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Cohort study, 2020

Are immune and oxidative stress markers linked to menstrual cycle symptoms?

Certain markers related to antioxidant defenses and immune function may play a role in menstrual cycle symptoms, though this isn't due to general inflammation. However, this is a small study with no control group, so the findings need confirmation.

Early or limited evidence 41 women with menstrual cycle associated symptoms

What they did

41 women recorded symptoms daily for 28 consecutive days using a symptom scale and had blood tests measuring various immune and oxidative stress markers at 4 time points during their menstrual cycle.

What they found

Most blood markers changed during the menstrual cycle. In women with menstrual cycle symptoms, certain markers were lower (arylesterase and malondialdehyde) or higher (lipid hydroperoxides and C4) at specific times. Progesterone and estradiol appeared to protect against oxidative stress.

What it means for you

Certain blood markers may be involved in PMS symptoms, but the picture is complex and not due to simple inflammation. Limited by small sample size and no control group to compare against.

41

women studied

28

consecutive days of tracking

>0.666

DRSP percentile threshold for diagnosis

About the study

Original title
The role of immune and oxidative pathways in menstrual cycle associated depressive, physio-somatic, breast and anxiety symptoms: Modulation by sex hormones
Authors
Roomruangwong C, Matsumoto AK, Michelin AP et al.
Journal
Journal of psychosomatic research
Year
2020
Study design
Cohort study
Participants
41
What was tested
None - observational study
Open access
Yes
Original abstract

Objective: To examine whether 1) immune and nitro-oxidative stress (IO&NS) biomarkers are associated with premenstrual syndrome (PMS); and 2) changes in IO&NS biomarkers during the menstrual cycle (MC) are associated with PMS symptoms and plasma estradiol and progesterone. Methods: This longitudinal study examined 41 women who completed the Daily Record of Severity of Problems (DRSP) rating scale during 28 consecutive days and assayed plasma levels of complement C3 and C4, highly sensitive C-reactive protein (hsCRP), haptoglobin (Hp), advanced oxidation protein products (AOPP), lipid hydroperoxides (LOOH), nitric oxide metabolites (NOx), total radical-trapping antioxidant parameter (TRAP), sulfhydryl (-SH) groups and the activity of paraoxonase (PON)1 at days 7 (D7), 14 (D14), 21 (D21) and 28 (D28) of the MC. MC Associated Syndrome (MCAS) was diagnosed when the summed DRSP score during the MC is >0.666 percentile. Results: All biomarkers, except hsCRP, showed significant alterations during the MC. Arylesterase (AREase) was lowered at D28, while LOOH increased at D14 and C4 at D21 in MCAS. Total DRSP scores were predicted by the combined effects of C4 (positively) and AREase and malondialdehyde (MDA) (both inversely associated). Progesterone lowered levels of LOOH, AOPP and C3 and estradiol lowered levels of Hp while both sex hormones increased 4-(chloromethyl)phenyl acetate (CMPA)ase and AREase activities and levels of -SH groups. Conclusion: PMS/MCAS is not accompanied by a peripheral inflammatory response. Lowered MDA and antioxidant defenses and increased C4 may play a role in MC symptoms while sex hormones may have a protective effect against oxidative stress toxicity.

Reproduced under CC-BY.

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