The Association of Inflammation with Premenstrual Symptoms

J Womens Health (Larchmt). 2016 Sep;25(9):865-74. doi: 10.1089/jwh.2015.5529. Epub 2016 May 2.


Background: About 80% of women experience premenstrual symptoms (PMSx), and about 50% of women seek medical care for them, posing a large medical care burden. However, despite women's use of anti-inflammatory agents for relief from these symptoms, and the fact that anti-inflammatory agents provide relief from some PMSx, the relationship of inflammation to PMSx has not been well investigated.

Methods: We, therefore, undertook the present cross-sectional analyses using baseline data from the longitudinal Study of Women's Health Across the Nation (SWAN), a racially/ethnically diverse cohort of midlife women (n = 2939), to determine if a biomarker of inflammation, high-sensitivity C-reactive protein (hs-CRP), was associated with PMSx. We performed factor analyses with Varimax rotations to determine five groupings of eight symptoms to develop a parsimonious set of outcome variables. We conducted backward stepwise multiple logistic regression models for each grouping, eliminating non-significant (p > 0.05) covariates.

Results: Having an hs-CRP level >3 mg/L was significantly positively associated with premenstrual mood symptoms (adjusted odds ratio [aOR] = 1.27, 95% confidence interval [95% CI] 1.02-1.58), abdominal cramps/back pain (aOR = 1.40, 95% CI 1.09-1.80), appetite cravings/weight gain/bloating (aOR = 1.41, 95% CI 1.04-1.89), and breast pain (aOR = 1.26, 95% CI 1.02-1.55). Elevated hs-CRP level was not associated with premenstrual headaches or reporting three or more PMSx.

Conclusions: The significant relationships of specific groups of PMSx with elevated hs-CRP levels have potential clinical implications for treatment and possibly for prevention by advising women about the factors associated with inflammation and the potential for treatment with anti-inflammatory agents.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Pain
  • Adult
  • Affect
  • Appetite
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammation / complications*
  • Logistic Models
  • Longitudinal Studies
  • Mastodynia
  • Middle Aged
  • Odds Ratio
  • Premenstrual Syndrome / blood
  • Premenstrual Syndrome / complications*
  • United States / epidemiology
  • Women's Health


  • Biomarkers
  • C-Reactive Protein