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Background It has been suggested that premenstrual syndrome (PMS) may derive from either elevated oxidative stress or reduced antioxidant vitamin levels in the body; however, these relationships have been minimally studied in a large cohort of healthy women. Our objective was to estimate the association between serum concentrations of antioxidant vitamins (A, C, and E) and markers of oxidative stress (F2-isoprostane) with symptoms and severity of PMS. Methods The BioCycle study was a prospective cohort study following 259 healthy premenopausal women aged 18–44 years for up to 2 menstrual cycles. Frequency/severity of 20 PMS symptoms were assessed via questionnaires 4 times/cycle, and antioxidant vitamins and oxidative stress biomarkers were measured up to 8 times/cycle to correspond with specific cycle phases. Generalized linear models were used to estimate associations between mean antioxidant concentrations and oxidative stress biomarkers with PMS symptoms and severity; linear mixed models were used to evaluate associations with symptom severity scores within groups (e.g. depression, cravings, pain). Results Higher concentrations of serum antioxidant vitamins were largely not associated with prevalence or severity of PMS symptoms. Though a few associations were observed, only associations between mean γ-tocopherol and decreased odds of swelling of the hands/feet survived adjustment for multiple comparisons (OR 0.33, 95% CI 0.16, 0.65, per ug/dL). However, F2-isoprostanes were associated with prevalence and severity of several symptoms specifically related to depression and cravings (depression score β  =  0.07, 95% CI 0.02, 0.12, per 10 ug/dL; cravings score β = 0.16, 95% CI 0.10, 0.22, per 10 ug/dL), as well as with classification of PMS severity (OR 1.07, 95% CI 1.01, 1.14, per 10 pg/dL), with these associations surviving adjustment for false discovery rate. Conclusions F2-isoprostanes, but not antioxidant vitamins, were associated with select PMS symptoms, as well as symptom and severity categories. Specific symptom relationships merit further research.

Background: Physical and emotional manifestations of premenstrual disorder cause increased absenteeism, decreased productivity, and decreased work-related quality of life. Objective: Due to the relatively high prevalence of premenstrual disorders in Iran and limited studies on its work-related problems, this study investigated the relationship between premenstrual disorders and work performance in working women. Materials and Methods: This cross-sectional study was conducted on 358 working women (teachers and industrial workers) in Yazd, Iran, from July 2019 to January 2020. Data were collected using premenstrual symptom screening tool, the work productivity and activity impairment (a modified version), and functional work capacity questionnaires. Women were classified into 2 groups: women with and without premenstrual disorders. Productivity, functional capacity, and ability to perform activities of daily living were compared between groups. Results: Among 358 participants, 121 women (33.8%) had premenstrual disorders. The prevalence of premenstrual disorders was significantly higher in teachers than workers (0.41% vs. 24.7%, respectively) (p = 0.002). The work results showed a worse score in the group with premenstrual disorder than the other group and teachers compared to workers (p < 0.001). Conclusion: This study showed a significant association between premenstrual disorders and worse work productivity, functional work capacity, and ability to perform activities of daily living. Teachers had a higher prevalence of premenstrual disorders and worse work performance than workers, which can be due to higher education levels, work stress, more complex tasks, and increased work responsibility in teachers.   Key words: Premenstrual syndrome, Premenstrual dysphoric disorder, Work performance, Working women, Productivity.

Background Suicide is the second leading cause of death among Americans ages 10 to 34, with alarming recent increases in suicide rates among those assigned female at birth. A large body of evidence points to menstrual cycle influences on self-injurious thoughts and behaviors (STBs), suggesting that neurobiological hormone sensitivities, such as in premenstrual dysphoric disorder (PMDD), may drive suicide risk in females. However, existing studies of STBs in PMDD use cross-sectional self-report measures of PMDD with poor validity. As a first step to establish accurate prevalence rates of STBs in PMDD, we examined the lifetime prevalence of STBs in a large global survey of patients reporting a diagnosis of PMDD based on daily ratings. Method Individuals with self-reported PMDD symptoms were invited to an online survey through online support groups for PMDD and social media posts from PMDD awareness accounts. Participants reported demographics, whether they had been diagnosed with PMDD by a healthcare provider using daily ratings, STBs using the Columbia Suicide Severity Rating Scale, and history of lifetime comorbid psychiatric diagnoses. Results Of 2,689 survey completers, 599 (23%) reported a diagnosis with PMDD based on two months of daily ratings and were included in analyses. We observed high rates of lifetime active suicidal ideation (72%), planning (49%), intent (42%), preparing for an attempt (40%), and attempt (34%), as well as non-suicidal self-injury (51%). The majority (70%) of the sample reported at least one lifetime comorbid psychiatric diagnosis. Predictors of lifetime active suicidal ideation included nulliparity, low-to-moderate (vs. high) income, and history of diagnosis with major depression or post-traumatic stress disorder. Predictors of lifetime attempts among those reporting lifetime active ideation included older age, nulliparity, lower income, and history of diagnosis with post-traumatic stress disorder or borderline personality disorder. Conclusions These data indicate high rates of STBs among those reporting prospective diagnosis of PMDD and highlight the need for prospective research on mechanisms and prevention of STBs in PMDD. Clinical practice guidelines for PMDD should accommodate comorbidities and recommend frequent screenings for STB risk. STBs should be considered for inclusion in future iterations of the DSM PMDD diagnostic criteria.

