Women who reported eating a diet rich in iron were 30 to 40 percent less likely to develop pre-menstrual syndrome (PMS) than women who consumed lower amounts, in a study reported this week by researchers at the University of Massachusetts Amherst School of Public Health and Health Sciences (SPHHS) and Harvard. It is one of the first to evaluate whether dietary mineral intake is associated with PMS development.Senior author Elizabeth Bertone-Johnson, Associate Professor of Epidemiology, and others at UMass Amherst, along with lead author Patricia Chocano-Bedoya and colleagues at Harvard, assessed mineral intake in approximately 3,000 women in a case-control study nested within the prospective Nurses’ Health Study II. Participants were free from PMS at baseline. Results appear in the early online edition of the American Journal of Epidemiology.Women in the study completed three food frequency questionnaires over the 10-year study period. After 10 years, 1,057 women were diagnosed with PMS and 1,968 remained free from PMS. Adjusting for calcium intake and other factors, the researchers then compared previous mineral intake reported by the women diagnosed with PMS with that of women who had few or no menstrual symptoms.“We found that women who consumed the most non-heme iron, the form found primarily in plant foods and in supplements, had a 30 to 40 percent lower risk of developing PMS than women who consumed the lowest amount of non-heme iron,” says Bertone-Johnson. Women in the highest intake group for non-heme iron had a relative risk of PMS of 0.60 compared to women in the lowest intake group.She adds, “We also saw some indication that high intake of zinc was associated with lower risk. In contrast, we were somewhat surprised to find that women consuming the highest amount of potassium had a higher risk of being diagnosed with PMS than women consuming the lowest amount of potassium. In general, results for minerals from food sources and minerals from supplements were similar.”Overall, “Our findings need to be replicated in other studies. However, women at risk for PMS should make sure they are meeting the RDA for non-heme iron and zinc.”“The level of iron intake at which we saw a lower risk of PMS, roughly greater than 20 mg per day, is higher than the current recommended daily allowance (RDA) for iron for premenopausal women, which is 18 mg per day,” Bertone-Johnson says. This amount may be obtained in 1 to 1.5 servings per day of iron-fortified cereal or with supplements.“However, as high iron intake may have adverse health consequences, women should avoid consuming more than the tolerable upper intake level of 45 mg per day unless otherwise recommended by a physician,” she notes. Iron may be related to PMS because it is involved in producing serotonin, a neurotransmitter that helps to regulate mood, she and colleagues point out.The unexpected finding of higher PMS risk with high potassium intake, even at levels below current recommendations of 4,700 mg per day, may be related to potassium’s role in regulating fluid balance in the body. It may affect PMS symptoms such as swelling in the extremities and bloating by affecting fluid retention. “More studies of potassium and menstrual symptoms are needed to better understand this,” they say.“The level of zinc intake at which we saw suggestion of a lower risk of PMS, greater than 15 mg per day, was also higher than current recommendations of 8 mg per day. However, as high zinc intake may also have adverse health consequences, women should avoid consuming more than the tolerable upper intake level of 40 mg per day unless recommended by a physician.”Intake of other minerals, including magnesium, copper, sodium and manganese were not associated with PMS risk, the authors point out.American Journal of Epidemiology: http://aje.oxfordjournals.org/content/early/2013/02/23/aje.kws363.abstract ||||| By Robert Preidt, HealthDay Reporter 
 
 TUESDAY, Nov. 24, 2015 (HealthDay News) -- Millions of women suffer through premenstrual syndrome (PMS), and now new research suggests that those with moderate-to-severe PMS may be at heightened risk for high blood pressure later in life. 
 
 While the study couldn't prove cause-and-effect, the finding may mean that "women with PMS should be screened for adverse changes in blood pressure and future risk of hypertension," wrote a team led by Elizabeth Bertone-Johnson, an epidemiologist at the University of Massachusetts, Amherst. 
 
 The investigators tracked nearly 1,260 women who developed clinically significant PMS between 1991 and 2005, as well as more than 2,400 women with mild PMS. Both groups were followed until 2011. 
 
 Women with moderate-to-severe PMS were 40 percent more likely to develop high blood pressure than those with mild or no PMS symptoms, the researchers found. 
 
 This higher risk remained after the researchers adjusted for high blood pressure risk factors such as being overweight or obese, smoking, drinking, inactivity, use of birth control pills, postmenopausal hormone use, and family history of high blood pressure. 
 
 The link between moderate-to-severe PMS and high blood pressure was strongest among women younger than 40, Bertone-Johnson's group said. In this age group, those with clinically significant PMS were three times more likely to develop high blood pressure. 
 
 "To my knowledge, this is the first large long-term study to suggest that PMS may be related to risk of chronic health conditions in later life," Bertone-Johnson said in a university news release. 
 
