.org/sequenc ) allocated into three groups, but data of 77 women (1, n = 25) online positive-oriented counseling group (6 sessions), (2, n = 27) vitamin D3 tablet group (one vitamin D3 tablet weekly for 6 weeks), and (3, n = 25) online lifestyle training group (6 sessions) were analyzed. Vitamin D3 was measured at baseline, week6 and fallow up week10. Primary outcome variable PMS was measured with Premenstrual Symptoms Screening Tool (PSST) at baseline, week 6, and follow-up week 10. Primary outcome satisfaction with intervention method was measured using satisfaction scale at week 6 and follow-up week 10. ANOVA, Repeated Measures, and Paired samples t-test were used for statistical analysis. There was no statistically significant difference in PMS at baseline between three groups respectively (33 ± 5.8, 34.1 ± 7.1, & 35.2 ± 6.4, P = 0.500). However, at follow-up week 10, there was statistically significant difference between three groups (22.3 ± 4.3, 25.4 ± 6.5, & 31.8 ± 6.5; P < 0.001), with greatest improvement in online positive-oriented counseling group (P < 0.001). Satisfaction differed significantly among three groups at week 6 (51 ± 6.8, 46.4 ± 12, & 42.3 ± 6.3, P = 0.001) and follow-up week 10 (55.7 ± 11.6, 51.4 ± 12; & 43 ± 3.3, P < 0.001), with most satisfaction in positive-oriented counseling group (P < 0.001). All three interventions alleviated PMS, but online positive-oriented counseling was more effective and satisfying. Superiority of positive-oriented counseling implies mechanism of adaptation, better relationships, forgiveness, self-mood-regulation, and feasibility of its skills that could be continued individually by women after counseling completion. It is recommended health providers, health policymakers and managers support use of these interventions in treatment program and clinical guidelines.Trial registration: RCT registration number: IRCT20191231045967N1, Registration date:11/02/2020, Registration timing: prospective (IRCT | Survey the effect of vitamin D3 tablet intake, positivism group consulting with changing in life style in the treatment of premenstrual syndrome in women).

Gender Differences in Premenstrual Syndrome and Premenstrual Dysphoric Disorder Diagnosis and Treatment among Japanese Obstetricians and Gynecologists: A Cross-Sectional Study.

Premenstrual symptoms are characterized by unpleasant psychophysical symptoms that appear during the luteal phase before menstruation and interfere with a woman's quality of life. Premenstrual syndrome (PMS) is a pathological condition with premenstrual symptoms, of which premenstrual dysphoric disorder (PMDD) is a particularly severe psychological symptom. This study aimed to examine the gender differences in the diagnosis and treatment of PMS and PMDD among obstetricians and gynecologists (OB/GYNs) in Japan. Data were obtained from the survey conducted by the Japanese Society of Obstetrics and Gynecology. We used data from 1,257 of the 1,265 OB/GYNs who are engaged in PMS/PMDD practice and reported their gender. Multivariate regression analysis adjusted for propensity scores was performed. Female OB/GYNs were more frequently engaged in treating patients with PMS/PMDD than males [odds ratio (OR) 1.74; 95% confidence interval (CI) 1.36-2.21]. With regard to the diagnostic methods, more female OB/GYNs selected the two-cycle symptom diary than males (OR 2.88; 95% CI 1.80-4.60). Regarding treatment, fewer female OB/GYNs selected selective serotonin reuptake inhibitors as their first-line drug (OR 0.39; 95% CI 0.17-0.89). Gender differences were found in the selection of PMS/PMDD diagnosis and treatment methods among Japanese OB/GYNs.

Investigating the effect of mindfulness counselling on sexual functioning of women with premenstrual syndrome.

