Premenstrual syndrome and inflammatory activity in adolescent familial Mediterranean fever

Premenstrual syndrome (PMS) comprises physical, emotional and behavioural symptoms occurring during the luteal phase of the menstrual cycle that impair quality of life. Familial Mediterranean fever (FMF) is an autoinflammatory disorder marked by chronic inflammation and recurrent attacks. This study aimed to assess the frequency and severity of PMS in adolescents with FMF, its association with disease activity, inflammatory markers and treatment adherence, and to compare findings with healthy peers.

This cross-sectional study was conducted between January 2024 and February 2025. Forty adolescent girls (12-18 years) with FMF and 40 age-matched healthy controls participated. The Premenstrual Syndrome Scale (PMSS) was administered to all; in the FMF group, the Autoinflammatory Disease Activity Index (AIDAI) and colchicine adherence were also assessed. Attack frequency, menstrual features and inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC)] and regular colchicine use were analysed.

PMS frequency (P = 0.012) and severity (P = 0.032) were overall lower in the FMF group. However, PMS scores correlated positively with attack frequency and AIDAI (r = 0.368, P = 0.019), and ESR, CRP and WBC were higher in PMS-positive individuals. PMS-positive patients also demonstrated significantly poorer medication adherence, with higher rates of forgetting doses and discontinuing colchicine.

PMS severity in adolescents with FMF appears linked to disease activity and inflammation. The observed relationship is consistent with an inflammatory contribution to PMS, while colchicine therapy may be associated with lower symptom burden through improved inflammation control.