Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms

Objective: To test the hypothesis that a low-fat, vegetarian diet reduces d ysmenorrhea and premenstrual symptoms by its effect on serum sex-hormone bi nding globulin concentration and estrogen activity. Methods: In a crossover design, 33 women followed a low-fat, vegetarian die t for two menstrual cycles. For two additional cycles, they followed their customary diet while taking a supplement placebo pill. Dietary intake, seru m sex-hormone binding globulin concentration, body weight, pain duration an d intensity, and premenstrual symptoms were assessed during each study phas e. Results: Mean (+/- standard deviation [SDI]) serum sex-hormone binding glob ulin concentration was higher during the diet phase (46.7 +/- 23.6 nmol/L) than during the supplement phase (39.3 +/- 19.8 nmol/L, P < .001). Mean (+/ - SD) body weight was lower during the diet (66.1 +/- 11.3 kg) compared wit h the supplement phase (67.9 +/- 12.1 kg, P <.001). Mean dysmenorrhea durat ion fell significantly from baseline (3.9 +/- 1.7 days) to diet phase (2.7 +/- 1.9 days) compared with change from baseline to supplement phase (3.6 /- 1.7 days, P < .01). Pain intensity fell significantly during the diet ph ase, compared with baseline, for the worst, second-worst, and third-worst d ays, and mean durations of premenstrual concentration, behavioral change, a nd water retention symptoms were reduced significantly, compared with the s upplement phase. Conclusion: A low-fat vegetarian diet was associated with increased serum s ex-hormone binding globulin concentration and reductions in body weight, dy smenorrhea duration and intensity, and premenstrual symptom duration. The s ymptom effects might be mediated by dietary influences on estrogen activity . (C) 2000 by The American College of Obstetricians and Gynecologists.