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Heavy drinking may worsen premenstrual syndrome
Alcohol consumption among women is associated with a moderate increase in the risk for premenstrual syndrome, or PMS, with the increase rising in those who report heavy drinking, according to findings from a systematic review and meta-analysis.
“WHO warned recently against the increasing alcohol consumption among women related to economic development and changing gender roles, and emphasized the fact that women may be more vulnerable to alcohol-related harm than men,” Maria del Mar Fernandez, of the department of preventive medicine at the University of Santiago de Compostela in Spain, and colleagues wrote in the study background. “Several studies have identified an increased burden of PMS among women who consume alcohol. However, it is not clear whether this increase in the risk for PMS is due to alcohol consumption or whether alcohol is consumed to mitigate the symptoms of a syndrome.”
Del Mar Fernandez and colleagues analyzed data from 19 case-control or cross-sectional studies from eight countries assessing PMS or its more severe form, premenstrual dysphoric disorder as an outcome, with alcohol consumption as an exposure factor. Low ethanol intake was defined as less than 10 g per day, moderate intake was defined as up to one average-sized drink per day, and consumption of at least one average-sized drink per day was considered heavy ethanol intake. Researchers weighted the study-specific log ORs or other ratio measures across included studies by the inverse of their variance to compute pooled estimates. Pooled ORs across the three drinking categories were used to determine an estimate for the “any drinking” category.
Researchers found that any alcohol intake was associated with a moderately increased risk for PMS (OR = 1.45; 95% CI, 1.17-1.79), with heavy drinking associated with a greater risk for PMS (OR = 1.79; 95% CI, 1.39-2.32).
When excluding studies that computed standardized mean differences, researchers found the pooled estimates were higher, with an OR of 1.51 for any drinking (95% CI, 1.22-1.88) and an OR of 1.9 for heavy drinking (95% CI, 1.45-2.49).
The researchers noted that alcohol use may plausibly increase the risk for PMS by altering levels of sex steroid hormones and gonadotropin during the menstrual cycle, and that alcohol intake may increase the risk for PMS through its effect on serotonin and gamma-aminobutyric acid (GABA) activity.
“The relatively large number of studies conducted and the consistency of the results across study designs and settings provide substantial epidemiological evidence that drinking alcohol may be associated with an increase in the risk for PMS,” the researchers wrote. “However, noncausal explanations of the relation should be carefully evaluated.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.