title: A prospective study of caffeine and coffee intake and premenstrual syndrome.
abstract: Clinically significant premenstrual syndrome (PMS) affects 15-20% of premenopausal women, substantially reducing quality of life. Women with PMS often are counseled to minimize caffeine intake, although only limited evidence supports this recommendation.
  
  
  
  We evaluated the association between total caffeine, coffee, and tea intake and the development of PMS in a case-control study nested within the prospective Nurses' Health Study II.
  
  
  
  All participants were free from PMS at baseline (1991). PMS cases reported a new clinician-made diagnosis of PMS on biennial questionnaires between 1993 and 2005, and then confirmed symptom timing and moderate-to-severe impact and severity of symptoms with the use of a retrospective questionnaire (n = 1234). Controls did not report PMS and confirmed experiencing no symptoms or few mild symptoms with limited personal impact (n = 2426). Caffeine, coffee, and tea intake was measured by food-frequency questionnaires every 4 y, and data on smoking, body weight, and other factors were updated every 2-4 y. Logistic regression was used to evaluate the associations of total caffeine intake and frequency of coffee and tea consumption with PMS.
  
  
  
  After adjustment for age, smoking, and other factors, total caffeine intake was not associated with PMS. The OR comparing women with the highest (quintile median = 543 mg/d) to the lowest (quintile median = 18 mg/d) caffeine intake was 0.79 (95% CI: 0.61, 1.04; P-trend = 0.31). High caffeinated coffee intake also was not associated with risk of PMS or specific symptoms, including breast tenderness (OR for ≥4 cups/d compared with <1/mo: 0.73; 95% CI: 0.48, 1.12; P-trend = 0.44).
  
  
  
  Our findings suggest that caffeine intake is not associated with PMS, and that current recommendations for women to reduce caffeine intake may not help prevent the development of PMS.
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA;
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Purdue-Smithe
authors.affiliation: Channing Division of Network Medicine and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA; Channing Division of Network Medicine and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA; ebertone@schoolph.umass.edu.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Bertone-Johnson
mesh_terms: D000328:Adult; D002110:Caffeine / Q000494:pharmacology*; D016022:Case-Control Studies; D040503:Coffea / Q000737:chemistry*; D003069:Coffee / Q000737:chemistry*; D005260:Female; D006801:Humans; D016015:Logistic Models; D011293:Premenstrual Syndrome / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013662:Tea
chemical_list: D003069:Coffee; D013662:Tea; D002110:Caffeine
keywords: caffeine; coffee; premenstrual syndrome; tea; women’s health