Prospectively reported symptom change across the menstrual cycle in users and non-users of oral contraceptives.

The aim of this research was to examine the pattern and incidence of premenstrual change in a reliable manner by addressing key methodological issues. One hundred and eighty-one women from the general population (mean age 30 years) completed a modified version of the Moos Menstrual Distress Questionnaire daily for 70 days. All symptom sub-scales fluctuated significantly across the menstrual cycle. Symptoms were at their lowest during the follicular phase and increased premenstrually. Somatic symptoms peaked menstrually and fluid retention peaked premenstrually. In general, however, symptom severity changed little from the premenstrual to the menstrual phase. A very high incidence of premenstrual change was noted, with over 40% of women demonstrating a 30% premenstrual increase in each symptom sub-scale. Close to 50% of women experienced increases in negative affect and over 70% experienced increases in fluid retention. Oral contraceptive (OC) use did not alter the incidence or severity of premenstrual change. Overall differences in symptom severity, however, were noted, with monophasic OC users reporting higher levels of fluid retention and somatic symptoms than the triphasic OC group. The results of this research suggest that women respond to the occurrence of normal neuroendocrine events that are not dependent on the sequelae to ovulation.