Beneficial Role of Calcium in Premenstrual Syndrome: A Systematic Review of Current Literature

Arman Arab, Nahid Rafie, Gholamreza Askari, Mina Taghiabadi

Abstract


Since premenstrual syndrome (PMS) is one of the most common and debilitating disorders in women, risk factor modification is an urgent health priority. Therefore, this systematic review aimed to summarize and discuss the outcomes of observational and interventional studies in humans regarding the relationship between Calcium and PMS. PubMed, Scopus, ISI web of sciences and Google scholar were searched up to January 2019 to identify relevant studies. The Newcastle‑Ottawa and Jadad scales were used for quality assessment. A total of 14 studies (8 interventional and 6 observational) met our inclusion criteria. Majority of the studies showed that not only serum calcium levels are lower in PMS subjects, but also calcium supplementation could significantly improve the incidence of PMS and its related symptoms. This systematic review suggests a beneficial role for calcium in PMS subjects. However, in order to draw a firm link between calcium and PMS, further dose‑response clinical trials with larger sample size and better methodological design are warranted.

Keywords


Calcium; premenstrual syndrome; systematic review

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References


Zendehdel M, Elyasi F. Biopsychosocial etiology of premenstrual

syndrome: A narrative review. J Family Med Prim Care

;7:346‑56.

Arslantaş H, Abacigil F, Çinakli Ş. Relationship between

premenstrual syndrome and basic personality traits:

A cross‑sectional study. Sao Paulo Med J 2018;136:339‑45.

Direkvand‑Moghadam A, Sayehmiri K, Delpisheh A,

Kaikhavandi S. Epidemiology of premenstrual

syndrome (PMS)‑A systematic review and meta‑analysis study.

J Clin Diagn Res 2014;8:106‑9.

del Mar Fernández M, Saulyte J, Inskip HM, Takkouche B.

Premenstrual syndrome and alcohol consumption: A systematic

review and meta‑analysis. BMJ Open 2018;8:e019490.

Thys‑Jacobs S. Micronutrients and the premenstrual syndrome:

The case for calcium. J Am Coll Nutr 2000;19:220‑7.

Logue CM, Moos RH. Perimenstrual symptoms: Prevalence and

risk factors. Psychosom Med 1986;48:388‑414.

Halbreich U, Endicott J, Lesser J. The clinical diagnosis

and classification of premenstrual changes. Can J Psychiatry

;30:489‑97.

Steiner M. Premenstrual syndrome and premenstrual dysphoric

disorder: Guidelines for management. J Psychiatry Neurosci

;25:459‑68.

Steiner M, Pearlstein T, Cohen LS, Endicott J, Kornstein SG,

Roberts C, et al. Expert guidelines for the treatment of severe

PMS, PMDD, and comorbidities: The role of SSRIs. J Womens

Health 2006;15:57‑69.

Bertone‑Johnson ER, Hankinson SE, Bendich A, Johnson SR,

Willett WC, Manson JE. Calcium and vitamin D intake and

risk of incident premenstrual syndrome. Arch Intern Med

;165:1246‑52.

Rapkin A. A review of treatment of premenstrual syndrome &

premenstrual dysphoric disorder. Psychoneuroendocrinology

;28:39‑53.

Carman J, Crews E, Bancroft A, Wyatt E, Cooper B, Ledbetter J,

et al. Calcium and calcium regulating hormones in the biphasic

periodic psychoses. J Operat Psychiat 1980;11:5‑17.

Jimerson DC, Post RM, Carman JS, Van Kammen DP, Wood JH,

Goodwin FK, et al. CSF calcium: Clinical correlates in affective

illness and schizophrenia. Biol Psychiatry 1979;14:37‑51.

Kia AS, Amani R, Cheraghian B. The association between the

risk of premenstrual syndrome and vitamin D, calcium, and

magnesium status among university students: A case control

study. Health Promot Perspect 2015;5:225‑30.

Shamberger RJ. Calcium, magnesium, and other elements

in the red blood cells and hair of normals and patients with

premenstrual syndrome. Biol Trace Elem Res 2003;94:123‑9.

Thys‑Jacobs S, Alvir M. Calcium‑regulating hormones across the

menstrual cycle: Evidence of a secondary hyperparathyroidism in

women with PMS. J Clin Endocrinol Metab 1995;80:2227‑32.

Bahrami A, Bahrami‑Taghanaki H, Afkhamizadeh M, Avan A,

Mazloum Khorasani Z, Esmaeili H, et al. Menstrual disorders

and premenstrual symptoms in adolescents: Prevalence and

relationship to serum calcium and vitamin D concentrations.