Women diagnosed with premenstrual dysphoric disorder (PMDD) report significant symptom relief when treated with selective serotonin reuptake inhibitors, but few studies have addressed the possibility of capturing this effect in behavioral, laboratory-based tests. This study examined the effects of intermittent treatment with escitalopram (vs. placebo) on a behavioral measure of impulsivity and inattentiveness in women reporting high levels of premenstrual irritability and anger. Participants (  = 27) rated cardinal PMDD mood symptoms over three menstrual cycles using Visual Analogue Scales. In Cycles 2 and 3, participants displaying cyclicity with respect to the irritability/anger item received escitalopram (20 mg) or placebo in a randomized, single-blind, crossover design. The participants completed the Conners Continuous Performance Test (CPT 3) in the luteal phase of the intervention cycles. Additionally, they filled out the UPPS Impulsive Behavior Scale, once in the luteal phase and once in the follicular phase of the placebo cycle. In line with previous reports, escitalopram caused a significant reduction in self-rated irritability and anger in the luteal phase. When on escitalopram, the participants demonstrated a lower frequency of anticipatory responses and greater consistency in response speed in the CPT 3. With respect to self-reported impulsivity, participants reported higher levels of urgency and lower levels of sensation seeking in the luteal placebo phase versus the follicular phase. The finding that escitalopram impacted the outcome of the CPT 3 test in women with premenstrual irritability highlights the possible role of impulsivity in this condition.

Premenstrual syndrome (PMS) is a cyclical late luteal phase disorder of the menstrual cycle whereby the daily functioning of women is affected by emotional and physical symptoms substantially interfering with their quality of life. Little is known about PMS in the United Arab Emirates (UAE). This study aimed to determine the prevalence and severity of PMS among university students in Sharjah, UAE, and clarify its associations with dietary habits, lifestyle behaviors, and anthropometric factors. A cross-sectional study was conducted on female college students at the University of Sharjah, UAE. Data were collected using self-administered questionnaires and anthropometric assessments. Descriptive statistics and multiple logistic regression analyses were performed. Participants were 300 adult university students aged 18–24 years (mean age 20.07 ± 1.53 years). In total, 95% of participants reported at least one PMS symptom during their menstrual period. The prevalence of PMS was 35.3%, with mild symptoms being the most commonly reported. Multiple regression analysis showed that smoking was associated with increased risk of reporting psychological (OR 2.5, 95% CI 1.1–5.8; p < 0.05) and behavioral symptoms (OR 2.2, 95% CI 1.0–4.9; p < 0.05), while high calorie/fat/sugar/salt foods intake was associated with increased risk of reporting physical symptoms (OR 3.2, 95% CI 1.4–7.3; p < 0.05). However, fruit consumption (OR 0.34, 95% CI 0.125–0.92; p < 0.05) was associated with a decreased risk of reporting behavioral symptoms. A high prevalence of PMS was reported among university students, with smoking and high calorie/fat/sugar/salt food consumption identified as strong risk factors for PMS.

Premenstrual dysphoric disorder (PMDD) affects 1.2 to 5% of women of reproductive age. Besides significant suffering and social, occupational, and interpersonal impairment, it has been suggested that this syndrome is associated with other affective disorders, in different reproductive phases, such as pregnancy and the postpartum period. However, the literature on this association is scarce and presents great variability in terms of adopted methodology and mixed results. To analyze the relationship between PMDD and other affective disorders, aiming to contribute to the clarification of whether PMDD can be considered a risk factor for perinatal depression (PND). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive literature search in PubMed, EMBASE, CINAHL, PsycINFO databases. Seven original studies were included. Only one study linked PMDD with depression during pregnancy, with evidence of a positive association between PMDD and PND. This and five other studies show a positive relationship between PMDD and postpartum depression (PPD), assessed in periods ranging from 2 to 4 days to 1 year after birth. Only one study found no significant association between PMDD and PPD, assessed at 4 weeks postpartum. There seems to be a positive and significant association between PMDD and the development of perinatal depression, particularly postpartum depression. This review supports the relevance of health professionals systematically evaluating the presence of premenstrual dysphoric disorder, when monitoring women throughout the perinatal period.

