Premenstrual disorders, a neglected public health issue

“Be indisposed”. According to the Larousse dictionary, “to be slightly unwell”. For almost 2 billion women worldwide, this means having their period, accompanied by possible premenstrual syndrome (PMS) – physical symptoms and/or mild mood changes, or premenstrual dysphoric disorder (PMDD), which are rarer and include more debilitating symptoms. These disorders, which begin a few days before the menstrual period, usually end a few hours after the start of the period. However, the data to study them on a global scale are limited. Hence the idea of ​​a team of researchers from the medical universities of Baltimore and Virginia (United States) to go digital by surveying users of the Flo Health application (Flo, in France) which offers to track menstrual cycles. The study, which brings together the responses of 238,114 women aged 18 to 55 in 140 countries, was published in Women’s Mental Health August 26.

“We wanted to determine how common different types of premenstrual symptoms are and whether they impact women functionally on a regular basis,” says Jennifer L. Payne, director of the reproductive psychiatry research program at the University of Virginia School of Medicine. We also wanted to know if there were differences between countries. To my knowledge, this is the largest study conducted to date. » Technically, this questionnaire was administered on the application using a chatbot (a conversational artificial intelligence), in ten languages ​​(from Chinese to Russian), from May 2017 to June 2020.

Disorders independent of age

First results, the most common symptoms expressed worldwide are food cravings, felt by 85% of women surveyed, followed by mood swings or anxiety (64% between them) and fatigue (57%). The frequency of these last three symptoms is comparable to a 2019 study of 43,000 women in the Netherlands. Jennifer L. Payne acknowledges having been surprised by the weak influence of age on the proportion of psychological symptoms (mood disorders/anxiety) which were almost similar in the four groups studied: 18-27 years old, 28-37 years old, 38 -47 years and 48-55 years. For the doctor, this “Study demonstrates that these mood symptoms are incredibly common and constitute a critical public health issue globally.”

Another trend revealed by the study, 29% of respondents said that their PMS interferes with their daily life during each menstrual cycle – for an additional 35% of women, it interferes “sometimes”. Among the most frequent symptoms experienced each month, in addition to the three mentioned above (food cravings, moodiness and fatigue), are breast tenderness, abdominal cramps, problems with bloating, weight gain, constipation or diarrhea, migraines, etc This global survey also confirms that age has many effects on the increase in certain physical symptoms commonly associated with the period of perimenopause, such as hot flashes, low libido, etc., experienced by respondents. 48-55 years old.

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