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January 2016 · Volume 5 · Issue 1 Page 194
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Adienbo OM et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):194-197
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Research Article
Assessment of menstrual characteristics among nulliparous female
consumers of carbonated soft drinks
Ologhaguo M. Adienbo*, Victor O. Hart, Austine A. Ajah
INTRODUCTION
Soft drinks are non-alcoholic, usually carbonated, drinks
with a sweet bubbly refreshing taste. They contain mainly
water, sugar and chemicals in the form of colorings,
flavors, preservatives and sweeteners. There has been an
overwhelming rise in the global consumption of soft
drinks, in particular carbonated beverages, over the recent
past decades. They are consumed in large quantities
globally as beverages for refreshment, and or for social
purposes as substitutes or supplements to alcoholic
drinks. They are now the most popular refreshments
among much of the world’s population and age groups
ranging from infants, adolescents, youth to adults.1-3
Although considered as fairly innocuous by most people,
regular consumption of soft drinks has been associated
with several health concerns such as development of
cardiovascular disease, diabetes mellitus, dental/bone
problems, obesity and formation of kidney stones,4-8 as
well as a delayed or lower chance of conception.9,10
Menstrual characteristics, on the other hand, can be
affected by life-style such as cigarette smoking,11 caffeine
consumption12 and alcohol consumption.13 This present
study was therefore designed to assess the menstrual
Department of Human Physiology, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria
Received: 11 October 2015
Revised: 24 November 2015
Accepted: 12 December 2015
*Correspondence:
Dr. Ologhaguo M. Adienbo,
E-mail: ologhaguo.adienbo@uniport.edu.ng
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background:
Soft drinks are consumed in large quantities globally as beverages for refreshment and for social
purposes as substitutes or supplements to alcoholic drinks. Health concerns over soft drinks consumption have been
severally reported. Aim: This study is aimed at investigating the effect soft drink consumption on the menstrual
characteristics of female Nigerians.
Methods:
A cross sectional descriptive study of 639 nulliparous females of age range 16-40 years with regular
menstruation were randomly selected, comprising 392 (61.30%) who consume carbonated soft drink regularly during
menstruation, and 247 (38.70%) who do not. Structured questionnaires were administered to each subject to
determine their age and menstrual characteristics (duration, flow, pain and cycle).
Results:
The results showed that consumption of soft drinks during menstruation causes an increase in menstrual flow
in 85.71% of consumers; 89.54% observed an increase in menstrual pain, while 51.53% reported prolongation in
duration of menstrual bleeding. Also, a significant (p=0.002) increase in the duration of menstrual bleeding, with an
insignificant (p>0.05) increase in menstrual cycle (p>0.05) were observed among soft drink consumers when
compared to non-consumers.
Conclusions:
This study has shown that consumption of soft drinks during menstruation could alter menstrual
characteristics in nulliparous females by increasing the menstrual flow, menstrual pain and menstrual duration.
Keywords: Menstrual characteristics, Menstrual cycle, Soft drink
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151623
Adienbo OM et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):194-197
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 5 · Issue 1 Page 195
characteristics of subjects that consume soft drink during
menstruation.
METHODS
Study area and population
This is a cross-sectional descriptive survey carried out
from September to December, 2014 in Port Harcourt,
Rivers State, Nigeria. A total number of 639 nulliparous
female students aged between 16 and 40 years were
recruited from the departments of Human Physiology and
Biomedical technology, University of Port Harcourt.
Respondents were selected from both departments using
stratified random sampling method based on their faculty
and year of study. University students were chosen for
the study because they comprised of girls from diverse
ethnic and socioeconomic background.
Inclusion criteria
Respondents included into the study were nulliparous,
have attained menarche at least one year before the date
of interview, not on any contraceptive, without any
gynaecological disorder, and have regular uninterrupted
menstruation for a minimum period of 12 months, from
the day of the interview.
