Good News-Bad News On PMS and Menopause

Young women, take heart: if you are among the vast majority of us who suffer from PMS —  the irritability, anxiety, headaches, breast tenderness, or bloating — it doesn't mean you're doomed to suffer from hot flashes when you hit menopause.

But don't go out and celebrate just yet.

Because this is a good news/bad news kind of report:

The Bad: They did find a connection between PMS and other seriously annoying problems shortly after menopause —  including impaired memory and concentration, poor sleep and depression.

Oh well.

The study of 150 recently menopausal woman published in the journal Menopause, claims its findings — linking a history of PMS with worsened so-called "health-related quality of life" measures, but not with hot flashes — are "novel."

Here's more on the mechanics of the connection, from the study:

The resemblance between premenstrual and menopausal symptoms raises a question on whether they also share similar physiological characteristics. One mechanism that has been suggested to contribute to premenstrual symptoms is deficiency in, or abnormal functioning of, neurotransmitters in the central nervous system, such as serotonin and F amino butyric acid. This might affect gonadal hormone levels or their fluctuations during the menstrual cycle and again in early menopause.

Abnormal functioning of the neurotransmitters could explain the genesis of various premenstrual symptoms and could contribute to diminished HRQL in menopause. Moreover, alterations in autonomic nervous system regulation have been associated with both premenstrual symptoms and the menopausal transition.

And here's context from the news release:

The research team at the Helsinki University Central Hospital and Folkhälsan Research Institute in Helsinki, Finland, are the first to show a link between PMS and a worse quality of life after menopause. They uncovered the link by asking 120 healthy postmenopausal women who had not taken hormones to answer standard questionnaires about the premenstrual symptoms they had had and about their current health. The investigators also had the volunteers keep a diary of their hot flashes, recording how many they had and the severity of each.

Nearly 90% of the women recalled having PMS. For half of these women, the symptoms interfered with work, home or social life, and about 40% of these women rated their PMS as moderate or severe. But the analysis showed that hot flashes and their severity had no significant relationship to PMS. The symptoms were, however, linked with depression, poor sleep, feeling less attractive, and especially with memory and concentration problems after menopause.

Whether these results mean that PMS and menopause complaints other than hot flashes have a common cause, such as a similar change in regulation of the autonomic nervous system or genes that predispose to both, are topics for future research.

Meanwhile, says NAMS Executive Director Margery Gass, MD, “Women who are troubled by PMS can be reassured that it doesn’t mean bothersome hot flashes are inevitable later.”