Mindfulness exercises can improve a wide range of the psychological and interpersonal consequences of premenstrual syndrome. Nevertheless, there is sparse information about the effect of mindfulness counselling on sexual dysfunction in women with this condition. This study aimed to determine the effect of mindfulness counselling on the sexual functioning of women with premenstrual syndrome. In this controlled randomized study, 112 women diagnosed with premenstrual syndrome referred to selected urban healthcare centers in Isfahan, Iran, were randomly allocated to two groups (intervention and control), each with 56 participants. The intervention group underwent mindfulness counselling in eight 60-minute sessions online via Google Meet. The control group did not receive any kind of intervention. The principal measure was score on the Rosen Female Sexual Functioning Index (FSFI) before, immediately, and one month after the intervention. The data were analyzed by SPSS 23, through descriptive and analytical statistical tests (chi-square, Mann-Whitney, independent t-test, ANOVA, and repeated measure) with a significance level of 0.05. There was no statistically significant difference in the mean FSFI score (or the subscores) between the intervention and control groups (p greater than 0.05) at baseline. In the intervention group, there were significant increases (relative to both baseline and in comparison with the control group) in the mean subscores for sexual desire (P < 0.0001), orgasm (P = 0.01), satisfaction (P = 0.0001), sexual pain (P = 0.003), and general sexual functioning (P < 0.0001) immediately after and one month after the intervention, but the score for sexual arousal was significantly greater only at the one-month evaluation (P < 0.0001) and there were no differences in the scores for vaginal lubrication. On the other hand. Mindfulness counselling was effective in improving the sexual functioning of women suffering from premenstrual syndrome, and should be used for this purpose in healthcare centers.

The effect of progressive muscle relaxation technique and myofascial release technique on premenstrual symptoms, blood circulation, and quality of life in women with premenstrual syndrome: A single-blind randomized controlled study.

BACKGROUND: Premenstrual syndrome (PMS) is a common condition in women of reproductive age. It is characterized by a range of behavioral, physical, and psychological symptoms. The aim of this study is to investigate the effects of progressive relaxation and myofascial release technique (MRT) on premenstrual symptoms, blood flow rate, pain, sleep quality and quality of life, in women with PMS. METHOD: The study will conduct as a single-blind randomized controlled trial. Study registered at the ClinicalTrial.gov Protocol ID: NCT05836454. The volunteers will be randomized using allocation software to be divided into 3 groups: the progressive muscle relaxation group, the MRT group, and the control group. Assessments will be conducted by another physical therapist who is blinded to the groups. The assessments will include the Premenstrual Syndrome Severity Score, Blood Flow Measurements, Short Form McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index and Short Form-36 Health Survey. DISCUSSION: Since both methods provide relaxation, improve symptoms and quality of life, they have not been compared to each other in the literature. This prompt to us to plan this study.

The Effect of a Mindfulness-Based Stress Reduction Program on Premenstrual Symptoms: A Randomized Controlled Trial.

INTRODUCTION: Premenstrual syndrome (PMS) is an important health problem that affects women of childbearing age. Mindfulness, a meditation practice that cultivates the acceptance of events as they occur in the moment without judgment, is a promising strategy to help women cope with PMS. This study aimed to test the efficacy of a mindfulness-based stress reduction (MBSR) program in decreasing premenstrual symptoms compared with a control group. METHODS: This study was a prospective, single-masked randomized controlled trial conducted between February and April 2022 with 90 university students. Participants were women between 20 and 30 years of age, scored at least 45 on the Premenstrual Syndrome Scale (PMSS), and were not receiving other treatments for PMS. Participants were randomized into experimental (MBSR) and control groups in a 1:1 allocation. MBSR was provided in 8 weekly sessions lasting 2.5 hours and a 6-hour silence retreat during week 6. Symptoms of PMS were evaluated with the PMSS at baseline and postintervention. Differences between groups were compared postintervention using analysis of covariance to correct for baseline scores. The study was registered at www. CLINICALTRIALS: gov before the data collection process was initiated (NCT05191108). RESULTS: Of the 90 enrolled participants, 74 participants completed the study and postintervention assessment (37 in each group). Immediately postintervention, the women in the experimental group had significantly lower PMS symptoms than women in the control group (PMSS total score, 96.35 vs 123.02; P < .001). The effect size for the change in premenstrual symptoms was large (partial η2 , 0.510). Specific symptoms measured by the PMSS subscales all showed significant reductions in scores in the MBSR group compared with the control group. DISCUSSION: A mindfulness stress reduction program was effective in reducing premenstrual symptoms. MBSR programs may be used as a therapy for PMS. Future studies should test MBSR in larger and more diverse groups of women with PMS.

[Recognition and treatment of premenstrual mood disorders]. / Het herkennen en behandelen van premenstruele stemmingsklachten.

