A few days before menstruation, a series of discomforts can be experienced, which in some cases are intense and are known as premenstrual syndrome, a problem that affects a large number of women around the world, but whose long-term effects are not known. knows too much.
Now, a new observational study conducted in Sweden has shown that women with premenstrual disorders (PMD) have a higher risk of suicide. In fact, they are more than twice as likely to die by suicide than women who do not suffer from these disorders, which highlights the need for more research to help those affected. The results have been published in JAMA Network Open.
“The findings from this matched cohort study suggest that women with premenstrual disorders are not at increased risk of premature death overall,” writes a team led by women’s mental health epidemiologist Marion Opatowski of the Karolinska Institute in Sweden. “However,” they add, “the risk was higher among young women and with respect to death by suicide. “This supports the importance of careful follow-up for young patients and highlights the need to develop suicide prevention strategies for all women with premenstrual disorders.”
High suicidal prevalence in premenstrual disorders
On average, people who menstruate will have about 480 periods in their lifetime, in a cycle that generally lasts between 23 and 38 days. The premenstrual period lasts about a week before menstruation begins, accounting for about a quarter of the entire cycle. That equates to a lot of time experiencing premenstrual symptoms, especially for those with disorders. The most serious of these, premenstrual dysphoric disorder, includes severe depression, anxiety, anger, and mood swings.
Previous studies found that women suffering from these disorders have a higher risk of injuries due to accidents, as well as a higher incidence of suicidal behaviors. Opatowski and her colleagues sought to better understand this by investigating the link between premenstrual disorders and mortality through a cohort study.
This type of study follows a specific group of people over a period of time to observe changes in that population. They used multiple Swedish population registries to track the mortality outcomes of 67,748 women diagnosed with PMT between January 1, 2001 and December 31, 2018, randomly matching each patient with five women who had not been diagnosed with premenstrual disorder ( 338,740), with a total of 406,488 participants.
Then, they studied the mortality rates for these groups, as well as the cause of death. There were 367 deaths observed among women with MPD, or 8.4 deaths per 10,000 person-years; and 1,958 deaths among women without MPD, or 9.1 deaths per 10,000 person-years. This means that, in general, women with diagnosed premenstrual disorder did not have an increased risk of mortality, but there was an increased risk of death from unnatural causes, such as accidents, and, particularly, suicide. The incidence of suicide among women with MPD was 2.3 deaths per 10,000 person-years, compared with 1.06 deaths per 10,000 person-years for women without MPD.
“This research supports the importance of closely monitoring young women with premenstrual disorders, as well as the need to develop suicide prevention strategies for these conditions.”
Interestingly, women with premenstrual disorders were found to have a lower risk of death associated with cardiovascular causes. This could be because these women maintain closer contact with their doctors. Or it may have something to do with medication; Selective serotonin reuptake inhibitor antidepressants often prescribed for premenstrual disorders may confer protection against some cardiovascular diseases, as can hormone replacement therapy.
“This research delves into the scarce existing evidence on the long-term consequences of premenstrual disorders on the health of women of reproductive age, particularly on the risk of mortality. It should be remembered that both premenstrual syndrome and premenstrual dysphoric disorder are characterized by the cyclical presence of a wide variety of affective, somatic and behavioral symptoms in the week before menstruation, with a great negative impact on women’s quality of life. young people who suffer from them. Despite being common, their exact etiology is unknown and their diagnosis can be delayed for years. For all these reasons, the World Health Organization considers them a public health problem in modern societies,” Cristina Carrasco, substitute professor and researcher in the Department of Physiology of the Faculty of Medicine and Sciences of the Faculty of Medicine and Sciences, explained in statements to SMC Spain. Health of the University of Extremadura.
And he adds that “the findings confirm previous evidence on the high prevalence of suicide in premenstrual disorders, but they also throw up new unknowns that should be explored in future research. For example, why women with menstrual disorders have a lower risk of death from natural causes, particularly cardiovascular events. In this sense, the authors point out the potential cardioprotective effect of first-line treatments in these conditions, such as selective serotonin reuptake inhibitors with antidepressant effect, or hormone replacement therapy. Other factors associated with this observation could be a greater concern for health, which would mean greater contact with the health system, treatment of comorbidities and behavioral changes.”
“However, we must not forget that some of the limitations of the study, such as possible errors in the classification of both study groups, or the non-availability of data related to other confounding factors (smoking, body mass index, etc.), could also influence the results obtained. Finally, the conclusions may not be fully extrapolated to other countries, due to the difference in sociodemographic and cultural characteristics.”
“In any case, as the authors conclude, this research supports the importance of carefully monitoring young women with premenstrual disorders, as well as the need to develop suicide prevention strategies in these conditions,” concludes the expert.
