Study: PMS Increases Risk For Pelvic Floor Disorders


WASHINGTON — Women with premenstrual syndrome are at increased risk for pelvic floor disorders, according to results from a study of twin sisters.

In addition, women who do not have PMS but who have a first-degree relative with PMS may also be at increased risk for pelvic floor disorders, Dr. Sarit O. Aschkenazi said at the annual meeting of the AAGL.

The findings come from a cross-sectional survey of 362 premenopausal identical twin sisters who were recruited at the 2005–2006 Twins Day Annual Festival in Twinsburg, Ohio.

The women filled out two validated questionnaires. One, the 14-item Premenstrual Symptoms Screening Tool (PSST), identifies individuals with PMS and premenstrual dysphoric disorder (PMDD), and grades severity. The other, the short form of the Pelvic Floor Disorder Inventory (PFDI-20), comprises subscales for distress related to urinary, pelvic organ prolapse, and colorectal/anal symptoms.

Each subscale is scored from 0 (least distress) to 100 (greatest distress), yielding a 0–300 range of total score.

A total of 12% of the women met criteria for moderate to severe PMS/PMDD.

The patients had a mean age of 26 years and a mean body mass index of 23.4 kg/m

Ninety percent were white; 3%, black; 3%, Hispanic; and 4%, other ethnicities, noted Dr. Aschkenazi, a urogynecologist at Evanston (Ill.) Northwestern Hospital.

Compared with the 318 women who had no or mild PMS/PMDD, the 44 who had severe PMS or PMDD scored significantly higher on all three of the PFDI-20 distress subscales: 12.4 vs. 4.8 for pelvic organ prolapse, 10.2 vs. 2.9 for co-lorectal/anal, and 18.6 vs. 6.7 for urinary symptoms.

Scores for symptoms of pelvic pressure and dullness, incomplete bowel emptying, fecal urgency, and frequent urination/leakage were each significantly worse in the women with severe PMS/PMDD, compared with those without, she reported.

The mean total PDFI-20 scores were higher among the 28 women without severe PMS/PMDD whose twin did have PMS than they were among the 262 women whose twin did not have severe PMS/PMDD, reaching significance for the urinary symptom component (12.8 vs. 6.0).

This finding suggests that the PMS-free women whose twin sisters have PMS might be at increased risk for pelvic floor disorders because of genetic factors, she commented.

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