 She and her colleagues did find that moderate-to-severe PMS did not increase the risk of high blood pressure in women with high intakes of the B vitamins thiamine and riboflavin. Recently, the researchers found that women who consumed high levels of those vitamins were 25 to 35 percent less likely to develop PMS. 
 
 Clinically significant PMS affects as many as 8 percent to 15 percent of women, the researchers said. However, they believe that it may be possible to reduce the risk of high blood pressure in these women by increasing their intake of B vitamins. 
 
 Two experts said the new findings could be important, but questions remain. 
 
 "The study is important in identifying an important condition that should lead to closer observation for the onset of high blood pressure," said Dr. Stacey Rosen, vice president of women's health at The Katz Institute for Women's Health in New Hyde Park, N.Y. 
 
 She added, however, that "one important limitation is that the average age of these patients was 27 years -- it would be helpful to see if this association persisted in younger women as well." 
 
 Dr. Deena Adimoolam is assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. She said that, right now, "many physicians don't consider PMS as a risk factor for hypertension." 
 
 And while the study findings are "interesting," she added that "I don't think women should be overly concerned about this association for a few reasons." 
 
 First, the study didn't identify and exclude women with conditions that can look like PMS -- chronic fatigue syndrome, anxiety disorders and irritable bowel syndrome, for example -- so, "PMS might have been wrongly diagnosed in some patients," Adimoolam said. 
 
 "Also, high blood pressure was self-reported by study participants and not diagnosed by a physician, which makes me question if certain participants truly developed hypertension," she added. 
 
 The study was published Nov. 24 in the American Journal of Epidemiology. 
 
 More information 
 
 The U.S. Office on Women's Health has more on premenstrual syndrome. 
 
 Copyright © 2015 HealthDay. All rights reserved. 
 
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 Symptoms By Mayo Clinic Staff 
 
 The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems. 
 
 Emotional and behavioral symptoms 
 
 Tension or anxiety 
 
 Depressed mood 
 
 Crying spells 
 
 Mood swings and irritability or anger 
 
 Appetite changes and food cravings 
 
 Trouble falling asleep (insomnia) 
 
 Social withdrawal 
 
 Poor concentration 
 
 Physical signs and symptoms 
 
 Joint or muscle pain 
 
 Headache 
 
 Fatigue 
 
 Weight gain related to fluid retention 
 
 Abdominal bloating 
 
 Breast tenderness 
 
 Acne flare-ups 
 
 Constipation or diarrhea 
 
 For some, the physical pain and emotional stress are severe enough to affect their daily lives. Regardless of symptom severity, the signs and symptoms generally disappear within four days of the start of the menstrual period for most women. 
 
 But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of PMS is called premenstrual dysphoric disorder (PMDD). 
 
 PMDD signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension. 
 
 When to see a doctor 
 
 If you haven't been able to manage your premenstrual syndrome with lifestyle changes and the symptoms of PMS are affecting your health and daily activities, see your doctor. 
 
 
 
 ||||| AMHERST, Mass. ­– In the first prospective study to consider premenstrual syndrome (PMS) as a possible sentinel for future risk of hypertension, epidemiologist Elizabeth Bertone-Johnson and colleagues in the School of Public Health and Health Sciences at the University of Massachusetts Amherst and the Harvard School of Public Health report that women with moderate-to-severe PMS had a 40 percent higher risk of developing high blood pressure over the following 20 years compared to women experiencing few menstrual symptoms. 
 
 Bertone-Johnson says, “To my knowledge, this is the first large long-term study to suggest that PMS may be related to risk of chronic health conditions in later life.” Details appear in the current issue of the American Journal of Epidemiology. 
 
 The higher risk persisted after adjusting for known risk factors including body mass index, pack-years of cigarette smoking, physical activity, alcohol use, postmenopausal hormone use, oral contraceptive use and family history of hypertension, the authors state. Results were strongest for hypertension occurring before age 40. In this age group, women with PMS had a three-fold higher risk of developing hypertension compared to women without PMS. 
 
 Clinically significant PMS affects as many as 8 to 15 percent of women, Bertone-Johnson says. Her findings suggest that PMS may be associated with future development of hypertension and that this may be modifiable. The authors recommend that “women with PMS should be screened for adverse changes in blood pressure and future risk of hypertension.” 
 
 Bertone-Johnson and colleagues evaluated the PMS-blood pressure relationship in 1,257 women who developed clinically significant PMS between 1991 and 2005 and in 2,463 age-matched control participants with few menstrual symptoms, all of whom were participants in the Nurses’ Health Study II. The authors assessed PMS with a modified Calendar of Premenstrual Experiences, which includes such symptoms as palpitations, nausea, forgetfulness, dizziness, hot flashes, insomnia, depression, acne and cramping. 
 
 In their sub-study, researchers followed participants for new diagnoses of hypertension until 2011. They found women with PMS had a hazard ratio for hypertension of 1.4 compared to women without PMS, a statistically significant increased risk of 40 percent. The risk associated with PMS was not modified by oral contraceptive or antidepressant use. However, the higher risk was not present in women with high intakes of the B vitamins thiamine and riboflavin. 
 
