Premenstrual Symptomatology Research Articles

Luteal phase sertraline treatment of premenstrual dysphoric disorder (PMDD): Effects on markers of hypothalamic pituitary adrenal (HPA) axis activation and inflammation

RationalePremenstrual dysphoric disorder (PMDD) is characterized by severe affective symptoms during the luteal phase of the menstrual cycle. There is some evidence of altered interactions between the hypothalamic pituitary gonadal (HPG) and hypothalamic pituitary adrenal (HPA) axes in PMDD. There is also evidence that similar affective disorders such as major depression and perinatal depression are associated with dysregulation in immune factors, but this has not been characterized in PMDD. AimsThe goals of this exploratory study were to identify 1) whether HPA-HPG axis interactions and immune markers differ between PMDD patients and controls across the menstrual cycle; 2) how luteal phase sertraline treatment impacts stress and inflammatory markers. MethodsParticipants were females age 18–50 with regular menstrual cycles, not using psychotropic or hormonal medications, and were assigned to a control group or PMDD group based on prospective daily symptom ratings and clinical interview. Blood was drawn in the follicular and luteal phases, during laboratory sessions involving a mildly stressful task. In a second luteal phase, PMDD participants received open-label sertraline (50 mg/d) from ovulation to menses. Serum cortisol and ACTH were measured via ELISA and operationalized as area under the curve with respect to ground (AUCg), and peak level following laboratory task. Serum TNF-α, IL-6, CXCL-8, and IL-1β were measured using multiplex kits. Serum allopregnanolone (ALLO) was measured by gas chromatography/mass spectroscopy. To characterize HPA-HPG axis interactions across the menstrual cycle in PMDD participants and controls, multilevel linear models predicted cortisol and ACTH from the interaction of cycle phase (controlling for sertraline treatment), ALLO, and group. To determine the effects of sertraline treatment on inflammatory markers and how groups might differ in cyclical change on each marker, multilevel linear models predicted inflammatory markers from cycle phase (controlling for sertraline treatment) and group. A final set of exploratory models tested whether inflammatory markers predict premenstrual symptom score severity. ResultsThe sample included n=77 participants (41 controls, 36 PMDD); 28 participants with PMDD completed sertraline treatment. Group x phase x ALLO interactions showed that higher ALLO levels predicted lower cortisol peak in the treated luteal phase (interaction between phase and ALLO, p=0.042), and there was a higher cortisol peak in the treated luteal phase than the untreated luteal phase (p=0.038). CXCL-8 was significantly associated with premenstrual symptom severity after controlling for group and cycle phase (p=0.011). There were no main effects of group, phase, or ALLO on cortisol AUCg, ACTH AUCg, IL-6, CXCL-8, IL-1β, nor TNF-α (p’s>0.05). ConclusionSerum markers of HPA axis and immune function did not vary by menstrual cycle phase nor PMDD status. However, sertraline treatment in the luteal phase was associated with higher ALLO levels predicting lower cortisol peak in response to mild laboratory stress, suggesting that sertraline treatment may normalize HPG-HPA axis interactions among individuals with PMDD. Greater premenstrual symptomatology was associated with higher levels of the inflammatory marker CXCL-8, but further research is needed into the potential role of inflammation in PMDD.

Alleviating premenstrual symptoms with smartphone-based heart rate variability biofeedback training: a pilot study.

