Premenstrual syndrome in Sahelian Africa. A comparative study of 400 literate and illiterate women in Niger.

From March to November 1984, the authors examined 400 African women 14 to 30 years old. They were classed as urban or rural, literate or illiterate, wage-earning or not. Signs of premenstrual syndrome (PMS) were analysed and the intensity of symptoms evaluated. Only 5% of the women were asymptomatic. 31% described socially debilitating severe symptoms. The most common signs were painful breasts, lower abdominal pains and nervousness. Oedema of the legs was rare. PMS was more frequent in young, literate, urban women; illiterate rural women were more often asymptomatic and, when they were symptomatic, signs were less intense than in urban women. These differences are related to pregnancies and breast-feeding. Urban illiterate women were protected from PMS by the cycle of pregnancy-breast feeding-weaning-new pregnancy. In this group menstruation was rare because of the length of gravidic amenorrhea.