Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study

Abstract

Objective: To examine the longitudinal relation between perceived stress in the previous month and perimenstrual symptom severity across two cycles among regularly menstruating, healthy women (n ¼ 259). Methods: At baseline (11 days before the first cycle), participants completed the 4-item Perceived Stress Scale (PSS) for the previous month (first cycle exposure) and questionnaires on lifestyle factors. On cycle day 22 of a standardized 28-day cycle, participants again completed the PSS for the previous week (second cycle exposure) and each week rated the severity (none, mild, moderate, severe) of 17 psychological and physical symptoms (e.g., crying, cramping, pain). Mixed models estimated the association between perceived stress scores and number of moderate=severe symptoms and symptom severity scores, allowing both stress and perimenstrual symptoms to vary by cycle. Results: Adjusting for age, education, passive and active smoking, and waist=height ratio (WHtR), high stress (fourth quartile PSS) was associated with an increased risk of reporting !8 or more (OR 7.2,) and !5 (OR 2.5, 1.6-4.1) symptoms as moderate=severe during the perimenstrual period compared with lower stress (quartiles one, two, and three). Stress scores were positively ( p < 0.0001) associated with increased symptom severity scores for total, psychological, and physical symptoms. Conclusions: These analyses show that higher perceived stress precedes an increased severity of perimenstrual symptoms. Stress reduction programs may be an effective, nonpharmaceutical treatment for physical and psychological symptom relief.

Analysis of perceived stress, cardiovascular and central nervous system changes before and after menstruation in the age group 18-22 years

“…5 Premenstrual symptoms have been associated with perceived stress, and perceived stress is the strongest predictor of Premenstrual Syndrome. 6 In this study, we assessed stress by using perceived stress score (PSS scale). 7 Perceived stress is one of the primary factors associated with premenstrual syndrome; ahead of physical activity and dietary patterns.…”

A Structural Equation Modeling on Premenstrual Syndrome in Adolescent Girls

“…www.kan.or.kr 선행 연구에 따르면 청소년기 여학생의 월경전증후군은 초경연 령 [5], 체질량지수 [12], 월경량 [9], 월경태도 [3], 여성성 [13], 일상과 학 업에 대한 스트레스 [5,6], 시험불안 [14] 및 사회적 지지 [15] …”

The magnitude, long-term trend and lifestyle risk factors of dysmenorrhea and premenstrual syndrome

“…A higher stress was associated with increased risk of PMS/PMDD consistently in all three studies reporting it [25,125,130]. The only study examining the longitudinal relation between perceived stress in the previous month and premenstrual symptom severity across two cycles was among 259 American women aged 18 to 44 years [130].…”

“…Due to the limited evidence base, longitudinal studies which follow women over a sufficient period of time are needed to fully elucidate the course of the disorder. [22,108,109,130] examined the associations of the risk factors and PMS/PMDD, taking into consideration the temporal relationship, whereas the others [25,26,131,132] examined the associations in a cross-sectional fashion. In addition, three reports [22,26,132] included largely overlapping study populations, varying slightly in the total sample size; so caution should apply to avoid double counting the evidence.…”

“…The exact mechanism of how stress contributes to increased premenstrual symptom severity is not clear, but stress-induced changes in ovarian hormone levels through hypothalamicpituitary-ovarian axis may be involved, which may render a woman more susceptible to menstrual disorders [130,158]. In addition, there is suggestion that PMS was related to activation of the hypothalamic-pituitary-adrenal axis or a heightened sensitivity to its function as women with PMS are more sensitive to increased cortisol levels (related to fluid retention and associated symptoms) [159].…”