Heart rate variability biofeedback (HRVB) is a well-studied intervention known for its positive effects on emotional, cognitive, and physiological well-being, including relief from depressive symptoms. However, its practical use is hampered by high costs and a lack of trained professionals. Smartphone-based HRVB, which eliminates the need for external devices, offers a promising alternative, albeit with limited research. Additionally, premenstrual symptoms are highly prevalent among menstruating individuals, and there is a need for low-cost, accessible interventions with minimal side effects. With this pilot study, we aim to test, for the first time, the influence of smartphone-based HRVB on depressive and premenstrual symptoms, as well as anxiety/stress symptoms and attentional control. Twenty-seven participants with above-average premenstrual or depressive symptoms underwent a 4-week photoplethysmography smartphone-based HRVB intervention using a waitlist-control design. Laboratory sessions were conducted before and after the intervention, spaced exactly 4 weeks apart. Assessments included resting vagally mediated heart rate variability (vmHRV), attentional control via the revised attention network test (ANT-R), depressive symptoms assessed with the BDI-II questionnaire, and stress/anxiety symptoms measured using the DASS questionnaire. Premenstrual symptomatology was recorded through the PAF questionnaire if applicable. Data analysis employed linear mixed models. We observed improvements in premenstrual, depressive, and anxiety/stress symptoms, as well as the Executive Functioning Score of the ANT-R during the intervention period but not during the waitlist phase. However, we did not find significant changes in vmHRV or the Orienting Score of the ANT-R. These findings are promising, both in terms of the effectiveness of smartphone-based HRVB and its potential to alleviate premenstrual symptoms. Nevertheless, to provide a solid recommendation regarding the use of HRVB for improving premenstrual symptoms, further research with a larger sample size is needed to replicate these effects.

Efficient assessment of premenstrual symptoms - German translation of the shortened Premenstrual Assessment Form and its psychometric evaluation

Premenstrual symptomatology is a widespread and yet under-researched problem. To date, there is no German instrument for assessing the broad spectrum of possible symptoms and their degree of expression. For this reason, the short versions of the Premenstrual Assessment Form with 20 and 10 items were translated and validated in a sample of N=147 menstruating persons. The internal consistencies of the 20-item and 10-item versions are high (Cronbach's αPAF20=0.93 and αPAF10=0.88, respectively) and comparable to the original versions. Factor analysis identified two scales that assess psychological and physiological symptoms. Convergent validity was demonstrated by a correlation with the PMS Impact Questionnaire (rPAF20=0.66, p<.001). This association was significantly higher (z=2.67, p=0.004) than the correlation with the Brief Symptom Inventory-18 (rPAF20=0.50, p<0.001), which verifies divergent validity. Additionally, cut-off values for suspected diagnoses based on DSM-V diagnostic criteria for both short forms were calculated. The translated Premenstrual Assessment Form is a valid, reliable, and parsimonious instrument that can be used flexibly. It is suitable for quantifying premenstrual symptomatology in research.

Moving online: Implementation of virtual sessions of physical activity and movement training as a therapeutic approach to premenstrual symptoms

BackgroundAerobic exercise and movement training improve premenstrual syndrome (PMS) symptoms in women. However, the data is still preliminary, and online-based training has not been evaluated yet. Thus, this pilot study aims to assess the workability and usefulness of an online protocol based on aerobic exercise and movement training as an intervention for premenstrual symptoms. MethodsA sample of 30 women from the general population was enrolled in this study, with an average age of 28.27 ± 9.35, and an average BMI of 23.47 ± 3.42 kg/m2. A total of 29 women completed an eight-week online protocol consisting of 30-min aerobic exercises twice a week, as well as a weekly 30-min movement training protocol. A psychological evaluation was conducted at the baseline and after completing the training via the patients’ health questionnaire, the body weight image and self-esteem questionnaire, and the premenstrual symptoms screening tool, looking for changes in well-being and specific symptoms related to menses. ResultsSignificant improvements in PMS (p = .015) and mood (p = .011) were recorded, with specific mood effects related to PMS symptomatology. The patients provided positive feedback on the protocol, and adherence was optimal. ConclusionThe effectiveness of a combination of aerobic and isometric exercises was confirmed as a valuable tool in improving women's well-being and reducing premenstrual symptomatology, even if the protocol is delivered online, which tends to be more affordable for the participants than in-presence sessions. Future studies might assess the difference between online programs and face-to-face interventions.

