Biological, social, and behavioral factors associated with premenstrual syndrome

Objective: To investigate the influence of various biological, socioeconomic, and behavioral factors on premenstrual syndrome (PMS). Design: Random-digit dialing technique. Of 7900 calls from all area codes, exchanges, and 2 digits known to be open in Virginia, with a pair of random digits, 1700 women were eligible for telephone interviews. A total of 874 women completed interviews, for a response rate of 67%. Setting: State of Virginia. Patients or Other Participants: All women between the ages of 18 and 44 years and living in Virginia between August 1 and September 15, 1994, were eligible. Main Outcome Measures: Scores on Menstrual Distress Questionnaire, biological variables, lifestyle behaviors, socioeconomic status, and menstrual and reproductive history. Results: Of the 874 women, 8.3% (95% confidence interval, 6.4%-10.2%) experienced PMS. Adjusted prevalence odds ratios for perceived stress and alcohol intake were 3.7 and 2.5, respectively, in women with PMS. Women with PMS were 2.9 times more likely to be physically active than women without PMS. Younger women, black women, and women with longer menses were more likely to have PMS. Conclusions: Scores on the stress scale and alcohol intake support the concept that PMS is stress related; intervention strategies to cope with stress may be effective. Further study will be required to determine the influence of race on PMS and whether women with PMS exercise more regularly than women without PMS because they believe exercise is effective in attenuating their symptoms.