J Obstet Gynaecol 2018;38:989‑95.

Yonkers KA, Pearlstein TB, Gotman N. A pilot study to compare

fluoxetine, calcium, and placebo in the treatment of premenstrual

syndrome. J Clin Psychopharmacol 2013;33:614‑20.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A,

Petticrew M, et al. Preferred reporting items for systematic

review and meta‑analysis protocols (PRISMA‑P) 2015 statement.

Syst Rev 2015;4:1.

Stang A. Critical evaluation of the Newcastle-Ottawa scale for

the assessment of the quality of nonrandomized studies in metaanalyses. European J Epidemiol 2010;25:603-5.

Arab A, Rafie N, Mansourian M, Miraghajani M, Hajianfar H.

Dietary patterns and semen quality: A systematic review and

meta‑analysis of observational studies. Andrology 2018;6:20‑8.

Arab A, Mehrabani S, Moradi S, Amani R. The association

between diet and mood: A systematic review of current literature.

Psychiatry Res 2019;271:428‑37.

Ghanbari Z, Haghollahi F, Shariat M, Foroshani AR, Ashrafi M.

Effects of calcium supplement therapy in women with

premenstrual syndrome. Taiwan J Obstet Gynecol 2009;48:124‑9.

Masoumi SZ, Ataollahi M, Oshvandi K. Effect of combined use

of calcium and vitamin B6 on premenstrual syndrome symptoms:

A randomized clinical trial. J Caring Sci 2016;5:67‑73.

Samieipour S, Kiani F, Babaei Heydarabadi A, Tavassoli E.

Comparing the effects of vitamin B1 and calcium on Premenstrual

syndrome (PMS) among female students, Ilam‑Iran. Int J Pediatr

;4:3519‑28.

Shobeiri F, Araste FE, Ebrahimi R, Jenabi E, Nazari M. Effect of

calcium on premenstrual syndrome: A double‑blind randomized

clinical trial. Obstet Gynecol Sci 2017;60:100‑5.

Thys‑Jacobs S, Ceccarelli S, Bierman A, Weisman H,

Cohen MA, Alvir J. Calcium supplementation in premenstrual

syndrome. J Gen Intern Med 1989;4:183‑9.

Thys‑Jacobs S, Starkey P, Bernstein D, Tian J, Group PSS.

Calcium carbonate and the premenstrual syndrome: Effects on

premenstrual and menstrual symptoms. Am J Obstet Gynecol

;179:444‑52.

Bharati M. Comparing the effects of yoga & oral calcium

administration in alleviating symptoms of premenstrual syndrome

in medical undergraduates. J Caring Sci 2016;5:179‑85.

Thys‑Jacobs S, McMahon D, Bilezikian JP. Cyclical changes

in calcium metabolism across the menstrual cycle in women

with premenstrual dysphoric disorder. J Clin Endocrinol Metab

;92:2952‑9.

Fatemi M, Allahdadian M, Bahadorani M. Comparison of serum

level of some trace elements and vitamin D between patients with

premenstrual syndrome and normal controls: A cross‑sectional

study. Int J Reprod BioMed 2019;17:647‑52.

Penland JG, Johnson PE. Dietary calcium and manganese

effects on menstrual cycle symptoms. Am J Obstet Gynecol

;168:1417‑23.

Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence

and impacts heavy menstrual bleeding on anemia, fatigue and

quality of life in women of reproductive age. Pak J Med Sci

;35:365‑70.

Heaney RP. Estrogens and postmenopausal osteoporosis. Clin

Obstet Gynecol 1976;19:791‑803.

Stice SL, Ford SP, Rosazza JP, Van Orden DE. Role of

‑hydroxylated estradiol in reducing Ca2+uptake of uterine

arterial smooth muscle cells through potential‑sensitive channels.

Biol Reprod 1987;36:361‑8.

Lokuge S, Frey BN, Foster JA, Soares CN, Steiner M.

Depression in women: Windows of vulnerability and new

insights into the link between estrogen and serotonin. J Clin

Psychiatry 2011;72:e1563‑9.

Ebrahimi F, Shariff ZM, Rezaeian M, Tabatabaei SZ, Mun CY,

Tajik E. Socioeconomic status and intake of energy and sodium

are associated with calcium intake among pregnant women in

Rafsanjan city, Iran. J Obstet Gynaecol Res 2013;39:146‑53.