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BMC Medicine
Published in: BMC Medicine 1/2022

Open Access 01-12-2022 | Research article

Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women

Authors: Qian Yang, Edda Björk Þórðardóttir, Arna Hauksdóttir, Thor Aspelund, Jóhanna Jakobsdóttir, Thorhildur Halldorsdottir, Gunnar Tomasson, Harpa Rúnarsdóttir, Hilda Björk Danielsdottir, Elizabeth R. Bertone-Johnson, Arvid Sjölander, Fang Fang, Donghao Lu, Unnur Anna Valdimarsdóttir

Published in: BMC Medicine | Issue 1/2022

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Abstract

Background

Childhood abuse and neglect have been associated with premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). However, the associations of other adverse childhood experiences (ACEs) and the cumulative number of ACEs with PMDs remain to be explored.

Methods

To evaluate the associations of the cumulative number and types of ACEs with PMDs, we conducted a cross-sectional analysis with a subsample of menstruating women within the Stress-And-Gene-Analysis (SAGA) cohort, assessed for PMDs and ACEs (N=11,973). The cumulative and individual exposure of 13 types of ACEs was evaluated by a modified ACE-International Questionnaire. A modified version of the Premenstrual Symptom Screening Tool was used to identify probable cases of PMDs, further sub-grouped into PMS and PMDD. Prevalence ratios (PRs) of PMDs in relation to varying ACEs were estimated using Poisson regression.

Results

At a mean age of 34.0 years (standard deviation (SD) 9.1), 3235 (27%) met the criteria of probable PMDs, including 2501 (21%) for PMS and 734 (6%) for PMDD. The number of ACEs was linearly associated with PMDs (fully-adjusted PR 1.12 per ACE, 95% CI 1.11–1.13). Specifically, the PR for PMDs was 2.46 (95% CI 2.21–2.74) for women with 4 or more ACEs compared with women with no ACEs. A stronger association was observed for probable PMDD compared to PMS (p for difference <0.001). The associations between ACEs and PMDs were stronger among women without PTSD, anxiety, or depression, and without childhood deprivation and were stronger among women a lower level of social support (p for interaction<0.001). All types of ACEs were positively associated with PMDs (PRs ranged from 1.11 to 1.51); the associations of sexual abuse, emotional neglect, family violence, mental illness of a household member, and peer and collective violence were independent of other ACEs.

Conclusions

Our findings suggest that childhood adverse experiences are associated with PMDs in a dose-dependent manner. If confirmed by prospective data, our findings support the importance of early intervention for girls exposed to ACEs to minimize risks of PMDs and other morbidities in adulthood.
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Metadata
Title
Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women
Authors
Qian Yang
Edda Björk Þórðardóttir
Arna Hauksdóttir
Thor Aspelund
Jóhanna Jakobsdóttir
Thorhildur Halldorsdottir
Gunnar Tomasson
Harpa Rúnarsdóttir
Hilda Björk Danielsdottir
Elizabeth R. Bertone-Johnson
Arvid Sjölander
Fang Fang
Donghao Lu
Unnur Anna Valdimarsdóttir
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2022
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-022-02275-7

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