Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women

Abstract

Background Childhood abuse and neglect have been associated with premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). However, the associations of other adverse childhood experiences (ACEs) and the cumulative number of ACEs with PMDs remain to be explored. Methods To evaluate the associations of the cumulative number and types of ACEs with PMDs, we conducted a cross-sectional analysis with a subsample of menstruating women within the Stress-And-Gene-Analysis (SAGA) cohort, assessed for PMDs and ACEs (N=11,973). The cumulative and individual exposure of 13 types of ACEs was evaluated by a modified ACE-International Questionnaire. A modified version of the Premenstrual Symptom Screening Tool was used to identify probable cases of PMDs, further sub-grouped into PMS and PMDD. Prevalence ratios (PRs) of PMDs in relation to varying ACEs were estimated using Poisson regression. Results At a mean age of 34.0 years (standard deviation (SD) 9.1), 3235 (27%) met the criteria of probable PMDs, including 2501 (21%) for PMS and 734 (6%) for PMDD. The number of ACEs was linearly associated with PMDs (fully-adjusted PR 1.12 per ACE, 95% CI 1.11–1.13). Specifically, the PR for PMDs was 2.46 (95% CI 2.21–2.74) for women with 4 or more ACEs compared with women with no ACEs. A stronger association was observed for probable PMDD compared to PMS (p for difference <0.001). The associations between ACEs and PMDs were stronger among women without PTSD, anxiety, or depression, and without childhood deprivation and were stronger among women a lower level of social support (p for interaction<0.001). All types of ACEs were positively associated with PMDs (PRs ranged from 1.11 to 1.51); the associations of sexual abuse, emotional neglect, family violence, mental illness of a household member, and peer and collective violence were independent of other ACEs. Conclusions Our findings suggest that childhood adverse experiences are associated with PMDs in a dose-dependent manner. If confirmed by prospective data, our findings support the importance of early intervention for girls exposed to ACEs to minimize risks of PMDs and other morbidities in adulthood.

Antenatal depressive symptoms are strongly predicted by the severity of pre-menstrual syndrome: results of partial least squares analysis

“…A population-based study that looked at the relationship between cumulative and individual ACE exposure and premenstrual disorders, such as PMS and PMDD, discovered a positive, linear relationship between the cumulative number of ACEs and likely premenstrual disorders (PR: 1.12, 95 percent CI: 1.11–1.13). The latter were linked to sexual abuse, emotional neglect, familial violence, a household member's mental illness, as well as peer and communal violence ( Yang et al, 2022 ). Another study found that women who were abused as children had a significantly higher incidence of premenstrual syndrome (OR: 1.47, 95 percent CI: 1.20–1.88).…”

“…There is also evidence that adverse childhood experiences (ACEs) are strongly associated with the onset of AD ( Abe et al, 2022 ), major depressive disorder ( Maes et al, 2019 ; Maes et al, 2022 ), and possibly PMS ( Jacobs et al, 2015 ; Yang et al, 2022 ). Such findings suggest that ACEs may underlie the association between PMS and AD.…”

Top 100 Cited Papers on Premenstrual Syndrome/Premenstrual Dysphoric Disorder: A Bibliometric Study

“…For instance, studies showed that the prevalence of PMS among Academics at a University in Midwest Brazil was 46.9% ( 38 ), and 21.1% for university students ( 39 ), which are higher than ever before. Moreover, risk factors for PMS/PMDD include childhood abuse and neglect ( 40 ), childhood maltreatment ( 41 ), and perinatal depression ( 42 ), among others.…”

Association between Adverse Childhood Experiences and Multiple Sclerosis in Icelandic Women—A Population-Based Cohort Study

“…A second model additionally adjusted for educational level and childhood deprivation given the known correlation of the latter with ACEs [ 41 ]. A third model included adjustment for a full set of covariates which included those selected for consideration because of their potential as risk factors for MS [ 42 ] or guided by previous research [ 25 , 26 , 27 , 28 , 29 ] including that on the SAGA cohort [ 43 ]. Covariables were retained in regression models if they modified associations by 10% or more or if there was a rationale for their inclusion.…”