Abstract
Introduction
Premenstrual syndrome is a prevalent disorder affecting a large number of women in their reproductive ages. Nutritional importance of zinc has been known for a long time and studies have shown that zinc can positively affect psychological disorders.
Purpose
The aim of this study was to evaluate the effects of zinc supplementation on quality of life and sleep quality of young women diagnosed with premenstrual syndrome.
Methods
This randomized, double-blind, placebo-controlled trial was carried out on 60 young university women that were allocated into two groups of intervention who took 30 mg/day of elemental zinc or placebo for three months. Pre- and post-intervention, participants completed the questionnaires of quality of life and Pittsburgh sleep quality.
Results
After supplementation, quality of life score in the intervention group was increased (+ 9.185 ± 7.29, P < 0.001), however, in comparison with the control group, results were not significant; Physical aspects of quality of life score were significantly enhanced (+ 5.55 ± 3.71 vs. + 0.13 ± 2.87, P < 0.001). Sleep quality was marginally improved just in the zinc group (− 1.48 ± 4.12, P = 0.07).
Conclusion
Zinc supplementation for 12 weeks had beneficial effects on physical aspects of quality of life in young women with premenstrual syndrome.
Similar content being viewed by others
References
Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S (2014) Epidemiology of premenstrual syndrome (PMS)—a systematic review and meta-analysis study. J Clin Diagn Res JCDR 8(2):106
Kleinstäuber M, Schmelzer K, Ditzen B, Andersson G, Hiller W, Weise C (2016) Psychosocial profile of women with premenstrual syndrome and healthy controls: a comparative study. Int J Behav Med 23(6):752–763
Rapkin AJ, Winer SA (2009) Premenstrual syndrome and premenstrual dysphoric disorder: quality of life and burden of illness. Expert Rev Pharmacoecon Outcomes Res 9(2):157–170
Dennerstein L, Lehert P, Heinemann K (2012) Epidemiology of premenstrual symptoms and disorders. Menopause Int 18(2):48–51
Chung S-H, Kim T-H, Lee H-H, Lee A, Jeon D-S, Park J, Kim Y (2014) Premenstrual syndrome and premenstrual dysphoric disorder in perimenopausal women. J Menopausal Med 20(2):69–74
di Scalea TL, Pearlstein T (2017) Premenstrual dysphoric disorder. Psychiatr Clin 40(2):201–216
Abdelmoty HI, Youssef MA, Abdallah S, Abdel-Malak K, Hashish NM, Samir D, Abdelbar M, Hosni AN, Ghafar MA-E, Khamis Y, Seleem M (2015) Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey. BMC Womens Health 15(1):70. https://doi.org/10.1186/s12905-015-0228-8
Tolossa FW, Bekele ML (2014) Prevalence, impacts and medical managements of premenstrual syndrome among female students: cross-sectional study in college of health sciences, Mekelle University, Mekelle, Northern Ethiopia. BMC Womens Health 14(1):52. https://doi.org/10.1186/1472-6874-14-52
Drosdzol A, Nowosielski K, Skrzypulec V, Plinta R (2011) Premenstrual disorders in Polish adolescent girls: prevalence and risk factors. J Obstet Gynaecol Res 37(9):1216–1221. https://doi.org/10.1111/j.1447-0756.2010.01505.x
Ranjbaran M, Samani RO, Almasi-Hashiani A, Matourypour P, Moini A (2017) Prevalence of premenstrual syndrome in Iran: a systematic review and meta-analysis. Int J Reprod Biomed 15(11):679
Hammarbäck S, Bäckström T, Hoist J, von Schoultz B, Lyrenäs S (1985) Cyclical mood changes as in the premenstrual tension syndrome during sequential estrogen-progestagen postmenopausal replacement therapy. Acta Obstet Gynecol Scand 64(5):393–397
Kumar P, Sharma A (2014) Gonadotropin-releasing hormone analogs: understanding advantages and limitations. J Hum Reprod Sci 7(3):170
