PMS and Alcohol
© David Waldorf/Getty ImagesPMS is frequently unpleasant, but does alcohol help or hinder?
The unpleasant symptoms of premenstrual syndrome (PMS) may be linked to alcohol consumption, according to a new analysis.

The authors of the review, from Spain's University of Santiago de Compostela, say the evidence gathered cannot unambiguously determine whether PMS is made worse by alcohol, or whether some women who experience the syndrome use alcohol to manage the symptoms.

However, they note that a higher prevalence of reported PMS symptoms among women who drink heavily, "which favours a causal explanation of the relation between alcohol intake and PMS".

If further study supports the contention, they add, then encouraging women to lay off the booze might make the secondary effects of the menstrual cycle more bearable.

To conduct their analysis, the researchers, led by María del Mar Fernández, combed medical databases looking for research that recorded PMS incidence, duration and symptom strength as well as lifestyle behaviours, including alcohol intake. They identified 19 suitable studies involving 47,000 participants.

Running the numbers, they discovered that, over all, 11% cases of PMS were linked to alcohol drinking.

In general, drinking was associated with a 45% increased risk of PMS, but the chances of experiencing it rose to 79% for women classified as heavy drinkers.

The nature and structure of the studies included in the analysis meant that a definite causal relationship between PMS and drinking could not be established.

However, the researchers suggest that the consistency of the results points in that direction.

This, they say, is significant, in light of the fact that "the worldwide prevalence of alcohol drinking among women is not negligible."

Indeed, del Mar Fernández and her colleagues report that around the world about 30% of women drink alcohol, with about 6% drinking heavily. In the US and Europe about 60% of women drink, with the heavy-usage cohort rising to 12.5%.

"Based on the figures above and on our results, we estimate that 11% of the PMS cases may be associated to alcohol intake worldwide and 21% in Europe," write the researchers.

"Furthermore, heavy drinking may be associated with 4% of the PMS cases in the world and over 9% in Europe."

They suggest a "plausible" pathway in which alcohol may influence PMS symptoms is by altering levels of sex steroid hormones.

The research is published in the journal BMJ Open.