The inconvenience due to women’s monthly bleeding (ISY) survey: a study of premenstrual symptoms among 5728 women in Europe

Abstract

Objectives: The aim of the ISY study was to investigate the prevalence of menstrual-related symptoms prior to and/or during menstrual or withdrawal bleeding among women from 12 European countries.

Methods: A 15-min quantitative online survey was conducted in two waves from February to September 2015 among 5728 women aged between 18 and 45 years, with an equal distribution of women using a combined hormonal contraceptive, including regular combined oral contraceptives (COCs) (CHC group, n = 2739) and women using a non-hormonal contraceptive or no contraceptive (non-HC group, n = 2989).

Results: The prevalence of at least one menstrual-related symptom was high in CHC users (93%) and in non-HC users (95%) (p < .0001) and the average number of symptoms reported was 5.3 vs. 5.9, respectively, (p < .0001). Pelvic pain, bloating/swelling, irritability and mood swing were reported in more than half of the women in both groups. Although generally modest, symptom severity was higher in non-HC users, except for headache. Overall, during the last four cycles, 60–75% of women did not require a treatment for most symptoms but headaches and pelvic pain. Mood swings/irritability, water retention/weight gain, lack of energy/mood swings and lack of energy/irritability were common symptoms that frequently co-occurred. No associations were reported between symptoms and age, educational qualifications or women’s desire to reduce the frequency of menstruation.

Conclusions: Premenstrual and menstrual symptomatology was less frequent, less numerous and less severe (except for headache) in women using CHCs; however, it remains a common concern. Reducing the frequency of menstrual periods could reduce withdrawal-related symptoms.

Chinese abstract

目的：ISY研究的目的是调查来自欧洲12个国家的经前/期综合征或撤退性出血的患病率

方法：自2015年二月到九月我们对5728名18到45岁女性进行了为时15分钟的网上调查问卷, 包括使用合成口服避孕药包括常规复方口服避孕药（COC）组（CHC组, n = 2739）,不使用激素避孕药或不避孕组（非-HC组, n = 2989）, 两组妇女的比例相当。

结果：至少患一种月经相关症状的概率两组均较高, CHC使用者（93%）,非-HC使用者（95%）（p<.0001）平均症状数量分别是5.3vs.5.9, （p<.0001）。两组均至少有一半的女性报告了盆腔疼痛, 肿/胀, 易怒以及情绪波动。虽然两组症状普遍适度, 但除了头痛外, 非HC患者的症状严重程度更高。 总体而言, 在过去的四个周期中, 60-75％的女性除头痛和骨盆疼痛之外大多数症状不需要治疗。 情绪波动/烦躁, 水潴留/体重增加, 无力/情绪波动和无力/烦躁是常见的症状, 经常同时发生。 症状与年龄, 学历或妇女减少月经频率的愿望没有关联。

结论：使用CHC妇女的经前期和经期症状少, 发生频率低, 程度较轻（头痛除外）, 但头痛仍然是一个普遍的问题。减少月经频率可以减少停药相关的症状。

Keywords:

• Premenstrual symptoms
• bleeding
• hormone withdrawal symptoms
• combined hormonal contraception
• Europe

Acknowledgements

This study was supported by Teva. The authors would like to thank the collaboration of Stethos International for their helpful comments. The manuscript was prepared with writing and editorial assistance from Jean-Louis Carsol and Tristan Blundell, both employed by Publicis Health.

Disclosure statement

IL has a financial relationship (lecturer, member of advisory boards and/or consultant) with MSD, Teva, Gedeon Richter, HRA Pharma and Nordic Pharma. PLA has a financial relationship (member of advisory boards, lecturer and/or consultant) with Bayer, Effik, MSD, Smith & Nephew and Teva. CJ is a consultant for MSD, Teva and HRA Pharma. REN has a financial relationship (lecturer, member of advisory boards and/or consultant) with Bayer HealthCare, Endoceutics, Gedeon Richter, HRA Pharma, MSD, Novo Nordisk, Pfizer, Shionogi and Teva. CF is member of the European scientific advisory board of Teva and Exelgyn, and has been a lecturer for Teva, Bayer HealthCare and Exelgyn. NC-B is a member of the European board of Teva/Theramex without personal gain. AP is a member of the European board of Teva/Theramex without personal gain.