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Drinking alcohol linked to higher risk of PMS

If causal, eliminating heavy drinking in women could prevent one in 12 cases of PMS in Europe

Louise Prime

Tuesday, 24 April 2018

Drinking alcohol is associated with the risk of premenstrual syndrome (PMS), and the association is stronger for heavy drinking, according to a new study* published today in BMJ Open. The study authors suggested that if the association is causal, it could mean that eliminating heavy drinking in women could prevent one in every 12 cases of PMS in Europe.

A research team from Spain and Southampton, UK, said that although previous research has found that PMS tends to be more severe among women who drink alcohol, it has not been clear in which direction the association works – whether the alcohol worsens symptoms, or whether women drink more in trying to lessen their symptoms. To try to answer this, they conducted what they believed to be the first meta-analysis to assess the relationship of alcohol with the occurrence of PMS.

They analysed 19 studies from eight countries, which included a total of more than 47,000 women. They found that, overall, alcohol intake was associated with a moderately raised relative risk of PMS (odds ratio OR 0.45) compared with not drinking; heavy drinking was associated with a greater increase in risk of PMS (OR 0.79). They contended that the fact that the increase in relative risk is more pronounced for heavy drinking than for moderate drinking, results favour a causal explanation of the relation between alcohol intake and PMS.

The researchers pointed out that although fewer than 30% of women worldwide are estimated to be drinkers, and only 5.7% heavy drinkers, the figures are far higher in America and Europe – almost 60% for current drinking in Europe, and close to 13% for heavy drinking.

They estimated that, based on these figures, about 11% of PMS cases worldwide and 21% in Europe might be associated with alcohol intake; and 4% of global PMS cases and over 9% in Europe with heavy drinking. They suggested: “If this association is of causal nature, eliminating heavy drinking in women would then prevent one in every 12 cases of PMS in Europe.”

The authors said that although it was plausible that this association might arise because women drank more in order to mitigate the effects of PMS, they believed that the consistency of their results strengthened their conclusions – although to clarify matters they called for further research that uses validated questionnaires, and avoids cross-sectional design.

They concluded: “Future studies should avoid cross-sectional designs and focus on determining whether there is a threshold of alcohol intake under which the harmful effect on PMS is non-existent.”

*Fernández MdM, Saulyte J, Inskip HM, et al. Premenstrual syndrome and alcohol consumption: a systematic review and meta-analysis. BMJ Open 2018; 8:e019490. doi:10.1136/bmjopen-2017-019490

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