Halbreich U (2003) The etiology, biology, and evolving pathology of premenstrual syndromes. Psychoneuroendocrinology 28:55–99
Rosenfeld R, Livne D, Nevo O, Dayan L, Milloul V, Lavi S, Jacob G (2008) Hormonal and volume dysregulation in women with premenstrual syndrome. Hypertension 51(4):1225–1230
Groupt W (1993) Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 2(2):153–159
Pearlstein TB, Halbreich U, Batzar ED, Brown CS, Endicott J, Frank E, Freeman EW, Harrison WM, Haskett RF, Stout AL, Yonkers KA (2000) Psychosocial functioning in women with premenstrual dysphoric disorder before and after treatment with sertraline or placebo. J Clin Psychiatry 61(2):101–109
Borenstein J, Chiou C-F, Dean B, Wong J, Wade S (2005) Estimating direct and indirect costs of premenstrual syndrome. J Occup Environ Med 47(1):26–33
Wallenstein GV, Blaisdell-Gross B, Gajria K, Guo A, Hagan M, Kornstein SG, Yonkers KA (2008) Development and validation of the Premenstrual Symptoms Impact Survey (PMSIS): a disease-specific quality of life assessment tool. J Womens Health 17(3):439–450
Nicolau ZFM, Bezerra AG, Polesel DN, Andersen ML, Bittencourt L, Tufik S, Hachul H (2018) Premenstrual syndrome and sleep disturbances: results from the Sao Paulo Epidemiologic Sleep Study. Psychiatry Res 264:427–431. https://doi.org/10.1016/j.psychres.2018.04.008
Halbreich U, Endicott J, Nee J (1983) Premenstrual depressive changes: value of differentiation. Arch Gen Psychiatry 40(5):535–542
Moos RH, Kopell BS, Melges FT, Yalom ID, Lunde DT, Clayton RB, Hamburg DA (1969) Fluctuations in symptoms and moods during the menstrual cycle. J Psychosom Res 13(1):37–44
Baker FC, Kahan TL, Trinder J, Colrain IM (2007) Sleep quality and the sleep electroencephalogram in women with severe premenstrual syndrome. Sleep 30(10):1283–1291
Jehan S, Auguste E, Hussain M, Pandi-Perumal SR, Brzezinski A, Gupta R, Attarian H, Jean-Louis G, McFarlane SI (2016) Sleep and premenstrual syndrome. J Sleep Med Disord 3(5):1061
Andrea J, Sharon A (2009) Premenstrual syndrome. Winer Expert Rev Pharmacoecon Outcomes Res 9(2):157–170
Do Kaur G, Gonsalves L, Thacker HL (2004) Premenstrual dysphoric disorder: a review for the treating practitioner. Clevel Clin J Med 71(4):303
Hara T, Takeda T-a, Takagishi T, Fukue K, Kambe T, Fukada T (2017) Physiological roles of zinc transporters: molecular and genetic importance in zinc homeostasis. J Physiol Sci 67(2):283–301
Posaci C, Erten O, Üren A, Acar B (1994) Plasma copper, zinc and magnesium levels in patients with premenstrual tension syndrome. Acta Obstet Gynecol Scand 73(6):452–455
Chuong CJ, Dawson EB (1994) Zinc and copper levels in premenstrual syndrome. Fertil Steril 62(2):313–320
Fathizadeh S, Amani R, Haghighizadeh MH, Hormozi R (2016) Comparison of serum zinc concentrations and body antioxidant status between young women with premenstrual syndrome and normal controls: a case–control study. Int J Reprod BioMed 14(11):699
Sowa-Kućma M, Legutko B, Szewczyk B, Novak K, Znojek P, Poleszak E, Papp M, Pilc A, Nowak G (2008) Antidepressant-like activity of zinc: further behavioral and molecular evidence. J Neural Transm 115(12):1621
Levenson CW (2006) Zinc: the new antidepressant? Nutr Rev 64(1):39–42
de Moura JE, de Moura ENO, Alves CX, de Lima Vale SH, Dantas MMG, de Araújo SA, Das Graças Almeida M, Leite LD, Brandão-Neto J (2013) Oral zinc supplementation may improve cognitive function in schoolchildren. Biol Trace Elem Res 155(1):23–28