PREVALENCE, PATTERN, AND PREDICTORS OF PREMENSTRUAL SYNDROME AND PREMENSTRUAL DYSPHORIC DISORDER AMONG COLLEGE GIRLS

Objective: Premenstrual syndrome (PMS) occurs 7–14 days before the onset of menstruation and subsides with the commencement of menstrual flow, affects women during their reproductive age, and is associated with physical, psychological, and behavioral changes. If the mental symptoms predominate are very severe and are associated with impairment, then the patient is classified as having premenstrual dysphoric disorder (PMDD) which may be viewed as a severe subtype of PMS. This can interfere with the lives of the affected, as well as their interpersonal relationships. Methods: This study was conducted at KMCT medical college from November 2021 to May 2022. An awareness program which was informative and well-interacted was conducted for each batch of students regarding the various aspects of this disorder before screening for this study. Premenstrual symptoms screening tool (PSST) was used to screen students for the presence of disturbing symptoms. They were asked to write down the various ways that they deal with these menacing symptoms in a separate form. Institution ethics committee approval was taken to carry out this study. PSST it is the screening tool developed by Steiner et al. Results: A total of 318 students from all batches of college took part in this study actively. On screening by PSST, 44 students qualified for PMDD, 89 students met the criteria for PMS, and the remaining 185 had no to mild premenstrual symptoms (Table 1). Among the 89 students in premenstrual symptoms group, most common symptoms reported were anger/irritability −66%, fatigue/lack of energy −45%, and difficulty concentrating −45%. In 44 students who had qualified for PMDD, 84% reported anger/irritability, 81% reported tearful/increased sensitivity, and 75% reported anxiety/ tension followed by depressed mood in 73%. Conclusion: PMS and PMDD are prevalent among substantial proportion of college girls with significant negative influence on academic performance, emotional well–being, and behavior. The pattern of premenstrual symptomatology is different between PMS, PMDD, and in overall college students. The predictors of PMS and PMDD are age, education, heavy menstrual flow, dysmenorrhea, and family history of PMS. The knowledge and health seeking behavior of college students toward PMD are quite low. Strategies should be drawn and implemented for timely recognition and management of PMS and PMDD in college girls.

Menstrual cycle and exogenous attention toward emotional expressions

Several studies suggest that the menstrual cycle affects emotional processing. However, these results may be biased by including women with premenstrual syndrome (PMS) in the samples. PMS is characterized by negative emotional symptomatology, such as depression and/or anxiety, during the luteal phase. This study aimed to explore the modulation of exogenous attention to emotional facial expressions as a function of the menstrual cycle in women without PMS. For this purpose, 55 women were selected (from an original volunteer sample of 790) according to rigorous exclusion criteria. Happy, angry, and neutral faces were presented as distractors, while both behavioral performance in a perceptual task and event-related potentials (ERPs) were recorded. This task was applied during both phases of the menstrual cycle (luteal and follicular, counterbalanced), and premenstrual symptomatology was monitored daily. Traditional and Bayesian ANOVAs on behavioral data (reaction times and errors in the task) and ERP indices (P1, N170, N2, and LPP amplitudes) confirmed the expected lack of an interaction of phase and emotion. Taken together, these results indicate that women free of PMS present steady exogenous attention levels to emotionally positive and negative stimuli regardless of the menstrual phase.

Behavioral Symptomatology in the Premenstruum.

Objective: Sleep and eating behaviors are disturbed during the premenstrual phase of the menstrual cycle in a significant number of reproductive-age women. Despite their impact on the development and control of chronic health conditions, these behaviors are poorly understood. In the present study, we sought to identify affective and psychological factors which associate with premenstrual changes in sleeping and eating behaviors and assess how they impact functionality. Methods: Fifty-seven women provided daily ratings of premenstrual symptomatology and functionality across two-three menstrual cycles (156 cycles total). For each participant and symptom, we subtracted the mean day +5 to +10 (“post-menstruum”) ratings from mean day −6 to −1 (“pre-menstruum”) ratings and divided this value by participant- and symptom-specific variance. We completed the statistical analysis using multivariate linear regression. Results: Low interest was associated with a premenstrual increase in insomnia (p ≤ 0.05) and appetite/eating (p ≤ 0.05). Furthermore, insomnia was associated with occupational (p ≤ 0.001), recreational (p ≤ 0.001), and relational (p ≤ 0.01) impairment. Conclusions: Results of the present analysis highlight the importance of apathy (i.e., low interest) on the expression of behavioral symptomatology, as well as premenstrual insomnia on impairment. These findings can inform treatment approaches, thereby improving care for patients suffering from premenstrual symptomatology linked to chronic disease conditions.

Association between Neuroticism and Premenstrual Affective/Psychological Symptomatology.

