The impact of premenstrual symptomatology on functioning and treatment-seeking behavior: Experience from the United States, United Kingdom, and France

Up to 80% of women experience mood and physical symptoms associated with th e menstrual cycle. This study assessed the impact of premenstrual symptomat ology on functioning and treatment-seeking behavior for a community-based s ample of women in the United States, United Kingdom, and France. A sample o f 1045 menstruating women (aged 18-49) completed a telephone questionnaire that measured, at a point in time, premenstrual symptoms, impact on functio ning, and treatment-seeking behavior. Results were generally consistent acr oss the three countries. Irritability/anger, fatigue, and physical swelling /bloating, or weight gain were among the most commonly reported symptoms (a pproximately 80%). Functional impairment tended to be highest at home, foll owed by social, school, and occupational situations. Among working women, o ver 50% reported at least somewhat affected occupational functioning. Of wo men who ever missed work because of symptoms, 1-7 days were missed in the p ast year. Almost three fourths of the women had never sought treatment, and symptom severity was an important factor in treatment-seeking behavior. Tr eatment with selective serotonin reuptake inhibitors (SSRIs), which have de monstrated efficacy in this population, occurred with surprisingly low freq uency. The functional impairment of premenstrual symptomatology (home, soci al, and occupational) and treatment-seeking behavior is consistent across c ountries. Women who experience more impairment are more likely to have seve re symptoms and are more likely to believe, relative to women with less sev ere symptoms, that no treatment is available. This suggests significant unm et medical need in this more severely affected population. Improved clinica l identification of these women and increasing awareness of the efficacy of SSRIs in treating premenstrual symptomatology may be of benefit.