Kordas K, Siegel EH, Olney DK, Katz J, Tielsch JM, Kariger PK, Khalfan SS, LeClerq SC, Khatry SK, Stoltzfus RJ (2009) The effects of iron and/or zinc supplementation on maternal reports of sleep in infants from Nepal and Zanzibar. J Dev Behav Pediatr JDBP 30(2):131
Akhondzadeh S, Mohammadi M-R, Khademi M (2004) Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry 4(1):9
Chocano-Bedoya PO, Manson JE, Hankinson SE, Johnson SR, Chasan-Taber L, Ronnenberg AG, Bigelow C, Bertone-Johnson ER (2013) Intake of selected minerals and risk of premenstrual syndrome. Am J Epidemiol 177(10):1118–1127
Siahbazi S, Behboudi-Gandevani S, Moghaddam-Banaem L, Montazeri A (2017) Effect of zinc sulfate supplementation on premenstrual syndrome and health-related quality of life: clinical randomized controlled trial. J Obstet Gynaecol Res 43(5):887–894
Jafari F, Amani R, Tarrahi MJ (2020) Effect of zinc supplementation on physical and psychological symptoms, biomarkers of inflammation, oxidative stress, and brain-derived neurotrophic factor in young women with premenstrual syndrome: a randomized, double-blind, placebo-controlled trial. Biol Trace Elem Res 194(1):89–95
Ebrahimi E, Motlagh SK, Nemati S, Tavakoli Z (2012) Effects of magnesium and vitamin b6 on the severity of premenstrual syndrome symptoms. J Caring Sci 1(4):183
Dadkhah H, Ebrahimi E, Fathizadeh N (2016) Evaluating the effects of vitamin D and vitamin E supplement on premenstrual syndrome: a randomized, double-blind, controlled trial. Iran J Nurs Midwifery Res 21(2):159
Pakgohar M, Mehran A, Salehi Sormaghi M, Akhondzadeh S, Ahmadi M (2003) Effect of hypericum flowers in treatment of premenstrual syndrome in students living in dormitories of Tehran University of Medical Sciences and Tehran University [MSc Thesis]. Tehran: School of Nursing and Midwifery, Tehran University of Medical Sciences
Gholipour Baradari A, Alipour A, Mahdavi A, Sharifi H, Nouraei SM, Emami Zeydi A (2018) The effect of zinc supplementation on sleep quality of ICU nurses: a double blinded randomized controlled trial. Workplace Health Saf 66(4):191–200
Cheng S-H, Shih C-C, Yang Y-K, Chen K-T, Chang Y-H, Yang Y-C (2013) Factors associated with premenstrual syndrome—a survey of new female university students. Kaohsiung J Med Sci 29(2):100–105
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213
Nedjat S, Montazeri A, Holakouie K, Mohammad K, Majdzadeh R (2008) Psychometric properties of the Iranian interview-administered version of the World Health Organization’s Quality of Life Questionnaire (WHOQOL-BREF): a population-based study. BMC Health Serv Res 8(1):61
Homsher R, Zak B (1985) Spectrophotometric investigation of sensitive complexing agents for the determination of zinc in serum. Clin Chem 31(8):1310–1313
Tetsuo M, Saito M, Horiguchi D, Kina K (1982) A highly sensitive colorimetric determination of serum zinc using water-soluble pyridylazo dye. Clin Chim Acta 120(1):127–135
Braverman PK (2007) Premenstrual syndrome and premenstrual dysphoric disorder. J Pediatr Adolesc Gynecol 20(1):3–12
Maharaj S, Trevino K (2015) A comprehensive review of treatment options for premenstrual syndrome and premenstrual dysphoric disorder. J Psychiatr Pract 21(5):334–350
Das K, Chowdhury A (1997) Metallic ion concentration during menstrual cycle in normally menstruating women. Indian J Med Sci 51(2):52–54
Takeda A, Tamano H (2009) Insight into zinc signaling from dietary zinc deficiency. Brain Res Rev 62(1):33–44
Ribeiro SMdF, Braga CBM, Peria FM, Martinez EZ, Rocha JJRd, Cunha SFC (2017) Effects of zinc supplementation on fatigue and quality of life in patients with colorectal cancer. Einstein (Sao Paulo) 15(1):24–28
