How has PMS burden changed worldwide from 1990 to 2021?

Background: Premenstrual syndrome (PMS) imposes significant psychological and mental health burdens on women's reproductive and general well-being. Disparities in the recognition and reporting of PMS symptoms exist across different regions, influenced by social, cultural, and economic inequalities. This study aims to inform the development of future resource allocation, and ultimately safeguard women's reproductive mental health. Methods: Utilizing data from the Global Burden of Disease (GBD) 2021 database, we employed Joinpoint regression analysis to examine trends in the burden of PMS from 1990 to 2021, and investigated the impact of the Socio-demographic Index (SDI) on the PMS burden. Additionally, we compared the age distribution characteristics of prevalent PMS cases in 1990 and 2021 and projected the burden to 2050 using the Bayesian Age-Period-Cohort (BAPC) model. Results: Despite fluctuations, the global burden of PMS was higher in 2021 compared to 1990. The low-middle SDI region consistently had the highest age-standardized prevalence rate (ASPR) and age-standardized years lived with disability (YLDs) rate, which continued to rise; the middle SDI region followed. The high SDI region generally had the lightest burden for most of the period. Among the five SDI regions, only the high-middle SDI region showed a decrease in burden in 2021 compared to 2019. ASPR and age-standardized YLDs rate demonstrated an initial increase followed by a decrease with rising SDI levels. The age distribution of prevalent PMS cases shifted: the peak prevalence moved from the 20-24 age group in 1990 to the 35-39 age group in 2021, while the 40-44 age group was followed by 35-39 in the the same year. Projections showed a declining trend in the global burden of PMS by 2050. Conclusion: Overall, the global burden of PMS has shown an increasing trend from 1990 to 2021. The burden in low SDI regions may be substantially underestimated, influenced by social, cultural, and economic factors. In socioeconomically disadvantaged regions, attention to menstrual-related mental health, scientific diet, and allocation of healthcare resources require further optimization. In fact, mental health of women aged 35-44 should be emphasized throughout their lifespans, for a better reproductive and general well-being.

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