Table 2_Global, regional, and national burden of premenstrual syndrome from 1990 to 2021 and projections to 2050: an analysis based on the 2021 Global Burden of Disease study.xlsx

BackgroundPremenstrual 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.
MethodsUtilizing 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.
ResultsDespite 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.
ConclusionOverall, 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.

背景：经前期综合征（Premenstrual syndrome, PMS）会对女性的生殖健康与整体健康福祉造成显著的心理与精神健康负担。受社会、文化与经济不平等因素影响，不同地区对PMS症状的识别与报告存在显著差异。本研究旨在为未来医疗资源配置提供参考依据，最终保障女性的生殖心理健康。
方法：本研究依托2021年全球疾病负担（Global Burden of Disease, GBD）数据库数据，采用连接点回归分析（Joinpoint regression analysis）探究1990年至2021年PMS负担的变化趋势，并分析社会人口指数（Socio-demographic Index, SDI）对PMS负担的影响。此外，本研究对比了1990年与2021年PMS现患病例的年龄分布特征，并通过贝叶斯年龄-时期-队列（Bayesian Age-Period-Cohort, BAPC）模型将PMS负担预测至2050年。
结果：尽管存在波动，2021年全球PMS负担较1990年有所上升。中低SDI地区的年龄标化患病率（age-standardized prevalence rate, ASPR）与年龄标化伤残生存年率（age-standardized years lived with disability rate, YLDs）始终处于最高水平，且呈持续上升趋势；中SDI地区次之。高SDI地区在多数研究时段内的负担整体最轻。在五个SDI分区中，仅高中SDI地区在2021年的PMS负担较2019年有所下降。ASPR与年龄标化伤残生存年率随SDI水平升高呈现先升后降的趋势。PMS现患病例的年龄分布发生了偏移：1990年的患病高峰集中于20~24岁年龄组，2021年则转移至35~39岁年龄组，同年40~44岁年龄组的患病率紧随其后。预测结果显示，至2050年全球PMS负担将呈下降趋势。
结论：整体而言，1990年至2021年全球PMS负担呈上升趋势。受社会、文化与经济因素影响，低SDI地区的PMS负担可能被严重低估。在社会经济欠发达地区，针对月经相关心理健康的关注、科学膳食以及医疗资源配置仍需进一步优化。此外，应在全生命周期内重视35~44岁女性的心理健康，以提升其生殖健康与整体健康福祉。