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Menstrual health

One in five cases of PMS in Europe could be linked to alcohol consumption, meta-analysis shows

Women who consume alcohol could be increasing their risk of premenstrual syndrome (PMS), say the authors of a recent meta-analysis.

Overall, they estimate than one in ten cases of PMS worldwide are linked to alcohol consumption, but in Europe, where twice as many women drink compared with worldwide, one in five cases could be alcohol-related.

“These findings are important given that the worldwide prevalence of alcohol drinking among women is not negligible,” they write in the BMJ Open.

The researchers looked at data from 19 studies, involving a total of 47,000 women (of unreported age), which reported alcohol consumption as a variable and PMS as an outcome.

They found that any alcohol intake was associated with a moderately increased risk of PMS (odds ratio [OR]: 1.45). Heavy drinking was associated with a more pronounced risk (OR: 1.79).

PMS consists of a number of recurrent physical and emotional symptoms during the luteal phase of the menstrual cycle that can vary in severity from woman to woman. These can include mood swings, tender breasts, food craving, fatigue, irritability and depression.

Previous research has indicated that alcohol consumption can affect the severity of PMS symptoms but the team say this is the first indication that alcohol could play a causative role in the condition.

They suggest alcohol could increase the risk of PMS through its effects on sex hormones, as well as serotonin and gamma-amino butyric acid activity, neurotransmitters associated with mood and anxiety.

The team, led by Bahi Takkouche from the University of Santiago de Compostela, Spain, says the dose-dependent relationship identified in their analysis lends support to a causal relationship. However, there is the possibility of reverse causation, such as if women increase their alcohol consumption in response to their PMS symptoms.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20204758

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