Menstrual Cycle Phase Modulates Emotional Conflict Processing in Women with and without Premenstrual Syndrome (PMS) – A Pilot Study

Jana Hoyer,Julia Sacher,Lydia Hellrung,Inga Burmann,Katrin Arelin,Florian Vollrath,Arno Villringer,Marie-Luise Kieseler,Elisabeth Roggenhofer,Ulrike Schmidt

doi:10.1371/journal.pone.0059780

Abstract

BackgroundPremenstrual syndrome (PMS) is characterized by a cluster of psychological and somatic symptoms during the late luteal phase of the menstrual cycle that disappear after the onset of menses. Behavioral differences in emotional and cognitive processing have been reported in women with PMS, and it is of particular interest whether PMS affects the parallel execution of emotional and cognitive processing. Related to this is the question of how the performance of women with PMS relates to stress levels compared to women without PMS. Cortisol has been shown to affect emotional processing in general and it has also been shown that women with severe PMS have a particular cortisol profile.MethodsWe measured performance in an emotional conflict task and stress levels in women with PMS (n = 15) and women without PMS (n = 15) throughout their menstrual cycle.ResultsWe found a significant increase (p = 0.001) in the mean reaction time for resolving emotional conflict from the follicular to the luteal cycle phase in all subjects. Only women with PMS demonstrated an increase in physiological and subjective stress measures during the luteal menstrual cycle phase.ConclusionsOur findings suggest that the menstrual cycle modulates the integration of emotional and cognitive processing in all women. Preliminary data are supportive of the secondary hypothesis that stress levels are mediated by the menstrual cycle phase only in women with PMS. The presented evidence for menstrual cycle-specific differences in integrating emotional and cognitive information highlights the importance of controlling for menstrual cycle phase in studies that aim to elucidate the interplay of emotion and cognition.

Highlights

Up to 75 percent of women experience some degree of premenstrual syndrome (PMS) during their reproductive years [1,2]
We investigated whether performance in an emotional conflict task and stress levels are altered by the menstrual cycle in a group of women affected by Premenstrual syndrome (PMS) compared to a control group not affected by PMS
There were no significant differences in the average day of testing in the follicular cycle phase between the PMS group and the control group, or in the late luteal cycle phase (PMS group: day = 27, SD = 3; control group: day = 27, SD = 2; details given in Table 1), or the average time of day when testing occurred (PMS group: Central European Time (CET) mean 6 SD = 12.506114 min; control group: CET mean 6 SD = 12.066102 min)

Summary

Introduction

Up to 75 percent of women experience some degree of premenstrual syndrome (PMS) during their reproductive years [1,2]. PMDD is included in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Text Revision; the depressed mood that women with PMDD experience corresponds in severity to a major depressive episode (MDE) [14]. This emphasizes the interrelatedness of PMS/PMDD and depression, an association which is further supported by evidence revealing higher comorbidity and lifetime prevalence for major depressive disorder (MDD) in women experiencing PMS and PMDD [15,16]. Cortisol has been shown to affect emotional processing in general and it has been shown that women with severe PMS have a particular cortisol profile

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