Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts 01003-9304, USA.
J Womens Health (Larchmt). 2009 Dec;18(12):1945-53. doi: 10.1089/jwh.2009.1468.
Relatively little is known about factors that influence the initial development of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), although these conditions are common in reproductive age women and are associated with substantial impairment. Previous studies have observed higher alcohol use in prevalent PMS/PMDD patients compared with controls, but it is unknown if drinking predisposes women to developing these disorders or is instead influenced by symptom experience.
To address this, we conducted a case-control study nested within the prospective Nurses' Health Study II (NHS2). Participants were a subset of women aged 27-44 and free from PMS at baseline (1991), including 1057 women who developed PMS over 10 years of follow-up, 762 of whom also met criteria consistent with PMDD, and 1968 control women. Alcohol use at various time periods, before and after onset of menstrual symptoms, was assessed by questionnaire.
Overall, alcohol use was not strongly associated with the incidence of PMS and probable PMDD. Relative risks (RR) for women with the highest cumulative alcohol use vs. never drinkers were 1.19 (95% confidence interval [CI] 0.84-1.67) for PMS and 1.28 (95% CI 0.86-1.91) for PMDD, although results did suggest a positive relationship in leaner women (p trend=0.002). Women who first used alcohol before age 18 had an RR of PMS of 1.26 (95% CI 0.91-1.75) compared with never drinkers; the comparable RR for PMDD was 1.35 (95% CI 0.93-1.98).
These findings suggest alcohol use is not strongly associated with the development of PMS and PMDD, although early age at first use and long-term use may minimally increase risk.
尽管经前期综合征（PMS）和经前期烦躁障碍（PMDD）在育龄期妇女中较为常见，且会对其造成严重影响，但人们对影响其初始发生的因素知之甚少。既往研究观察到，现患 PMS/PMDD 患者的酒精使用量高于对照组，但目前尚不清楚是饮酒使女性易患这些疾病，还是其受症状体验影响。
为解决这一问题，我们开展了一项巢式病例对照研究，该研究嵌套于前瞻性护士健康研究 II （NHS2）中。参与者为年龄在 27-44 岁且基线时无 PMS 的女性亚组（1991 年），其中包括 1057 名在 10 年随访期间发生 PMS 的女性，其中 762 名也符合 PMDD 标准，1968 名对照女性。通过问卷评估了不同时期（月经症状出现前后）的酒精使用情况。
总体而言，酒精使用与 PMS 和可能的 PMDD 的发生并无密切关联。与从不饮酒者相比，累积饮酒量最高的女性发生 PMS 和 PMDD 的相对风险（RR）分别为 1.19（95%置信区间 [CI]0.84-1.67）和 1.28（95% CI 0.86-1.91），尽管结果提示在体型较瘦的女性中存在正相关关系（趋势检验 p 值=0.002）。与从不饮酒者相比，18 岁前首次饮酒的女性发生 PMS 的 RR 为 1.26（95% CI 0.91-1.75）；PMDD 的 RR 为 1.35（95% CI 0.93-1.98）。
这些发现表明，酒精使用与 PMS 和 PMDD 的发生无明显关联，但初次使用年龄较小和长期使用可能会使风险略有增加。