 Bertone-Johnson and colleagues recently found that women with high dietary intake of the B vitamins thiamine and riboflavin had 25 to 35 percent lower risks of developing PMS. Results from the present study are “consistent with these findings, and suggest that improving B vitamin status in women with PMS may both reduce menstrual symptom severity and lower hypertension risk,” they write. 
 
 Few studies have directly evaluated the association of PMS with blood pressure or risk of hypertension, but a handful provide some support for the existence of underlying differences in vascular physiology in women with PMS compared to symptom-free women, which could plausibly predispose PMS cases to hypertension and cardiovascular disease later in life, the authors state. 
 
 This work was supported by the NIH’s Office for Research on Women’s Health and the National Heart, Lung, and Blood Institute and by the National Cancer Institute. ||||| The headaches, fatigue and other symptoms of premenstrual syndrome may be more than just a monthly aggravation — they may also signal greater future health problems for those women suffering from the syndrome: Women who have PMS may have an increased risk of developing high blood pressure in the future, according to a new study. 
 
 Researchers found that the women who had PMS at the beginning of the study were 40 percent more likely to develop high blood pressure over the next 20 years, compared to women who experienced few menstrual symptoms. High blood pressure is a major risk factor for heart disease and stroke. 
 
 "To my knowledge, this is the first large, long-term study to suggest that PMS may be related to risk of chronic health conditions in later life," study author Elizabeth Bertone-Johnson, an epidemiologist at the University of Massachusetts at Amherst, said in a statement. 
 
 In the study, the researchers looked at the relationship between PMS and the risk of high blood pressure in about 1,250 women who developed clinically significant PMS between 1991 and 2005, and nearly 2,500 women with few menstrual symptoms. 
 
 The women were between 25 and 42 years old at the beginning of the study and the researchers followed them for six to 20 years. At the start of the study, and every two years afterward, the women were asked whether they had received a diagnosis of high blood pressure from their doctors in the past two years. [Beyond Vegetables and Exercise: 5 Ways to be Heart Healthy] 
 
 The researchers found that the link between high blood pressure and PMS was strongest among women who were younger than 40. The women in this age group who had PMS were three times as likely to also have high blood pressure, compared to women in the same age group who did not have PMS, they found. 
 
 The new findings suggest that women with PMS should be screened for high blood pressure, the researchers said. 
 
 "We are seeing hypertension increase in women younger and younger," said Dr. Suzanne Steinbaum, director of Women's Heart Health at Lenox Hill Hospital in New York City, who was not involved in the new study. "And now we are really honing in on who is at risk for high blood pressure and subsequent heart disease." 
 
 The new study shows that it is important to "understand that what is happening to a woman — and her entire body — is going to affect her cardiovascular risk," Steinbaum said. 
 
 Exactly what mechanism might link PMS and high blood pressure is not clear, the authors of the new study said, but they suggested that there might be underlying differences in the blood vessels of women with PMS and those who do not have PMS. These differences could also predispose women who have PMS to an increased risk of high blood pressure later in life, the researchers said. 
 
 In the study, the researchers also found that, among women with PMS, those who consumed high amounts of the B vitamins thiamine and riboflavin were less likely to develop high blood pressure later than the women with PMS who consumed low amounts of these vitamins. The same researchers have previously found that women who consumed high amounts of these vitamins had a 25 to 35 percent lower risk of developing PMS, compared to those who consumed low amounts of these vitamins. 
 
 The new findings suggest that "improving B vitamin status in women with PMS may both reduce menstrual symptom severity and lower hypertension risk," the researchers wrote in their study, published today (Nov. 24) in the American Journal of Epidemiology. 
 
 Follow Agata Blaszczak-Boxe on Twitter. Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.
– Women who suffer from moderate to severe premenstrual syndrome (PMS) appear to be at greater risk of having high blood pressure later in life, report researchers at the University of Massachusetts Amherst in the American Journal of Epidemiology. The team, which also worked with the Harvard School of Public Health, found that the 1,257 25- to 42-year-old women with moderate-to-severe PMS they studied had a 40% higher risk of hypertension over the next 20 years compared to 2,463 control women without significant premenstrual symptoms. Live Science points out that those with high blood pressure have an elevated risk of heart disease and stroke. The researchers noted that the PMS-high blood pressure relationship was most pronounced among women younger than 40, reports Live Science, though "one important limitation is that the average age of these patients was 27 years," an outside researcher tells HealthDay. "It would be helpful to see if this association persisted in younger women as well." Nearly three years ago, the same University of Massachusetts team found that iron may offer some protection against PMS, which the Mayo Clinic notes can be marked by a range of symptoms, including anxiety, depression, insomnia, headache, fatigue, acne, and diarrhea. (Previous research has shown that premenstrual women are the fastest at spotting, well, snakes.)