Bernardi F, Pluchino N, Begliuomini S, Lenzi E, Palumbo M, Luisi M, Genazzani A (2004) Disadaptive disorders in women: allopregnanolone, a sensitive steroid. Gynecol Endocrinol 19(6):344–353
Monteleone P, Luisi S, Tonetti A, Bernardi F, Genazzani AD, Luisi M, Petraglia F, Genazzani AR (2000) Allopregnanolone concentrations and premenstrual syndrome. Eur J Endocrinol 142(3):269–273
Pearlstein T, Steiner M (2008) Premenstrual dysphoric disorder: burden of illness and treatment update. J Psychiatry Neurosci JPN 33(4):291
Carver CM, Chuang S-H, Reddy DS (2016) Zinc selectively blocks neurosteroid-sensitive extrasynaptic δGABAA receptors in the hippocampus. J Neurosci 36(31):8070–8077
Mauri M (1990) Sleep and the reproductive cycle: a review. Health Care Women Int 11(4):409–421
Ji X, Liu J (2015) Associations between blood zinc concentrations and sleep quality in childhood: a cohort study. Nutrients 7(7):5684–5696
Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C (2011) The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial. J Am Geriatr Soc 59(1):82–90. https://doi.org/10.1111/j.1532-5415.2010.03232.x
Sandstead HH (1994) Understanding zinc: recent observations and interpretations. J Lab Clin Med 124(3):322–327
Cherasse Y, Urade Y (2017) Dietary zinc acts as a sleep modulator. Int J Mol Sci 18(11):2334
Parry BL, Berga SL, Mostofi N, Klauber MR, Resnick A (1997) Plasma melatonin circadian rhythms during the menstrual cycle and after light therapy in premenstrual dysphoric disorder and normal control subjects. J Biol Rhythms 12(1):47–64
Hosie AM, Dunne EL, Harvey RJ, Smart TG (2003) Zinc-mediated inhibition of GABA A receptors: discrete binding sites underlie subtype specificity. Nat Neurosci 6(4):362
Wittchen H-U, Becker E, Lieb R, Krause P (2002) Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med 32(1):119–132
Acknowledgements
We wish to thank all the participants who kindly cooperated in the trial. This study was extracted from Fatemeh Jafari’s MSc dissertation that was approved and supported by a granted from Vice-Chancellor for Research, Isfahan University of Medical Sciences under the registration code: (IR.MUI.REC.1396.3.247).
Funding
This study was financially supported by a grant from the Vice-chancellor for Research of Isfahan University of Medical Sciences (code: 39627).
Author information
Authors and Affiliations
Contributions
FJ: Developed the project and did the data collection, Manuscript writing, RA: Proposed the subject, supervised the project development and edited the manuscript. MJT: Did the data analysis, AF: Helped with lab works.
Corresponding author
Ethics declarations
Ethical approval
All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 (in its most recently amended version). The study protocol was approved by the Medical Ethics Committee at the Isfahan University of Medical Sciences (code: IR.MUI.REC.1396.3.247) and it was registered in the official website for Iranian registration of clinical trials (https://www.irct.ir) under the registration number IRCT20180215038738N1.
Informed consent
Written Informed consents were obtained from all participants for all the procedures and to allow data collection and analysis for research purpose and publication.
Conflict of interest
None.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jafari, F., Tarrahi, M.J., Farhang, A. et al. Effect of zinc supplementation on quality of life and sleep quality in young women with premenstrual syndrome: a randomized, double-blind, placebo-controlled trial. Arch Gynecol Obstet 302, 657–664 (2020). https://doi.org/10.1007/s00404-020-05628-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-020-05628-w