White, C. P., Hitchcock, C. L., Vigna, Y. M., & Prior, J. C. (2011). Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort. Obstetrics and Gynecology International, 2011, 138451. https://doi.org/10.1155/2011/138451
White CP, Hitchcock CL, Vigna YM, Prior JC. Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort. Obstet Gynecol Int. 2011;2011:138451. doi:10.1155/2011/138451
White, Colin P., et al. "Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort." Obstetrics and Gynecology International, vol. 2011, 2011, pp. 138451.
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Vancouver Hospital and Health Sciences Centre05p83my93
Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada.03rmrcq20
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RRM Academy Synopsis
Self-reported bloating peaks on day one of flow in healthy women
In a one-year diary cohort, self-reported bloating peaked on the first day of flow in 62 healthy women. Scores rose slowly around ovulation. Hormone levels showed no significant link to premenstrual scores. Cycles with and without ovulation did not differ significantly, though only 14 cycles lacked ovulation.
Study at a glance, observational cohort of 62 healthy women: Self-reported bloating peaked on the first day of flow in healthy women. Source: White CP et al., 2011, PMID 21845193.
Key Findings
The analysis covered 765 menstrual cycles in 62 healthy women aged 20 to 42, who scored fluid retention daily on a 0 to 4 scale.
Bloating scores were highest on day one of menstrual flow (mean ± SE: 0.9 ± 0.1) and lowest in the mid-follicular phase.
Over the 11 days around ovulation, scores rose gradually from 0.22 ± 0.05 to 0.50 ± 0.09.
Scores were higher around menstruation than at mid-cycle (P < 0.0001). Ovulatory and anovulatory cycles did not differ significantly (P = 0.546; 14 anovulatory cycles analyzed).
Estradiol and progesterone levels were not significantly associated with premenstrual scores. Runners (n = 39) scored higher than normally active women (n = 23).
Interpretation
The study is an observational cohort, so it maps patterns and cannot show what causes them. Volunteers were screened to be healthy, normal weight and initially ovulating, and nearly all were White. Scores stayed low overall, peaking near 1 on the 0 to 4 scale. Only 14 cycles without ovulation could be compared, so the authors say the study may have been underpowered on that question. Hormone samples were pooled, from two cycles per woman. The authors note the findings may not extend to women with clinically abnormal fluid retention or those seeking help for premenstrual symptoms. Women chose their own activity level, so the runner comparison is cross-sectional.
RRM Context
Daily diary entries sat beside basal temperature records. Those records estimated whether and when ovulation occurred in each cycle. Pairing symptoms with a charted ovulatory event is central to fertility awareness. The authors suggest that anyone documenting symptoms that change across the cycle continue records into the days after flow begins, because the peak fell there.
Our editorial summary of this paper, not the article's abstract.
Abstract
We report menstrual and mid-cycle patterns of self-reported "fluid retention" in 765 menstrual cycles in 62 healthy women. Self-reported "fluid retention," commonly described as bloating, is one element of the clinical assessment and diagnosis of premenstrual symptoms. These daily diary data were collected as part of an observational prospective one-year study of bone changes in healthy women of differing exercise characteristics. Ovulation was documented by quantitative basal temperature analysis, and serum estradiol and progesterone levels were available from initial and final cycles. Fluid retention scores (on a 0-4 scale) peaked on the first day of menstrual flow (mean ± SE : 0.9 ± 0.1), were lowest during the mid-follicular period, and gradually increased from 0.22 ± 0.05 to 0.50 ± 0.09 over the 11 days surrounding ovulation. Mid-cycle, but not premenstrual, fluid scores tended to be lower in anovulatory cycles (ANOVA P = 0.065), and scores were higher around menstruation than at midcycle (P < 0.0001). Neither estradiol nor progesterone levels were significantly associated with fluid retention scores. The peak day of average fluid retention was the first day of flow. There were no significant differences in women's self-perceived fluid retention between ovulatory and anovulatory cycles.
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