Gastrointestinal symptoms before and during menses in healthy women.
BACKGROUND
Little is known as to the extent gastrointestinal (GI) complaints are reported by women around menses. We aimed to describe GI symptoms that occurred premenstrually and during menses in healthy women, and to specifically assess the relationship of emotional symptoms to GI symptoms around menses.


METHODS
We recruited healthy, premenopausal adult women with no indication of GI, gynecologic, or psychiatric disease who were attending an outpatient gynecology clinic for well-woman care. They completed a survey that queried menstrual histories and the presence of GI and emotional symptoms. We compared the prevalence of primary GI symptoms (abdominal pain, diarrhea, constipation, nausea, vomiting), as well as pelvic pain and bloating, in the 5 days preceding menses and during menses, and assessed whether emotional symptoms or other factors were associated with the occurrence of GI symptoms.


RESULTS
Of 156 respondents, 73% experienced at least one of the primary GI symptoms either pre- or during menses, with abdominal pain (58% pre; 55% during) and diarrhea (24% pre; 28% during) being the most common. Those experiencing any emotional symptoms versus those without were more likely to report multiple (2 or more) primary GI symptoms, both premenstrually (depressed p = 0.006; anxiety p = 0.014) and during menses (depressed p < 0.001; anxiety p = 0.008). Fatigue was also very common (53% pre; 49% during), and was significantly associated with multiple GI symptoms in both menstrual cycle phases (pre p < 0.001; during p = 0.01).


CONCLUSIONS
Emotional symptoms occurring in conjunction with GI symptoms are common perimenstrually, and as such may reflect shared underlying processes that intersect brain, gut, and hormonal pathways.
Matthew T
MT
Bernstein
Department of Clinical Health Psychology, Faculty of Medicine, University of Manitoba, PZ350 - 771 Bannatyne Avenue, Winnipeg, MB R3E 3N4, Canada. lgraff@hsc.mb.ca.
Lesley A
LA
Graff
Lisa
L
Avery
Carrie
C
Palatnick
Katie
K
Parnerowski
Laura E
LE
Targownik
D015746:Abdominal Pain / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003248:Constipation / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008597:Menstrual Cycle; D008598:Menstruation; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology; D017699:Pelvic Pain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000453:epidemiology; D055815:Young Adult