Neuroticism and premenstrual conditions share pleiotropic loci and are strongly associated. It is presently not known which DSM-5 symptoms of premenstrual syndrome/premenstrual mood disorder are associated with neuroticism. We enrolled 45 study participants to provide prospective daily ratings of affective ("depression", "anxiety, "anger", "mood swings") and psychological ("low interest", "feeling overwhelmed", and "difficulty concentrating") symptoms across two-three menstrual cycles (128 total cycles). Generalized additive modeling (gam function in R) was implemented to model the relationships between neuroticism and the premenstrual increase in symptomatology. Significance level was adjusted using the False Discovery Rate method and models were adjusted for current age and age of menarche. Results of the association analysis revealed that "low interest" (p ≤ 0.05) and "difficulty concentrating" (p ≤ 0.001) were significantly associated with neuroticism. None of the remaining symptoms reached statistical significance. The late luteal phase of the menstrual cycle is characterized by complex symptomatology, reflecting a physiological milieu of numerous biological processes. By identifying co-expression between neuroticism and specific premenstrual symptomatology, the present study improves our understanding of the premenstrual conditions and provides a platform for individualized treatment developments.

Knowledge and Awareness on Premenstrual Symptoms – A Cross Sectional Survey

Background: A majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation. The aim of the study is to evaluate the awareness of premenstrual symptoms.&#x0D; Materials and Methods: A questionnaire of 16 questions was created and entered in the online survey creator ‘Google Forms’ and shared individually among dental students and specialist and data were collected subject to statistical analysis using SPSS software. Statistical tests used were descriptive statistics and Chi-square tests.&#x0D; Results: Regardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches, pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Results of this study 90% of the participants aware about premenstrual symptoms 10% of the participants unaware of premenstrual symptoms and they need an effective education and awareness campaign to increase their knowledge and awareness on premenstrual symptoms. The obtained p-value was &gt;0.05 was considered statistically insignificant.&#x0D; Conclusions: The present study indicates the prevalence of premenstrual symptoms, regardless of severity, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Psychometric Properties of a DSM-5-Based Screening Tool for Women's Perceptions of Premenstrual Symptoms.

A premenstrual screening tool is needed when time constraints and attrition limit the feasibility of daily ratings. The present study examines the utility of a novel, 33-item, retrospective, dimensional, DSM-5-based, screening measure developed to explore women's perceptions of premenstrual symptomatology. This is the first measure that examines perception of impairment for each DSM-5 symptom and assesses the frequency criterion. Participants (N = 331) reported symptoms ranging from none to a level consistent with a provisional DSM-5 diagnosis of Premenstrual Dysphoric Disorder (PMDD). Initial psychometric properties indicated a five-factor structure: (1) affective symptoms; (2) fatigue, sleep, and anhedonia; (3) symptom frequency; (4) impairment and severity of appetite change and physical symptoms; and (5) difficulty concentrating. The total symptom scale and the frequency, severity, and impairment subscales demonstrated high internal consistency. Strong correlations between this dimensional measure and other retrospective and prospective premenstrual symptom measures suggest strong convergent, concurrent, and predictive validity. Premenstrual symptom groups created using this screening measure (minimal, mild/moderate, severe) differed on other retrospective and prospective measures of premenstrual symptoms. There was evidence of divergent validity and lack of an acquiescence bias. We also report data describing women's perceptions of the frequency, level of impairment, and level of severity for each DSM-5 PMDD symptom over a 12-month period and discuss implications for future research on premenstrual phenomenology. Initial evidence for the reliability and construct validity of this symptom screening measure suggests potential value for assessing premenstrual symptomatology in research and practice.

