Is Premenstrual Syndrome Associated with Inflammation, Oxidative Stress and Antioxidant Status? A Systematic Review of Case-Control and Cross-Sectional Studies.

Antioxidants (Basel, Switzerland). 2021;10(4)
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Premenstrual syndrome (PMS) is a set of emotional and physical symptoms, which occurs in the days leading up to a woman’s period. The cause of PMS is unknown; however, it is thought that the occurrence of inflammation in the body, an imbalance in the number of free radicals in the body and a lack of dietary antioxidants may all contribute. This systematic review of observational studies aimed to determine if inflammation and imbalanced free radicals contribute to the development of PMS. The results showed that based on 11 studies, there was a small amount of evidence to suggest that increased inflammation and decreased antioxidants is present in women with PMS. However, there was inconsistent results and insufficient data to determine whether free radical imbalance may contribute. It was concluded that further research is required to make firm conclusions on the role of free radicals and inflammation in the development of PMS. This study could be used by healthcare professionals to understand the possible mechanisms behind the development of PMS.

Abstract

Premenstrual syndrome (PMS) is a cyclically occurring combination of various symptoms, leading to decreased life quality among approximately 30% of women of childbearing age. PMS etiology remains unknown; however, there are some suggestions that inappropriate inflammatory response and oxidative stress are involved. This study aimed to systematically review case-control and cross-sectional studies investigating inflammation markers, oxidative stress, and antioxidant status among women with PMS and controls. The study protocol was registered with PROSPERO (no. CRD42020178545), and the authors followed the guidelines for performing a systemic review recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). By searching PubMed and Scopus databases (up to 8 January 2021), six case-control studies and five cross-sectional studies of medium or high quality were classified to the review. The systematic review included 652 women with PMS and 678 controls, for whom 36 eligible markers were determined. Limited evidence indicates increased levels of inflammatory parameters and suggests decreased antioxidant status in PMS women. Insufficient data with inconsistent results made it impossible to formulate a firm conclusion on the contribution of oxidative stress in PMS occurrence. To acknowledge the role of inflammation, oxidative stress, and antioxidant status in the pathophysiology of PMS, further research with case-control design and large study groups is needed.

Lifestyle medicine

Fundamental Clinical Imbalances : Immune and inflammation
Patient Centred Factors : Mediators/Inflammation
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Not applicable
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article ; Review

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