Since 2014 premenstrual dysforic disorder (PMDD) has been included in the DSM-5. Although PMDD affects 3-8% of all fertile women, there is no psychiatric guideline on the treatment. Fortunately, there are multiple meta-analyses and gynecological guidelines to base the treatment on. We present a case of a woman with mood swings and irritability. Recognizing and treating the hormonal component of her complaints also helped her to deal with other problems. Psychiatrists and gynecologists use different approaches for similar symptoms. We compare the different classifications and suggest treatment recommendations. When treating women in the fertile age with mood symptoms, the influence of the menstrual cycle should always be considered.

Whole-body vibration versus supervised aerobic exercise on hormonal parameters and inflammatory status in women with premenstrual syndrome: A randomized controlled trial.

OBJECTIVES: To compare the effects of whole-body vibration (WBV) and aerobic exercise on the hormonal profile and inflammatory status in women with premenstrual syndrome (PMS). METHODS: A prospective, randomized, pre-post-test, single-blind, controlled trial was conducted in 105 women diagnosed with PMS. They were randomized into three equal groups. All women received magnesium and vitamin B complex supplementation once daily. WBV training was added three times per week to the WBV group. The aerobic exercise group added aerobic exercise three times per week, while the control group received no additional intervention. The Premenstrual Syndrome Questionnaire (PMSQ) was used to assess PMS symptoms. Blood analysis was performed to measure hormone assays (estradiol, progesterone, prolactin, and cortisol) and high-sensitivity C-reactive protein at the start and after the end of the treatment program. RESULTS: There was no statistically significant difference between WBV and aerobic exercise according to PMSQ and high-sensitivity C-reactive protein (P = 0.99 and P = 0.98, respectively), but there was a statistically significant difference between both groups in cortisol, progesterone, prolactin, and estradiol (P = 0.001), with more favor given to the WBV group. CONCLUSION: WBV and aerobic exercise have positive effects on women with PMS, with more favor given to WBV.

Effect of transcranial direct current stimulation on homeostatic and hedonic appetite control and mood states in women presenting premenstrual syndrome across menstrual cycle phases.

PURPOSE: This study investigated the acute effect of anodal transcranial direct current stimulation (a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on appetite, energy intake, food preferences, and mood states in the luteal and follicular phases of the menstrual cycle in women presenting premenstrual syndrome. METHODS: Sixteen women (26.5 ± 5.2 years; 1.63 ± 0.1 m; 64.2 ± 12.8 kg; body mass index 24.0 ± 5.0 kg/m2; body fat 27.6 ± 7.5%) with the eumenorrheic menstrual cycle were submitted to a-tDCS and sham-tDCS conditions over their follicular and luteal phases. At pre - and post-tDCS, hunger and desire to eat something tasty, (analogic visual scale), the profile of mood states (POMS), and the psychological components of food preferences (Leeds Food Preference Questionnaire-BR) were assessed. Participants recorded their food intake for the rest of the day using a diary log. RESULTS: There was a trend towards main effect of condition for decreased implicit wanting for low-fat savory food after a-tDCS but not sham-tDCS regardless of menstrual cycle phase (p = 0.062). There was no effect for self-reported hunger, desire to eat, energy and macronutrient intake, and on other components of food preferences (explicit liking and wanting for low- and high-fat savory and sweet foods, implicit wanting for low- and high-fat sweet and high-fat savory food); as well as for mood states. CONCLUSIONS: Although no significant effects of a-tDCS were found, the present investigation provides relevant perspectives for future studies.

Perspectives of Dutch women on premenstrual disorder. A qualitative study exploring women's experiences.