Childhood Trauma and Premenstrual Symptoms: The Role of Emotion Regulation

BackgroundWomen with Premenstrual Dysphoric Disorder (PMDD) are more likely to have a history of childhood trauma, and may experience more severe premenstrual symptomatology. However, the pathway in which childhood trauma affects the prevalence and severity of premenstrual symptoms remains largely unclear. ObjectiveTo determine whether childhood trauma is associated with increased premenstrual symptoms, and if so, whether emotional dysregulation mediates or moderates this relationship. Participants and settingsA total of 112 women were recruited for the study among students at the Hebrew University of Jerusalem. MethodsParticipants completed the Premenstrual Symptoms Screening Tool (PSST), the Childhood Trauma Questionnaire (CTQ) and the Difficulties in Emotion Regulation Scale (DERS). To test the mediation hypothesis, direct and indirect effects of childhood trauma on premenstrual symptoms were calculated. To test moderation, we performed multiple regression, including the interaction term between childhood trauma and emotion dysregulation ResultsTwenty-two women (18.6%) met criteria for premenstrual syndrome (PMS) and sixteen (13.6 %) for PMDD. The number and severity of premenstrual symptoms increased with more childhood trauma (r = .282), and this relationship was completely mediated by emotion regulation difficulties. Specifically, exposure to Sexual abuse (r = .243) and Emotional neglect (r = .198) were significantly associated with premenstrual symptoms. Abuse predicted greater emotion dysregulation (r = .33), whereas, neglect did not. ConclusionsThis study contributes to the current knowledge on the long-term effects of childhood trauma. Promoting use of adaptive emotion regulation strategies for women with a history of childhood trauma, could improve their capability to confront and adapt to premenstrual changes.

A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study

BackgroundA majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation.MethodsWe conducted a cross-sectional survey, which included 200 participants (mean age: 19.8 ± 0.1 years old). The subjects completed a rating of their premenstrual experiences relative to 46 symptoms in eight categories of the self-reporting menstrual distress questionnaire (MDQ) to evaluate the prevalence and severity of premenstrual symptoms. The participants also answered a standardized health questionnaire regarding subjective perceptions of health, self-rating stress, lifestyle, and demographic variables.ResultsRegardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches and pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Stepwise multiple regression analysis revealed subjective perception of health (β = 0.28; p < 0.001) and self-rating stress (β = 0.18; p = 0.008) as the factors most strongly related to the MDQ total scores. In addition, the 19 women who evaluated themselves as “unhealthy and stressed” had greater prevalence of severe or extremely severe physical (general aches and pains) and psychosocial symptoms (confusion, lowered school or work performance, decreased efficiency, loneliness, anxiety, restlessness, mood swings, and depression), compared to the healthy and non-stressed women.ConclusionsThe present study indicates the prevalence of premenstrual symptoms, regardless of severity and number, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Reproductive and demographic Predictors' of premenstrual syndrome severity among university students

Background: Premenstrual syndrome (PMS)is a group of psychological and somatic symptoms related to menstrual cycle amongyoung and middle-aged women. These symptoms occur during the luteal phase of the menstrual cycle. Aim of the study: Toexplore reproductive and demographic predictors that might affect premenstrual syndrome severity among University Students Design: a cross sectional descriptive research design was utilized for the current study. Setting: The study was conducted at Banha University. Sample: A purposive sample of 250students were included Three tools were used to collect data; (1) Self-administered structured questionnaire sheet, (2) visual analogue scale, and (3) premenstrual symptomatology tool. Results: The study findings reveal that type of collage, mother’s levels of education, family history of PMS, menstrual cycle intervals were the important predictors that might affect severity of PMS (P=< 0.05, 0.02, <0.05 & 0.043 respectively. Also, the results indicated that, menstrual irregularities, BMI and duration of menstrual flow were not statistically significant in relation to severity of PMS (P = 0.14, 0.45 & 0.08 respectively).

The influence of early life sexual abuse on oxytocin concentrations and premenstrual symptomatology in women with a menstrually related mood disorder

Oxytocin (OT), associated with affiliation and social bonding, social salience, and stress/pain regulation, may play a role in the pathophysiology of stress-related disorders, including menstrually-related mood disorders (MRMD's). Adverse impacts of early life sexual abuse (ESA) on adult attachment, affective regulation, and pain sensitivity suggest ESA-related OT dysregulation in MRMD pathophysiology. We investigated the influence of ESA on plasma OT, and the relationship of OT to the clinical phenomenology of MRMD's. Compared to MRMD women without ESA (n=40), those with ESA (n=20) displayed significantly greater OT [5.39pg/mL (SD, 2.4) vs. 4.36pg/mL (SD, 1.1); t (58)=−2.26, p=0.03]. In women with ESA, OT was significantly, inversely correlated with premenstrual psychological and somatic symptoms (r's=−0.45 to −0.64, p's<0.05). The relationship between OT and premenstrual symptomatology was uniformly low and non-significant in women without ESA. In women with ESA, OT may positively modulate MRMD symptomatology.