Data collection
A pre-tested questionnaire was administered to subjects
to complete. The aim of the study and the contents of the
questionnaire were explained to each respondent, and
voluntary participation was requested. The questionnaire
had questions on present age of participants, consumption
of sweetened carbonated soft drinks (coke, fanta and
pepsi) during menstruation; menstrual characteristics
such as length of cycle (ranging from short, <23 days to
long,>30 days, relative to 21-35 days normal cycle
length) as defined in previous studies;14,15 duration of
menstrual bleeding; regularity of menstruation; menstrual
pain (pain at the time of menstrual discharge), and
amount of menstrual flow (depending on a subjective
assessment based on the number of pads each subject
uses in a day during the bleeding period) was assessed as
heavy (>3 pads) or light (≤ 3 pads) as previously
reported;16,17 on the basis of self-reported menstrual
history from the baseline questionnaire. The returned
questionnaires were analysed using Statistical Package
for Social Sciences (SPSS) version 20.0 (SPSS Inc,
Chicago, II). Descriptive statistics (frequency, percentage
and mean calculation) was applied to compare the
menstrual characteristics variables, while students t-test
was used, were necessary, to compare different variables
for any significant difference (at p<0.05). The results
were presented in frequency, percentages and mean±SD.
RESULTS
Of the 639 nulliparous females that participated in the
study, 40.80% have age range 21-30 years; 55.10% were
aged 16-20 years while 4.1% were 31-40 years. Also, 392
(61.30%) of the total population consume soft drink
during menstruation while 247(38.7%) subjects do not
consume soft drink during menstruation (Table 2).
Table 1: Distribution of respondents in the
population studied according to their menstrual
characteristics.
Menstrual
characteristic
Number of
subjects (N)
Percentage
(%)
Length of cycle (days)
<23
51
8
23-26
140
21.9
27-30
403
63.1
>30
45
7
Total
639
100
Duration of bleeding (days)
2-3
98
15.3
4-6
531
83.1
>6
10
1.6
Total
639
100
Menstrual flow
Heavy (>3 pads/day)
247
38.7
Light (≤3 pads/day)
392
61.4
Total
639
100
Menstrual pain
Yes
441
69.00
No
198
31.00
Total
639
100
The menstrual characteristics of the population studied
(Table 1) shows that more of the respondents (63.1%)
have menstrual cycle interval of 27-30 days; 21.9% have
23-26 days while only 8% and 7% of the subjects have
<23 days and >30 days cycle respectively. Although the
mean cycle length for those that consume soft drink
during menstruation is higher compared to those that do
not consume, the difference is statistically not significant
(p>0.05).
Table 2: Mean menstrual duration and menstrual
cycle of subjects based on their consumption of soft
drink during menstruation.
Menstrual
characteristics
Soft drink consumption during
menstruation
Yes
n=392
(61.3 %)
No
n=247
(38.7 %)
Total
n=639
(100%)
Duration of
bleeding (days)
4.45±0.02*
4.20±0.01
4.38±0.01
Length of
cycle (days)
28.86±6.20
28.25±3.86
28.56±4.50
*Significant difference (p=0.002) compared to non-consumers
of soft drink
Adienbo OM et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):194-197
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 5 · Issue 1 Page 196
Further, majority of subjects in the population (83.1%)
have menstrual bleeding duration of 4-6 days while other
subjects menstruate for 2-3 days (15.30%) and >6 days
(1.6%) respectively (Table 1). Majority (51.53%) of
subjects that consume soft drink during menstruation
reported an increase in duration of bleeding (Figure 1).
The mean menstrual duration for the total population was
4.38±0.02 days, with a significant increase (p=0.002) in
the duration of bleeding among subjects that consume
soft drink, compared to those that do not consume soft
drinks (Table 2).
Figure 1: Percentage distribution of subjects
consuming soft drink during menstruation according
to severity of effect on their menstrual characteristics.
