Serum antioxidant vitamin concentrations and oxidative stress markers associated with symptoms and severity of premenstrual syndrome: a prospective cohort study

Abstract

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.

Plasma Carotenoids and Premenstrual Symptoms in a Multi-Ethnic Population of Young Women

“…Results from previous studies on vitamin A and premenstrual symptoms have been inconsistent. Frankel and colleagues recently evaluated the relationship between serum antioxidant vitamins, such as vitamins A, C and E, and PMS in 259 healthy women aged 18-49 in western New York, U.S.A [21]. There were no associations between serum vitamin A, measured using retinol as a biomarker, and the prevalence or the severity of PMS, a result that is consistent with the findings of the present study.…”

“…The present cross-sectional study of 553 young women living in Canada examined the association between plasma carotenoids and retinol on the severity of 15 common premenstrual symptoms. While previous research on this topic assessed retinol alone [19][20][21][22], the current study included six different plasma carotenoids along with retinol to provide a more comprehensive understanding of the role of vitamin A and provitamin A carotenoids, which may have unique biological effects. Further, using serum concentrations as opposed to dietary intake allowed a more direct measure of exposure as serum values take into account the variability of an individual's metabolism.…”

“…Given the limited number of studies on carotenoids and premenstrual symptoms [19][20][21][22], the present study examined whether plasma carotenoid concentrations were associated with premenstrual symptoms in young women of reproductive age. Based on their role as antioxidants, it was hypothesized that carotenoids would be associated with a lower risk of premenstrual symptoms; however, circulating concentrations of several common carotenoids were not associated with any symptoms.…”

“…The potential effects of carotenoids in the amelioration of premenstrual symptoms could involve their antioxidant capacity [11,13]. However, the evidence is limited, and previous studies have yielded inconsistent results [19][20][21][22]. The objective of the present study was to examine the association between plasma concentrations of seven individual carotenoids and premenstrual symptom severity in a multi-ethnic population of young women.…”

Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome

“…These new findings were confirmed in an up-to-date systematic review 102 . Moreover, a recent prospective study showed that serum concentrations of antioxidant vitamins A, C, and E were generally not associated with PMS symptoms or severity, supporting the evidence that the use of antioxidant vitamins as a remedy for PMS may be inconclusive 103 . On the other hand, zinc supplementation manifested different properties on inflammation and premenstrual symptoms.…”