Menstrual-cyclic fluctuation of autonomic nervous system activity among women with different degrees of premenstrual symptoms

Abstract

OBJECTIVE: Premenstrual syndrome (PMS) comprises psychophysiological symptoms in the luteal phase of the menstrual cycle and abates after menses starts. Despite its near omnipresence in reproductive-age women, we do not yet understand the etiopathogenesis of PMS. In this study we looked at how autonomic nervous system (ANS) activity—vital in orchestrating human homeostasis—changes during the menstrual cycle of women with different degrees of premenstrual symptoms.DESIGN: A within- and between-subjects study.MATERIALS AND METHODS: This study involved seventy-six women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. We also measured salivary chromogranin A (CgA), which reflects sympathoadrenal function, as a psychological stress marker. The Menstrual Distress Questionnaire evaluated psychosomatic and behavioral symptoms of the subjects’ menstrual cycles. The subjects were categorized into four groups depending on the severity of premenstrual symptoms: Control, Low-Molimina (L-Molimina), High-Molimina (H-Molimina), and PMS.RESULTS: No intramenstrual cycle difference in HRV parameters was found in the Control and L-Molimina groups, with zero and a small increase (9.7±0.7%) in premenstrual symptoms, respectively. In contrast, Total power and high-frequency (HF) power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the luteal phase from the follicular phase in the H-Molimina group with moderate increase (24.8±0.7%) in premenstrual distress. Luteal-phase reduction in Total and HF power was also detected in the PMS group with more severe symptoms (67.6±8.1%). In addition, all HRV components in both phases decreased markedly in the PMS group compared to that of the other groups. CgA in the PMS group increased in the luteal phase from the follicular phase, and the value was greater than that of the other groups.CONCLUSIONS: This study provides intriguing findings that the altered functioning of the ANS in the luteal phase might relate to diverse psychosomatic symptoms appearing premenstrually. The study further implies that noninvasive evaluation of ANS activity—reflecting mind-body interaction—with electrophysiological and biochemical indexes could contribute to monitoring and promoting women's physical and mental health. OBJECTIVE: Premenstrual syndrome (PMS) comprises psychophysiological symptoms in the luteal phase of the menstrual cycle and abates after menses starts. Despite its near omnipresence in reproductive-age women, we do not yet understand the etiopathogenesis of PMS. In this study we looked at how autonomic nervous system (ANS) activity—vital in orchestrating human homeostasis—changes during the menstrual cycle of women with different degrees of premenstrual symptoms. DESIGN: A within- and between-subjects study. MATERIALS AND METHODS: This study involved seventy-six women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. We also measured salivary chromogranin A (CgA), which reflects sympathoadrenal function, as a psychological stress marker. The Menstrual Distress Questionnaire evaluated psychosomatic and behavioral symptoms of the subjects’ menstrual cycles. The subjects were categorized into four groups depending on the severity of premenstrual symptoms: Control, Low-Molimina (L-Molimina), High-Molimina (H-Molimina), and PMS. RESULTS: No intramenstrual cycle difference in HRV parameters was found in the Control and L-Molimina groups, with zero and a small increase (9.7±0.7%) in premenstrual symptoms, respectively. In contrast, Total power and high-frequency (HF) power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the luteal phase from the follicular phase in the H-Molimina group with moderate increase (24.8±0.7%) in premenstrual distress. Luteal-phase reduction in Total and HF power was also detected in the PMS group with more severe symptoms (67.6±8.1%). In addition, all HRV components in both phases decreased markedly in the PMS group compared to that of the other groups. CgA in the PMS group increased in the luteal phase from the follicular phase, and the value was greater than that of the other groups. CONCLUSIONS: This study provides intriguing findings that the altered functioning of the ANS in the luteal phase might relate to diverse psychosomatic symptoms appearing premenstrually. The study further implies that noninvasive evaluation of ANS activity—reflecting mind-body interaction—with electrophysiological and biochemical indexes could contribute to monitoring and promoting women's physical and mental health.