Lifestyle Factors, Hormonal Contraception, and Premenstrual Symptoms: The United Kingdom Southampton Women's Survey

Objective: To estimate the prevalence of premenstrual symptoms in women from the general population in Southampton, U.K., and examine their association with lifestyle factors and contraceptive use. Methods: This was a cross-sectional survey in the city of Southampton, U.K., of 974 women aged 20-34 years (53% of the 1841 women invited to participate). The survey consisted of interviews, questionnaires, and completion of a prospective 6-week menstrual symptom diary recording on a daily basis the presence and severity of 11 common premenstrual symptoms. Premenstrual symptoms were identified from the diaries by two clinicians who reviewed them independently using a predefined algorithm to assess the onset and decline of symptoms in relation to the start of menstruation. Results: Of the women surveyed, 24% were considered to have premenstrual symptoms (95% confidence interval [CI] 21-27). Women were less likely to have symptoms if they had higher levels of educational attainment and suffered less from stress. No associations were found between premenstrual symptoms and diet, alcohol, or strenuous exercise nor after adjustment for other factors, with age, smoking, or body mass index (BMI). Use of any form of hormonal contraceptives was associated with a lower prevalence of premenstrual symptoms (prevalence ratio 0.66, 95% CI 0.52-0.84). Conclusions: Premenstrual symptoms were common in this cohort. Use of hormonal contraceptive methods was associated with a lower prevalence of these symptoms.