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 "Together with other researchers, we believe that alcohol increases
PMS risk by altering the level of hormones, such as gonadotropin,
during the menstrual cycle," Dr. Bahi Takkouche, the study’s senior
author, told Reuters Health in by email.
Up to 40 percent of women in the U.S. have at least moderate PMS,
while rates in global studies have ranged from 10 percent to 98
percent, Takkouche and colleagues noted in BMJ Open. Symptoms of PMS
include mood swings, breast tenderness, fatigue, irritability and
depression. PMS occurs during the luteal phase of the menstrual
cycle, which begins after ovulation and lasts about 14 days, ending
with menstruation if an egg has not been fertilized.
In 2014, the World Health Organization warned that women may be more
vulnerable than men to alcohol’s ill effects. Some studies have
found that women who drink alcohol have worse PMS than those who
abstain, the authors note, while others have not found a link.
Takkouche. a professor of preventive medicine at the University of
Santiago de Compostela in Spain, and colleagues analyzed 19 studies
of alcohol and PMS. They found PMS risk was 45 percent higher in
women who reported drinking compared to non-drinkers, which they
called a "moderate increase." Women who were heavy drinkers -
meaning those who drank more than the currently recommended one
drink a day for women (men are allowed two) -were 79 percent more
likely to have PMS than abstainers.
Globally, the authors note, 29 percent of women drink, while nearly
6 percent are heavy drinkers. In Europe, 60 percent of women drink
and about 13 percent are heavy drinkers. The authors say that if
heavy drinking does turn out to contribute to PMS, wiping out
excessive drinking could prevent one in every 12 cases of PMS in
Europe.
In addition to causing burdensome symptoms, PMS may be associated
with other health problems, Takkouche and colleagues write. "I know
of at least one U.S. study, very well designed, that found an
increase in the risk of hypertension among women who had suffered
PMS, especially among those who had suffered from hypertension
before 40 years of age,” Takkouche told Reuters Health.
"Although we do not pretend to make recommendations on the basis of
one study only, even if it is a 'study of studies' as ours (a
meta-analysis), we think it would be better to avoid heavy drinking
for women who are prone to PMS," he added.
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Takkouche's team is now investigating the role of tobacco smoking
and psychological factors, including stress, in PMS.
"I think that this disorder should be taken as seriously as any
other disease, both by women who suffer from it and by the community
of health professionals, part of which disregards this syndrome and
considers it as a social construct only," he said.
Most of the studies the authors analyzed could not show which came
first - drinking alcohol or PMS, said Dr. Elizabeth Bertone-Johnson,
a professor of epidemiology at the University of Massachusetts at
Amherst who studies PMS.
She told Reuters Health in a telephone interview that women with
severe PMS may drink to cope with anxiety and depression. The new
study doesn’t provide "any greater understanding of whether alcohol
increases the risk of PMS," she believes.
Bertone-Johnson and her colleagues conducted a prospective study of
alcohol use and PMS, meaning they started out with a group of women
who were PMS-free, and investigated whether those who drank more
were more likely to develop PMS over time. "In our study, we didn’t
see any increase in women with the highest intake at all," she said.
"The risk was almost lower."
While a woman can try to cut back on alcohol to see if it improves
her symptoms, there are other lifestyle measures that have more
evidence behind them, Bertone-Johnson added. Her own studies have
found that women with higher intakes of calcium, vitamin D, B
vitamins, and iron were at a lower risk of PMS. Both multivitamins
and some fortified cereals can provide enough of these
micronutrients, with no need for megadoses, Bertone-Johnson added.
Smoking and a higher body mass index have consistently been
associated with an increased risk of PMS, the researcher added, so
kicking the habit and maintaining a healthy weight are also likely
to improve symptoms.
SOURCE: http://bit.ly/2HVHyEu BMJ Open, online April 16, 2018.
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