Do oral contraceptive pills increase the risk of premenstrual syndrome symptoms?

Introduction: premenstrual syndrome (PMS) is a prevalent health problem affecting women of reproductive age and some young women use oral contraceptive pills (OCPs) to prevent unwanted pregnancy. However, the association between OCP use and the experience of symptoms of PMS has not been studied in Cameroon. We examined the association between the use of OCPs and PMS among female university students in Cameroon. Methods: we used data extracted from a larger study on sexual and reproductive health that was conducted between July and August 2018 among female university students at the University of Yaoundé 1, Cameroon. A pre-tested, validated and paper-based self-administered questionnaire was used to collect data. We extracted data (demographic and health characteristics, contraceptive use and experience of PMS) for the 424 sexually active students who participated in the larger study. We used Poisson regression analysis to examine the association between OCP use and PMS and conducted stratified analysis to determine effect modification. The level of statistical significance was set at p≤0.05. Results: the median age of the 424 sexually active female university students was 23 years (IQR=21-25). About 77.8% of participants self-reported to have experienced symptoms of PMS prior to their last menstrual period. The most commonly reported symptoms of PMS were breast tenderness (55.7%), acne/pimples (39.2%) and abdominal pain (31.1%). After adjusting for confounders in multivariate analysis, we found a statistically significant relationship between the use of OCPs and experience of symptoms of PMS. Current OCP users had a slightly increased risk (PR=1.21; 95%CI, 1.09-1.32, p<0.001) of developing symptoms of PMS compared to non-pill users. We found that age modified the effect of this association. Among older students (≥25 years), the direction of the effect was strongly positive and statistically significant (APR=1.32; 95%CI, 1.12-1.56, p=0.001). Conclusion: the proportion of female university students who reported to have experienced symptoms of PMS prior to their last menstrual period was high. The use of OCPs was positively associated with the risk of developing symptoms of PMS and this relationship was modified by age. Further studies in Cameroon and other sub-Saharan African countries are required to understand this relationship.

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