Abstract
100 women consecutively referred to a gynaecological clinic with premenstrual problems were prospectively assessed by daily completion of a set of visual analogue scales WAS). The relationship of their symptoms to menstrual cycle phase was quantified by calculating the percentage change in symptom intensity between the premenstrual week and the postmenstrual week and also during menstruation itself. The results indicated that the physical symptoms of breast discomfort and swelling were more closely related to menstrual cycle phase than were the psychological symptoms of tension, irritability or lethargy and depression. Only 32 of the women showed reduction of the premenstrual psychological symptoms by 75% or more during the postmenstrual week, while the corresponding degree of physical symptom relief was recorded by 62 women. For almost half the women, adverse mental symptoms reached their peak after the onset of menstrual bleeding. Significantly fewer of the women with almost total (75% or more) relief of their psychological symptoms postmenstrually had a history of psychiatric treatment, marital breakdown, or more than three children, compared with those whose symptoms were less completely relieved. The results suggest that a large proportion of women who experience premenstrual symptoms suffer a premenstrual and/or menstrual exacerbation of problems which are present throughout the cycle and are therefore unlikely to respond to hormonal manipulation.