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Global epidemiological study of variation of premenstrual symptoms with age and sociodemographic factors

Objectives. To determine patterns of premenstrual symptom experiences across the reproductive age range, and the effects of other factors on premenstrual symptoms. Study design. Global cross-sectional survey. Sample. A total of 7226 women aged 15–49 recruited by random sampling with approximately 400 each from France, Germany, Hungary, Italy, Spain, UK, Brazil, Mexico, Hong Kong, Pakistan and Thailand. Approximately 1000 women in Japan and Korea and 500 Australian women were found using Internet panels. Main outcome measures. Questionnaire of 23 premenstrual symptoms, sociodemographic and lifestyle variables. Results. Four different patterns of premenstrual symptoms were found with ageing: symptoms showing no change with age, symptoms decreasing with age, symptoms reaching a maximum just before or around age 35, and symptoms reaching a maximum around age 40–44. Smoking was associated with an increase in most of the premenstrual symptoms. Increasing parity was associated with a decrease in some of the symptoms. Conclusions. These results suggest that the premenstrual symptoms most associated with the years of regular ovulatory cycles are skin disorders, lack of energy, appetite problems, joint/muscle/back pain, anger, abdominal bloating, depressed mood and irritability. Other symptoms which peaked later (swelling of extremities, breast tenderness/pain, weight gain) may reflect exacerbation by hormonal changes of the late reproductive/early menopausal transition. Smokers report more problematic premenstrual symptoms.