(LB01-01-25) A Pilot Exploration of the Association of Dietary Monosaccharides With Menstrual Symptoms in Women on Oral Contraceptives

Objectives: The gut microbiome is influenced by diet and may influence menstrual pain. This secondary analysis examined if dietary monosaccharide content (DMC) influences menstrual symptoms (MS) in women who usually experience pain with menstruation and take an oral contraceptive.

Methods: This study includes data from 149 women with up to 3 ASA24 dietary recalls (pre, during, and post-menstruation) and MS questionnaires. The women were randomized to receive a daily placebo or probiotic; all participants were included. The ASA24s were used to analyze DMC via the Davis Food Glycopedia. Generalized Estimating Equation (GEE) models tested the association between DMC and MS while adjusting for menstruation and probiotic use. MS outcomes were average abdominal pain on a Visual Analog Scale (VAS); Gastrointestinal Symptom Rating Scale abdominal pain, constipation, indigestion, diarrhea, and reflux syndrome scores; and daily stress on a Likert scale measured 0 to 10.

Results: Modeled monosaccharides were allose, fucose, galactose (Gal), n-acetylgalactosamine (GalNAc), and glucuronic acid. Daily mean Gal consumption was 8.23±10.91 g/1000 kcal pre-menstruation, 7.98±10.29 g/1000 kcal during menstruation, and 8.15±10.48 g/1000 kcal post-menstruation. Daily mean GalNAc consumption was 1.36±5.92 mg/1000 kcal pre-menstruation, 1.14±4.99 mg/1000 kcal during menstruation, and 1.49±6.34 mg/1000 kcal post-menstruation. GalNAc and Gal were associated with a decrease in stress (β-coefficient -0.63, p=0.031 and β -0.0004, p=0.036, respectively). Gal was associated with decreased daily mean abdominal pain as measured by VAS in a separate model (β -0.004, p=0.037). There were no other significant associations between DMC and tested outcomes.

Conclusions: DMC and some MS were associated. However, the present study is a secondary analysis involving multiple models and effect sizes for galactose were small. Large studies designed specifically for looking into the connection between DMC and menstrual symptoms are needed, including more dense collection of dietary data and extensive collection of fecal samples for gut microbiome analysis.

Funding Sources: Lallemand Health Solutions