Date of Award


Document type


Access Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

First Advisor

Elizabeth Bertone-Johnson

Second Advisor

Lisa Chasan-Taber

Third Advisor

Carol Bigelow

Subject Categories

Epidemiology | Public Health


Premenstrual syndrome (PMS) is characterized by the presence of physical and psychological symptoms restricted to the late luteal phase of the menstrual cycle and associated with substantial impairment in life activities. In the U.S. about 8 to 15% of women of reproductive age suffer from PMS. Many micronutrients are potentially involved in the development of this disorder due to their role in the synthesis of neurotransmitters and hormones or in their regulation, but few previous studies have evaluated the effects of micronutrients on PMS. The first study examined the association between B vitamin intakes, and PMS development among women participating in the Nurses' Health Study 2 (NHS2). We found that high thiamin and high riboflavin intake from food sources were associated with lower risk of PMS. There were not significant associations between niacin, vitamin B6, folate, and vitamin B12 dietary intake and incident PMS. Intakes of B vitamins from supplements were not associated with lower risk of PMS. The second study evaluated the association between selected mineral intakes and PMS development in the NHS2. In this study, high iron intakes were associated with lower risk of PMS. Although there was no association between zinc and PMS risk, high intake of zinc relative to copper was associated with lower risk of PMS. There were no associations between of magnesium, copper, and manganese intakes and PMS. We observed a significantly higher risk of PMS in women with high intakes of potassium from food sources. The third study focused on the association between dietary intakes of B vitamins, zinc, magnesium, iron, potassium, and sodium and some biomarkers and PMS prevalence among younger women. In this study, we found an association between zinc intake and lower prevalence of PMS. Each 1 mg/d increase in vitamin B6 from foods was associated with a lower PMS symptom score. Blood magnesium levels were higher in women with PMS compared to women without PMS. We observed that intakes of some micronutrients were associated with lower risk of PMS, but further studies should be conducted. This dissertation contributes to the research on modifiable risk factors for PMS.


Included in

Epidemiology Commons