The results of menstrual flow of subjects show that 61.4
% of the population had light flow, while 38.6%
experienced heavy blood flow (table 1). Among the 392
subjects that usually consume soft drink during
menstruation (table 2), majority (85.71%) of them
reported an increase in menstrual flow (Figure 1).
Further, while 61% of the population experience
abdominal pain during menstruation, 89.54% of the 392
subjects that usually consume soft drink during
menstruation reported an increase in menstrual pain
(Figure 1).
DISCUSSION
In this study, majority of respondents reported that
consumption of carbonated soft drink during
menstruation increases their menstrual flow, menstrual
pain and prolong the duration of menstrual bleeding,
without altering the menstrual cycle length. Menstrual
blood flow is achieved by myometrial contractility,
vasoconstriction and haemostatic plug formation. While
vasoconstriction and the haemostatic plug formation
control the volume of menstrual blood flow; the duration
of menstrual bleeding is affected by contraction of the
myometrium, vasoconstriction, and haemostatic plug
formation mechanisms. The increase in menstrual pain,
menstrual flow and duration of bleeding reported by
majority of respondents in this study suggests that some
components of soft drink may have effect on the uterine
contractile and haemostatic mechanisms. For instance,
carbonated soft drinks contain several food additives
including artificial sweeteners, preservatives (potassium
sorbate, ascorbic acid, citric acid and sodium citrate),
antioxidants, colorants, and caffeine.18,19 Consumption of
caffeinated beverages has been reported to increase the
caffeine load,20 and caffeine has been shown to induce
transient contraction of smooth muscles through the
release of intracellular calcium from intracellular storage
sites.21-23 Also, the ascorbic acid component present in
soft drink has been reported to have a profound excitatory
effect on contractions of aortic smooth muscle,24
suggesting contractile effects of soft drink on smooth
muscles and blood vessels. Therefore, the uterus, made
up of smooth muscles, could contract more easily when
there is an increase blood supply rich in these various
components of soft drink. This increased contraction
could have resulted to the increase in abdominal pain
experienced by majority of the respondents, as well as
causing a degeneration of the spiral arteries that supply
the endometrium resulting to the observed heavy and
increased menstrual flow experienced by majority of the
respondents. The results from this study is consistent with
previous reports,25,26 where cigarette smoking has been
associated with increased daily amount of menstrual
bleeding (heavier menses), and increased duration of
menstrual pain, when compared with non-smokers.
Although, some studies12 have suggested that women
who consumed caffeine are less likely to have long
menstrual duration, contradicting our observation;
however, our observation suggests that when the various
components in a carbonated soft drink are taken together,
they may have acted differently, by altering some specific
systemic effects.
In conclusion, this study has shown that consumption of
carbonated soft drinks during menstruation alters the
menstrual characteristics by increasing menstrual flow,
pain and the duration of menstrual bleeding, without
altering the menstrual cycle length. These results suggest
that carbonated soft drinks may have effect on the
neuroendocrine and reproductive systems in females; and
consequently on their functions. Therefore, the pattern
and characteristics of menstrual variables could be
considered as indicators of reproductive health in
females. This necessitates the need for further
experimental studies in this direction.
CONCLUSIONS
This study has shown that consumption of soft drinks
during menstruation could alter menstrual characteristics
in nulliparous females by increasing the menstrual flow,
menstrual pain and menstrual duration.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
85.71 89.54
51.53
14.29 10.46
43.11
0 0 5.36
0
10
20
30
40
50
60
70
80
90
100
Menstrual flow Menstrual pain Duration of
bleeding (days)
Percentage (%)
Menstrual Characteristics
Increase No effect Decrease
Adienbo OM et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):194-197
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 5 · Issue 1 Page 197
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Cite this article as: Adienbo OM, Hart VO, Ajah
AA. Assessment of menstrual characteristics among
nulliparous female consumers of carbonated soft
drinks. Int J Reprod Contracept Obstet Gynecol
2016;5:194-7.