The influence of early life sexual abuse on oxytocin concentrations and premenstrual symptomatology in women with a menstrually related mood disorder

The influence of early life sexual abuse on oxytocin concentrations and premenstrual symptomatology in women with a menstrually related mood disorder

The Effects of Abuse History and Age on the Interrelationship between Perceived Stress and Premenstrual Symptom Reports

Abuse remains a pervasive issue for women throughout their lifespan, with far-reaching consequences on a woman’s physical and mental health. Previous studies have suggested that among other health issues, women who have been abused have higher reports of perceived stress (STRESS) and more severe premenstrual symptomatology. The current study assessed the effects of abuse history and age of abuse on the relationship between STRESS and Premenstrual Symptom Reports (PMSR) in women between 18 – 25 years. On the Abuse Questionnaire, participants indicated whether abuse events occurred as a child ( 14 years). Both PMSR and STRESS were greater in women with an abuse history. Moreover, the age of abuse significantly predicted both STRESS and PMSR over and above abuse history in general. To further probe these findings, interaction analyses were performed. Results revealed a significant interaction between abuse age and STRESS on PMSR, indicating more severe symptomatology with increased stress among women who were abused as children. These findings assert the relationship between abuse and detrimental physical health outcomes, while specifically highlighting that abuse age affects the relationship between STRESS and PMSR in women.

Beta-Adrenergic Receptor Mechanisms and Pain Sensitivity in Women With Menstrually Related Mood Disorders

Somatic symptoms experienced by women with a menstrually related mood disorder (MRMD) during their premenstrual luteal phase contribute to functional impairment. Yet, investigations on pathophysiological mechanisms contributing to heightened pain sensitivity in MRMD are sparse. During the luteal phase, 61 women with an MRMD and 61 non-MRMD controls were evaluated for β-adrenergic receptor (β-AR) responsivity using the isoproterenol sensitivity test. A subset (43 MRMD and 50 non-MRMD) then entered a double-blind, placebo-controlled, crossover protocol to examine the effect of β-AR blockade with intravenous propranolol on sensitivity to experimental (cold pressor and ischemic) and clinical (McGill Pain Questionnaire score) pain. Women with an MRMD exhibited greater β1- and β2-AR responsivity, ischemic pain intensity, and affective clinical pain ratings than controls. Propranolol increased cold pressor pain tolerance in both groups, but it decreased cold pain intensity and ischemic pain unpleasantness ratings only in non-MRMD women. In contrast, propranolol decreased affective ratings of clinical pain in women with MRMD. Exploratory analyses indicated that only in MRMD women did greater β-AR responsivity predict greater sensitivity to cold pressor and ischemic pain. This study provides the first evidence for a role of β-AR mechanisms in the hyperalgesia and clinical pain experienced by women with MRMDs. PerspectiveThis article describes the effects of β-adrenergic receptor stimulation and blockade on experimental and clinical pain sensitivity in women with an MRMD. The results of this study may have implications for the management of the substantial somatic premenstrual symptomatology experienced by women with an MRMD.

Hemodynamic and psychological responses to laboratory stressors in women: Assessing the roles of menstrual cycle phase, premenstrual symptomatology, and sleep characteristics

This study assessed whether premenstrual symptomatology and/or sleep characteristics explain increased luteal phase psychophysiological reactivity to laboratory stressors. We hypothesized that: (1) premenstrual symptoms and sleep characteristics would explain greater luteal versus follicular phase psychophysiological reactivity, (2) symptoms and sleep characteristics would differentially predict psychophysiological reactivity within each cycle phase, and (3) symptoms and sleep characteristics would interact to affect luteal but not follicular reactivity. Freely cycling women (N=87) completed two laboratory sessions, one follicular (cycle days 5–9) and one luteal (days 7–10 post-ovulation). We employed two stressors: one physical (cold pressor task) and the other cognitive in nature (Paced Auditory Serial Addition Task). During testing, electrocardiography monitored heart rate (HR) while a timed and auto-inflatable sphygmomanometer assessed blood pressure (BP). Participants also completed a one-time self-report measure of sleep characteristics and premenstrual symptomatology as well as a measure of state anxiety pre-post stressor. Results revealed greater luteal HR and systolic BP reactivity compared to follicular reactivity (p<0.001 for both analyses), however neither premenstrual symptoms nor sleep characteristics explained this luteal increase. Within cycle analyses revealed that symptoms and sleep characteristics interacted to affect luteal phase state anxiety reactivity (R2=.32, p=.002) with negative affect being associated with more reactivity when sleep hours were low (β=.333, p=.04). Overall, significant relationships existed during the luteal phase only. Findings are discussed in terms of clinical utility and methodological challenges related to performing laboratory stress testing in women.

