Clinical Medicine Reviews in Women's Health

Recent evidence suggests reduced levels of serotonin, which may be associated with premenstrual symptoms, among populations in socioeconomically disadvantaged areas. In this cross-sectional study, we examined the association between neighborhood socioeconomic status (SES) and premenstrual symptoms. Participants were 640 female Japanese dietetic students aged 18–22 years, residing in 210 municipalities in Japan. Neighborhood SES index was defined by seven municipal-level variables (unemployment, household overcrowding, poverty, education, income, home ownership, and vulnerable groups), with an increasing index signifying increasing neighborhood socioeconomic disadvantage. Menstrual cycle symptoms were assessed using the Moos Menstrual Distress Questionnaire, from which subscale (pain, concentration, behavioral change, autonomic reactions, water retention, and negative affect) and total scores in the premenstrual phase were calculated and expressed as percentages relative to those in the intermenstrual phase. Neighborhood SES index was positively associated with pain score in the premenstrual phase (P = 0.02). This association remained after adjustment for potential confounding factors (P = 0.008). Neighborhood SES index also showed a positive relation with water retention score in the premenstrual phase (P = 0.03), although not independently of potential confounding factors (P = 0.14). However, no association was seen between neighborhood SES index and other subscale scores or total score in the premenstrual phase (P > 0.05). In conclusion, neighborhood socioeconomic disadvantage was independently associated with higher pain in the premenstrual phase, although a clear relationship with premenstrual symptoms was not found. Considering the plausibility of the proposed mechanism, however, further investigation using more relevant neighborhood SES indicators is warranted.