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Premenstrual disorders, a neglected public health problem

Red ink in water on white background.
Red ink in water on white background.

“Be indisposed”. According to the Larousse dictionary, “feel a little bad”. For nearly 2 billion women worldwide, this means having periods, accompanied by a 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 period begins. 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 probing users of the Flo Health application (Flo, France) which offers monitoring of menstrual cycles. The study, which collects responses from 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 the different types of PMS symptoms are and whether they have a functional impact on women 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 any differences between the countries. To my knowledge, this is the largest study 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.

Age-independent disorders

First results, the most common symptoms expressed worldwide are the desire for food, felt by 85% of the women interviewed, followed by mood swings or anxiety (64% among them) and fatigue (57%). The frequency of the latter three symptoms is comparable to a 2019 study of 43,000 women in the Netherlands. Jennifer L. Payne acknowledges that she was surprised by the weak influence of age on the proportion of psychological symptoms (mood / anxiety disorders) that were almost similar in the four groups studied: 18-27 years, 28-37 years, 38 – 47 years and 48-55 years. For the doctor, this “The study shows that these mood symptoms are incredibly common and a critical public health problem globally.”

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

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