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Premenstrual disorders are associated with an increased risk of moderate-to-severe vasomotor symptoms and an early onset of menopause, allowing healthcare professionals to target at-risk women, according to a new study.

Premenstrual disorders (PMDs) are characterized by recurrent affective and physical symptoms that occur before menstruation. The subtypes are premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The existing literature lacks data on the long-term adverse outcomes of PMDs. These disorders may also predispose women to adverse events during the menopausal transition, including dramatic hormonal fluctuations. 

This matched cohort study investigated whether women with PMDs demonstrated a greater risk of early natural menopause and vasomotor symptoms. The findings are published in JAMA Network Open.

Study Characteristics

The study included 1220 and 2415 women with and without PMDs, respectively. The median age of the study participants with and without PMDs was 40.7 (37.3–43.8) years and 41.7 (38.3–44.8) years. Compared to women without PMDs, women with PMDs were younger and more likely to have a lower level of maternal education, to have experienced abuse in childhood, used oral contraceptives, smoked, or become overweight or obese.

Early Menopause and Premenstrual Disorders

The mean age of women with and without PMDs at natural menopause was 51.4 ± 0.1 years and 51.8 ± 0.1 years, respectively. The study indicated a null association between PMDs and normal menopause. However, an increased risk of early menopause was observed in women with PMDs.

Vasomotor Symptoms and Premenstrual Disorders

A total of 3119 women in the study cohort reported vasomotor symptoms. PMDs were positively associated with vasomotor symptoms, which were stronger and statistically significant in the case of moderate-to-severe vasomotor symptoms or women experiencing vasomotor symptoms for a minimum of 5 years.

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Vasomotor Symptoms and Subtypes of Premenstrual Disorders

The association of PMS and PMDD with moderate-to-severe vasomotor symptoms was comparable between the two PMD subtypes. The relationship between early menopause and PMDs was more prominent in women who did not experience anxiety or depression. Women with previous or current smoking practices had a stronger association with early menopause.

Source:

Yue, Y., Valdimarsdóttir, U., Manson, J. E., Sievert, L. L., Harlow, B. L., Eliassen, A. H., Bertone‐Johnson, E. R., & Lu, D. (2023). Premenstrual disorders, timing of menopause, and severity of vasomotor symptoms. JAMA Network Open, 6(9), e2334545. https://doi.org/10.1001/jamanetworkopen.2023.34545