The association of trace elements with premenstrual syndrome, dysmenorrhea and irritable bowel syndrome in adolescents

Eur J Obstet Gynecol Reprod Biol. 2019 Feb:233:114-119. doi: 10.1016/j.ejogrb.2018.12.017. Epub 2018 Dec 17.


Objective: Premenstrual syndrome (PMS), primary dysmenorrhea (PD), and irritable bowel syndrome (IBS) are common complaints in women of reproductive age. Trace element status may be associated with the development of these disorders but the current data are unclear. The present study focused on the relationship between serum and dietary copper and zinc with some common physical and psychosomatic conditions among young females.

Study design: This cross-sectional study comprised 448 adolescent girls who were classified into four groups: individuals with PMS (n = 67), PD (n = 161), both PMS and PD (n = 146), and normal (n = 74). IBS was diagnosed according to the Rome III questionnaire. Flame atomic absorption (Varian AA240FS) was used to measure serum zinc and copper. Food intake of micronutrients was estimated using a three-day dietary record.

Results: There was a significant difference in the frequency of IBS across the four corresponding groups as the percentage of subjects. The prevalence of IBS was significantly higher in the PD group [PMS (13.6%), PD (19.9%), both PMS and PD (17.4%) and normal (8.1%); P value < 0.05]. There was no significant differences between the mean values for serum and dietary intake of zinc and copper among four groups (p value > 0.05). Although, the mean dietary zinc intake was significantly lower in subjects with IBS (6.7 ± 2.8 mg/day) versus those without IBS (7.9 ± 3.1 mg/ day, p = 0.032).

Conclusion: Girls with IBS were found to have significantly higher rates of gynecological symptoms, including PD and PMS. The lower dietary intake of zinc in subjects with IBS indicate a need for greater attention towards dietary patterns in these individuals.

Keywords: Copper; Dietary intake; Nutrition; Premenstrual symptoms; Zinc.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Case-Control Studies
  • Child
  • Copper / blood*
  • Cross-Sectional Studies
  • Dysmenorrhea / epidemiology*
  • Female
  • Humans
  • Iran
  • Irritable Bowel Syndrome / epidemiology*
  • Premenstrual Syndrome / epidemiology*
  • Prevalence
  • Surveys and Questionnaires
  • Trace Elements / blood*
  • Zinc / blood*


  • Biomarkers
  • Trace Elements
  • Copper
  • Zinc