The Possible Beneficial Effects of Residential Greenspace on Premenstrual Syndrome

[This text was originally published in Catalan in Diputació de Barcelona’s EspaiS@lut bulletin.]

Premenstrual syndrome (PMS) causes clinically relevant psychological and physical symptoms in up to 20% of women of reproductive age. The findings of a recently published study have shown that women who reside throughout their lives in neighbourhoods where there are more green areas are less likely to experience the symptoms of PMS than those living in nearby areas with less vegetation. The study was coordinated by the Barcelona Institute for Global Health (ISGlobal) together with the University of Bergen.

The findings of a recently published study have shown that women who reside throughout their lives in neighbourhoods where there are more green areas are less likely to experience the symptoms of premenstrual syndrome

Despite growing scientific evidence indicating an association between natural environments and benefits for both general and reproductive health, there has to date been no investigation of the link between such environments and PMS. The aim of the team who carried out this study was to ascertain whether living close to urban greenspace could have a beneficial effect on the symptoms of PMS and the possible influence on this association of Body Mass Index (BMI), air pollution, and physical activity. The results of this research were published for the first time last November in the journal Environment International.

The study included data from over 1,000 women aged between 18 and 49 years living in four cities in Scandinavia: Gothenburg, Umeå and Uppsala in Sweden and Bergen in Norway. All the women were participants in the European RHINESSA cohort study. They completed a questionnaire on lifestyle, physical activity and reproductive health, indicating whether they suffered from any of the eight common symptoms of premenstrual syndrome: irritability, anxiety, tearfulness or sensitivity to rejection, depression, difficulty with sleeping, abdominal pain, breast tenderness or abdominal bloating, and headaches. The study used the Normalised Difference Vegetation Index (NDVI) to measure the amount of greenspace close to the residential address of each participant. The study also took into account BMI and estimated residential exposure to air pollution, assessed by analysing ambient levels of nitrogen dioxide (NO₂) and particulate material having a diameter less than 2.5 μm (PM_2.5) or between 2.5 and 10 μm (PM₁₀).

The findings of this study indicate that women who live in neighbourhoods with more greenspace experience fewer PMS symptoms and are less likely to suffer from four of the eight symptoms studied: breast sensitivity and abdominal bloating, difficulty sleeping, anxiety, and depression.

It is interesting to note that the analysis of greenspace exposure at a specific point in time showed no significant effect on PMS symptoms, but exposure over many years was found to correlate with fewer or less severe symptoms, indicating the importance of long-term exposure.

Three of the four symptoms found less often in participants with greater exposure to greenspace were psychological, a finding consistent with earlier evidence that contact with nature can reduce stress and improve mental health. Stress may exacerbate the symptoms of PMS because it increases levels of cortisol, a hormone that may also be associated with increased release of progesterone, which has been linked to the occurrence of PMS symptoms.

Three of the four symptoms found less often in participants with greater exposure to greenspace were psychological, a finding consistent with earlier evidence that contact with nature can reduce stress and improve mental health

In earlier research, exposure to greenspace was found to be linked to increased physical activity and lower levels of air pollution, but no mediating role was observed in this study.

In a study of data from 2,000 women living in nine European countries—led by the same team and published in 2020—it was observed that the women who lived in neighbourhoods with little greenspace became menopausal 1.4 years earlier than those who lived in the greenest areas. Those findings would suggest that exposure to greenspace might be associated with older age at the onset of menopause.

While more and more scientific studies are providing evidence that natural areas are beneficial for our health, there are still insufficient green spaces in many cities or the existing spaces are not located close to the places where people live. It is therefore essential that policy makers should prioritise natural environments as an urban component vital to our health.