Symptomatologie prémenstruelle, somatisation et anhédonie physique

Physical (headache, abdominal pain, e.g.), emotional (irritability, diminution of self-esteem, e.g.) and/or behavioral disturbances (fatigue, decrease of libido, e.g.) appear frequently during the premenstrual phase of menstrual cycles. Of moderate to severe intensity, these varied symptoms sometimes hinder the usual personal, social and/or professional functioning by generating significant suffering. Thus, premenstrual syndrome (PS) and premenstrual dysphoric disorder (PDD) are closely related to depressive disorders in many prior studies. In spite of solid links associating depression with premenstrual disorders in the literature, the psychological dimension of the premenstrual symptomatology still remains underestimated. The objective of this study is to examine the nature of possible relationships between a moderate premenstrual symptomatology and different modes of information processing with physical and emotional stimuli, such as somatization and physical anhedonia, well-known symptoms of depressive disorders. One hundred and five students in psychology from the François Rabelais university (France), aged between 18 to 50 years old (M=20.98, SD=3.43), were invited to fill in French versions of the Menstrual Distress Questionnaire [25] (Moos, 1991), the somatization subscale of the Symptom Check-List 90 [26] (Derogatis & Cleary, 1977), and the Physical Anhedonia Scale [28] (Chapman et al., 1976). Pearson correlation coefficients were calculated and a multiple regression analysis was conducted with Statistica software. Main results reveal that premenstrual symptomatology is positively related to somatization (r=0.58; P<0.001) and negatively to physical anhedonia (r=-0.27; P<0.05). Physical anhedonia (β=-0.20; P<0.05) and somatization (β=0.55; P<0.001) may take part in the appearance of a premenstrual symptomatology. These results allow us to enrich our knowledge on the origin and the nature of the premenstrual symptomatology, which would be physiological, psychological and social, in order to adapt and widen the therapeutic options by proposing, in parallel with the specific medical treatments, psychological interventions based on cognitive and behavioral techniques aiming a decentralization and a restructuration of the physical symptoms.

Premenstrual Syndrome: The Experience from a Sample of Sri Lankan Adolescents

Setting Government schools of Colombo. Main Outcome Measures Premenstrual symptomatology (PMS) was determined by a modified version of Premenstrual Symptom screening tool and American College of Obstetricians and Gynecologists (ACOG) diagnostic criteria were used in categorizing study units as having PMS. Other outcome measures were demographic and reproductive factors thought to be correlates of PMS, health seeking behavior for premenstrual symptoms, and how premenstrual symptoms impact their daily life. Results Individual premenstrual symptoms were experienced by 65.7% of the population. The most common somatic symptom was fatigue (29.9%) and affective symptom was feeling sad/hopeless (29.6%). Prevalence of PMS was 8.75% (95%CI: 6.43–11.07). Multivariate analysis revealed the presence of: chronic physical illness ( P = 0.001); dysmenorrhea ( P < 0.0001), and regular menstrual cycles ( P = 0.006) as correlates of PMS. Presence of PMS significantly disturbed “in school” activities, relationships and daily routines ( P < 0.005) indicating a high negative influence on adolescents’ daily life. Only 9.7% sought help from (western) medical practitioners for their premenstrual symptoms and a majority has not perceived it as a condition to report. Conclusion Premenstrual syndrome is a common condition among adolescent schoolgirls with a high negative influence on their daily life. The health care seeking behavior is poor, indicating the necessity to address the subject at adolescent reproductive health programs.