Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder.

Pai-Cheng Lin,Ju-Yu Yen,Yen-Ju Lin,Chih-Hung Ko

doi:10.3390/ijerph18126192

Abstract

Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD and their fluctuations during the menstrual cycle. Methods: A total of 100 women were diagnosed as having PMDD based on psychiatric interviews and a prospective investigation of three menstrual cycles. A total of 96 individuals without PMDD were recruited as controls. Their symptoms, namely insomnia, inattention, and fatigue as well as functional impairment were assessed by using the premenstrual symptoms screening tool, the Pittsburgh insomnia rating scale, the attention and performance self-assessment scale, and the fatigue-assessment scale during both premenstrual and follicular phases. Results: In both the premenstrual and follicular phases, women with PMDD experienced more severe insomnia, inattentiveness, and fatigue than did women in the control group. A paired t-test demonstrated that women with PMDD had more severe severity insomnia, inattentiveness, and fatigue in the luteal phase than in the follicular phase. A repeated-measures analysis of variance demonstrated that the interaction period of PMDD and a menstrual cycle was significantly associated with insomnia, inattentiveness, and fatigue. A further correlation analysis demonstrated that all three symptoms were positively associated with self-reported functional impairment due to PMDD. Conclusions: Our results demonstrated that women with PMDD experienced an exacerbation of insomnia, memory problems, difficulty maintaining focus, and fatigue in the premenstrual phase. These symptoms are correlated with PMDD symptoms severity and functional impairment, and as such, they should be evaluated, and interventions should be employed in the late luteal phase of women with PMDD.

Highlights

A total of 37 asymptomatic women were excluded from the Premenstrual dysphoric disorder (PMDD) group because they did not meet the criteria of having two consecutive symptomatic cycles [22] according to the prospective investigation completed using the PMDD severity questionnaire (PMDDSQ)
Our study demonstrated that fatigue had a strong effect on the functional impairment of women with PMDD, especially in the premenstrual phase, and this suggests that the fluctuation of ovarian hormones plays a role in the fatigue in PMDD
These results suggested that PMDD fatigue is associated with a decrease in estrogen and progesterone, especially in the premenstrual phase; further studies are required to investigate the relationships between estrogen, progesterone, and fatigue in women with PMDD during different phases of the menstrual cycle

Summary

Introduction

Premenstrual dysphoric disorder (PMDD) was included in the official diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). In 2013 based on adequate support for its inclusion [1]. It is defined as predictable, cyclic, and functionally impairing psychological and somatic symptoms that are aggravated in the late luteal phase of the menstrual cycle and are resolved by menstruation [2]. The typical emotional presentations, such as irritability, depression, and anxiety, recur before menstruation and last for an average of six days per month during the majority of reproductive years. The cyclic pattern of physical and cognitive presentations, such as insomnia, Int. J.

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