By Liisa Hantsoo, Ph.D.
If you have a menstrual cycle, you’ve likely experienced premenstrual symptoms at some point. Headaches, bloating, cramps, fatigue, and crankiness are all common. In fact, roughly 80% of women report experiencing at least one physical or mood symptom premenstrually [1,2]. If severe enough, symptoms can hinder productivity or even keep you out of school or work. However, premenstrual symptoms are often not discussed. A recent study in the Netherlands sought to get a better understanding of women’s experiences with premenstrual symptoms – how they are experienced, how they are discussed (or not), and how they impact work or productivity [3].
The researchers created an online survey that was completed by over 40,000 Dutch women over the course of four months. The survey asked about symptoms including abdominal pain, heavy bleeding, headache, fatigue, back pain, nausea / vomiting, breast tenderness, pain, GI problems, and psychological symptoms. The researchers asked how many days these symptoms occurred, how much they interfered with daily functioning, and how women coped with them. The researchers found that nearly all (85.4%) women experienced abdominal pain or cramping premenstrually. The second most common symptom was psychological complaints, such as low mood or irritability, experienced by over three quarters (77.3%) of women. Third was fatigue, reported by 70.7%. Back pain, headaches, and heavy bleeding were the next most common, experienced by a little more than half of women. Among the most common symptoms, most women experienced symptoms for 3 to 4 days of their cycle.
Figure adapted from Schoep et al, 2019.
In terms of impact on daily life, about one third (38.4%) reported that premenstrual symptoms interfered with usual activities. Most women coped with this by using painkillers to get through their usual daily activities (39.6%). Some diminished the amount of work they did (22.4%), and a small number reported delegating tasks (11%). Many women did not reveal to family or coworkers that the reason for difficulty with activities was premenstrual symptoms. Less than half (43.7%) approached their healthcare provider about the symptoms. The researchers suggest that there are still taboos around discussing menstrual health or premenstrual symptoms, whether with family, colleagues, or even healthcare providers. Recent efforts like Project Period, the documentary “Period. End of Sentence,” and #periodpositive have worked to increase the discussion of periods and reduce taboos or stigma in this area, but more work is still needed.
References
1. Hylan TR, Sundell K, Judge R. The impact of premenstrual symptomatology on functioning and treatment-seeking behavior: experience from the United States, United Kingdom, and France. J Womens Health Gend Based Med. 1999;8:1043–52.
2. Johnson SR, McChesney C, Bean JA. Epidemiology of premenstrual symptoms in a nonclinical sample. I. Prevalence, natural history and help-seeking behavior. J Reprod Med. 1988;33:340–6.
3. Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 2019;