BACKGROUND: Women presenting with Premenstrual Disorder (PMD) to general practitioners (GPs) experience problems with their biopsychosocial functioning. PMD is a disorder consisting of physical and/or mood-based symptoms cyclically occurring with a significant impairment of daily life. Little is known about the symptoms and coping strategies of women with PMD and their experiences with their GPs. OBJECTIVES: This present study aimed to improve understanding of the perspectives of women with PMD, their coping strategies and their expectations of the GP. DESIGN: Qualitative study with semi-structured interviews. SETTING: In 2017, Dutch women with symptoms of premenstrual disorder were recruited through local newspapers in the town of Nijmegen and the North-Holland region and via social media. After checking the inclusion and exclusion criteria, we interviewed 20 women (between 27 and 49 years of age). The interviews took place at a location of the interviewees' preference. RESULTS: PMD symptoms can strongly influence the quality of women's lives. Three themes emerged from our analysis: feelings of having two separate female identities, PMD as a life-controlling condition and different coping strategies. Most women used an active coping strategy. Women with PMD need recognition from their GPs and knowledge of proper treatment. CONCLUSION: PMD symptoms can have a high impact on daily life. Women with PMD expressed their need for acknowledgement and a personalised approach from their GP. Greater awareness and knowledge among GPs may be helpful in this.

Premenstrual disorders: Premenstrual syndrome and premenstrual dysphoric disorder.

Recently, the term premenstrual disorders (PMDs), which includes premenstrual syndrome and premenstrual dysphoric disorder as a continuum, has been proposed. Although the precise etiology of PMDs remains unknown, the involvement of hormonal fluctuations is clear. The brain transmitters, serotonin and γ-amino butyric acid, also seem to be involved. Serotonin reuptake inhibitors and oral contraceptives are the current mainstay of treatment, but these are insufficient. Even the currently used prospective two-period symptom diary is not widely used in actual clinical practice, creating a major problem of discrepancy between research and clinical practice. In this review, I would like to outline the latest information and problems in the etiology, diagnosis, and treatment of PMDs, with an emphasis on promising new therapies.

A 1-week sleep and light intervention improves mood in premenstrual dysphoric disorder in association with shifting melatonin offset time earlier.

To test the hypothesis that 1 week of combined sleep and light interventions (SALI), which phase-advance (shift earlier) melatonin circadian rhythms, improves mood significantly more than phase-delay (shift later) SALI. After a 2-month diagnostic evaluation for premenstrual dysphoric disorder (PMDD per DSM-5 criteria) in a university clinical research setting, 44 participants enrolled in baseline studies were randomized in the luteal phase at home to (A) a phase-advance intervention (PAI): 1 night of late-night wake therapy (LWT: sleep 9 pm-1 am) followed by 7 days of the morning (AM) bright white light (BWL), or (B) a phase-delay intervention (PDI): 1 night of early-night wake therapy (EWT: sleep 3-7 am) plus 7 days of the evening (PM) BWL. After a month of no intervention, participants underwent the alternate intervention. Outcome measures were mood, the melatonin metabolite, 6-sulfatoxymelatonin (6-SMT), and actigraphy (to assess protocol compliance). At baseline, atypical depression correlated positively with phase delay in 6-SMT offset time (r = .456, p = .038). PAI advanced 6-SMT offset from baseline more than PDI (p < .05), and improved raw mood scores more than PDI (p < .05). As hypothesized, percent improvement in mood correlated positively with a phase advance from baseline in 6-SMT offset time (p < .001). Treatment with 1 night of advanced/restricted sleep followed by 7 days of AM BWL (PAI) was more efficacious in reducing PMDD depression symptoms than a PDI; mood improvement occurred in association with phase advance in 6-SMT offset time. Combined SALIs offer safe, efficacious, rapid-acting, well-tolerated, non-pharmacological, non-hormonal, affordable, repeatable home interventions for PMDD. Clinical Trials.gov NCT # NCT01799733.

Unfolding the mystery of premenstrual syndrome (PMS): an overview.

Physical, emotional, and psychological symptoms are common among women in their reproductive years, particularly during their menstrual cycle's luteal phase and the week before their period. Approximately 5-8 percent of women suffer with premenstrual syndrome, with the majority of those suffering from premenstrual dysphoric disorder (PMDD). Because of the complexity and multifaceted nature of the aetiology, it is yet unknown. Premenstrual syndrome (PMS) is diagnosed entirely on the basis of signs and symptoms, with no particular diagnostic tests available to confirm the diagnosis. Only a small number of therapeutic modalities are backed by clinical data, yet there are many accessible. After providing a brief overview of the disease, the author goes on to discuss the various hypotheses as to why PMS occurs. With an emphasis on tailored treatment based on symptom profile, it examines the wide range of non-pharmacological and pharmaceutical methods that are accessible today.