Premenstrual syndrome is primarily diagnosed clinically, with consistent characteristic symptoms occurring in the luteal phase of the menstrual cycle and resolving during menstruation or within the week following it. For a premenstrual dysphoric disorder diagnosis, a patient’s symptoms must substantially interfere with work, school, social activities, or relationships or cause significant distress. Patients should record symptoms for at least two cycles because symptoms can vary from cycle to cycle. A symptom-tracking diary or diagnostic instrument, such as the Daily Record of Severity of Problems (a validated prospective survey tool), can be used to identify the cyclic pattern of symptoms. Selective serotonin reuptake inhibitors are first-line treatment for premenstrual syndrome and premenstrual dysphoric disorder, with rapid onset of improvement; however, adverse effects can limit their use. Cognitive behavior therapy, exercise, acupuncture or acupressure, and the herb Vitex agnus castus may be used to ameliorate premenstrual syndrome and premenstrual dysphoric disorder symptoms. Reassessment for another underlying cause of premenstrual dysphoric disorder symptoms should occur if symptoms are not controlled with medications or other interventions or persist throughout the month.

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.

Background Premenstrual dysphoric disorder (PMDD) is a debilitating condition, affecting women of reproductive age. It is characterized by severe periodic physical and psychological symptoms, which end after the onset of menstruation. This study aimed to evaluate the effectiveness of emotion-focused therapy (EFT) for PMDD patients. Methods A total of 48 PMDD women, in the age range of 18–44 years, were randomly assigned to two intervention and control groups. The intervention group participated in 16 weeks of EFT treatment, while the control group was selected based on the waiting list (waitlist control group) and followed-up after three months. Forty-four patients finally completed this study. The participants completed the Premenstrual Syndrome Screening Tool (PSST), Difficulties in Emotion Regulation Scale (DERS), and Depression Anxiety Stress Scale-21 (DASS-21) in the first premenstrual period before treatment, the first premenstrual period after treatment, and the premenstrual period three months after treatment. Results Based on the repeated measure analysis of variances, the total score of DERS and the total score of PSST decreased significantly ( P  < 0.05). Also, in DASS-21, the scores of depression and stress subscales reduced significantly ( P  < 0.05), while there was no significant decrease in the score of anxiety subscale ( P  > 0.05). Conclusion Based on the present results, EFT can be an effective treatment for alleviating the symptoms of PMDD. This treatment can reduce the emotion regulation difficulties of women with PMDD and alleviate the symptoms of depression and stress. Trial registration Iranian Registry of Clinical Trials, IRCT ID: IRCT20220920055998N1, Registered on: 12/2/2023.

Reproductive health literacy and menstrual health awareness play a crucial role in ensuring the health and well-being of women and people who menstruate. Further, awareness of one's own menstrual cycle patterns and associated symptoms can help individuals identify and manage conditions of the menstrual cycle such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Digital health products, and specifically menstrual health apps, have the potential to effect positive change due to their scalability and ease of access. The primary aim of this study was to measure the efficacy of a menstrual and reproductive health app, Flo, in improving health literacy and health and well-being outcomes in menstruating individuals with and without PMS and PMDD. Further, we explored the possibility that the use of the Flo app could positively influence feelings around reproductive health management and communication about health, menstrual cycle stigma, unplanned pregnancies, quality of life, work productivity, absenteeism, and body image. We conducted 2 pilot, 3-month, unblinded, 2-armed, remote randomized controlled trials on the effects of using the Flo app in a sample of US-based (1) individuals who track their cycles (n=321) or (2) individuals who track their cycles and are affected by PMS or PMDD (n=117). The findings revealed significant improvements at the end of the study period compared to baseline for our primary outcomes of health literacy (cycle tracking: D̄=1.11; t =5.73, P<.001; PMS or PMDD: D̄=1.20; t =3.76, P<.001) and menstrual health awareness (D̄=3.97; t =7.71, P<.001), health and well-being (D̄=3.44; t =5.94, P<.001), and PMS or PMDD symptoms burden (D̄=-7.08; t =-5.44, P<.001). Improvements were also observed for our secondary outcomes of feelings of control and management over health (D̄=1.01; t =5.08, P<.001), communication about health (D̄=0.93; t =2.41, P=.002), menstrual cycle stigma (D̄=-0.61; t =-2.73, P=.007), and fear of unplanned pregnancies (D̄=-0.22; t =-2.11, P=.04) for those who track their cycles, as well as absenteeism from work and education due to PMS or PMDD (D̄=-1.67; t =-2.49, P=.01). These pilot randomized controlled trials demonstrate that the use of the Flo app improves menstrual health literacy and awareness, general health and well-being, and PMS or PMDD symptom burden. Considering the widespread use and affordability of the Flo app, these findings show promise for filling important gaps in current health care provisioning such as improving menstrual knowledge and health. OSF Registries osf.io/pcgw7; https://osf.io/pcgw7 ; OSF Registries osf.io/ry8vq; https://osf.io/ry8vq.