Menstrual cycle, beta-endorphins, and pain sensitivity in premenstrual dysphoric disorder.

This study examined pain sensitivity and pain modularity mechanisms (e.g., beta-endorphin levels, blood pressure) in women with premenstrual dysphoric disorder (PMDD; n=27) and healthy controls (n=27) during the follicular and luteal phases of the menstrual cycle. Physiological measures were taken during rest and ischemic pain testing. In both cycle phases, PMDD women (a) displayed lower resting cortisol and beta-endorphin levels and (b) exhibited shorter pain threshold and tolerance times and greater pain unpleasantness ratings during pain. PMDD women also reported greater pain unpleasantness and intensity and had lower beta-endorphin levels in their luteal phase and tended to display higher blood pressure levels at rest and during pain testing. Results suggest that endogenous opioids may be pathophysiologically relevant to PMDD and that the hypothalamic-pituitary-gonadal axis may modulate pain sensitivity in PMDD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility, anger-in, and cardiovascular reactivity in White women.

Relations between cardiovascular reactivity and cynical hostility, aggressiveness, antagonism, and anger-in were examined in White college women tor conditions of high and low interpersonal stress. High stress was created by having the participants discuss an issue on which they held a strong view with a confederate who adamantly espoused an opposing view. Participants in the low-stress condition discussed an issue on which they held no strong views with a confederate who amicably expressed agreement. Participants higher in cynical hostility exhibited more systolic blood pressure reactivity than individuals lower in cynical hostility in the high interpersonal stress condition only. Also, antagonism was positively related to heart rate reactivity across conditions. However, neither aggressiveness nor anger-in was related to reactivity in either condition. Overall, cynical hostility and a disposition toward disagreeable, manipulative behaviors (i.e., antagonism) but not overt aggressive behavior were found to be related to cardiovascular reactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The premenstrual syndrome.

Reviews and discusses psychological studies of the premenstrual syndrome in 4 methodological categories: (a) studies reporting a positive correlation between specific behavioral acts and phase of the menstrual cycle; (b) those using retrospective questionnaires concerning symptom and mood changes; (c) studies involving day-to-day (self-) ratings of various behaviors, symptoms, and moods; and (d) thematic analyses of verbal material gathered in an unstructured situation throughout the cycle. The scientific status of the hypothesis of a premenstrual syndrome is considered, together with more general topics-in particular the question of control groups, the choice of a baseline for describing changes in behavior and the difficulties involved in physiological explanations of psychological phenomena. Brief consideration is given to publication practices of psychological journals as they affect the kind of scientific information available on behavioral changes associated with the menstrual cycle. (72 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of the psychological and hormonal factors in women with and without premenstrual syndrome.

Women with premenstrual syndrome (PMS; n?=?14) were compared with women without premenstrual syndrome (n?=?14). The diagnosis was based on the volunteers' responses to the Premenstrual Assessment Form, their medical history, a physical examination, and the Utah PMS Calendar. After assignment to the non-PMS or PMS group, each subject was studied for one menstrual cycle and was evaluated, once during the follicular phase and twice during the luteal phase. On each of these occasions, circulating concentrations of estradiol and progesterone were determined, and the Depression Adjective Checklist (DACL), the Minnesota Multiphase Personality Inventory (MMPI), and the Attributional Style Questionnaire were completed. Each subject recorded daily her physical symptoms on the Utah PMS Calendar. During the luteal phase, women with PMS had significantly higher levels of depression as measured by the DACL and MMPI than women without PMS. The two groups did not differ in the follicular phase. These findings suggest a luteal phase disorder superimposed on a background free of psychiatric or physiological illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The enigma of premenstrual syndrome.

Reviews the literature concerning premenstrual syndrome (PMS), including biomedical theories and methodological problems for research, diagnosis, and treatment. Diagnostic methods and evidence of treatment effectiveness are discussed. Lack of progress toward understanding the cause(s) and finding effective treatments has led to consideration of possible psychological, societal, and cultural factors in PMS; these theories are reviewed. Implications for clinicians and for women experiencing premenstrual symptoms are discussed throughout. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of menstrual cycle phase on neuroendocrine and behavioral responses to the serotonin agonist m-chlorophenylpiperazine in women with premenstrual syndrome and controls

To evaluate the potential role of serotonin in the premenstrual syndrome (PMS), we investigated the effects of menstrual cycle phase on neuroendocrine and behavioral responses to the serotonergic agent m-chlorophenylpiperazine (m-CPP) in women with PMS and controls. A single oral dose of m-CPP (0.5 mg/kg) was administered to 10 PMS patients and 10 healthy controls during the follicular and luteal phases of the menstrual cycle. We observed the following. m-CPP administration during the luteal phase resulted in an acute improvement of PMS symptoms; the plasma cortisol and ACTH responses to m-CPP were blunted in both menstrual cycle phases in PMS patients compared with controls. These data provide evidence for the acute efficacy of m-CPP in the treatment of PMS. Although there is additional evidence for dysregulation of either the hypothalamic-pituitary-adrenal axis or serotonin control of the hypothalamic-pituitary-adrenal axis in women with PMS, there is little evidence for luteal phase-specific serotonergic dysfunction. These findings, nonetheless, implicate the serotonin system as a modulating (not causal) factor in PMS.     

Discrimination and unfair treatment: Relationship to cardiovascular reactivity among African American and European American women.

This study examined the relationship of cardiovascular reactivity to both interpersonal mistreatment and discrimination in a community-based sample of African American and European American women (N?=?363) in midlife. Subtle mistreatment related positively to diastolic blood pressure (DBP) reactivity for African American participants but not their European American counterparts. Moreover, among the African American participants, those who attributed mistreatment to racial discrimination exhibited greater average DBP reactivity. In particular, these women demonstrated greater DBP reactivity to the speech task, which bore similarities to an encounter with racial prejudice but not to a nonsocial mirror tracing task. These findings are consistent with the hypothesis that racial discrimination is a chronic stressor that can negatively impact the cardiovascular health of African Americans through pathogenic processes associated with physiologic reactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's beliefs about the prevalence of premenstrual syndrome and biases in recall of premenstrual changes.

The present study investigated the relationship between women's beliefs about the prevalence of premenstrual syndrome (PMS) and biases in recall of premenstrual changes. Forty-nine women completed the Moos Menstrual Distress Questionnaire (R. H. Moos, 1968) both retrospectively and prospectively. Afterward, they were asked about their beliefs concerning the prevalence of PMS. The women reported higher premenstrual changes when they completed the retrospective questionnaire. Seventy-five percent of the women believed that the majority of women have premenstrual changes. From this percentage, those who answered that the majority also experience PMS were more biased in their premenstrual changes in the retrospective assessment. Many women have a misperception about the meaning of PMS; consequently, they amplify their premenstrual changes in recall, reflecting women's cultural stereotypes rather than their actual experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group

The association of progressive obliterative bronchiolitis (OB) with rheumatoid arthritis (RA) is uncommon but has been reported previously. Diffuse panbronchiolitis (DPB) is a unique inflammation principally affecting the respiratory bronchioli and has been reported mainly in Japanese adults. Recently, DPB has also been noted in patients with RA in Japan. Therefore, there might be considerable overlap in clinical features between DPB and OB associated with RA in Japan. The aim of this study was to evaluate the clinicopathological characteristics of bronchiolitis in patients with RA. Three RA patients clinically diagnosed as having DPB were evaluated. All patients underwent chest radiographs, pulmonary function tests (PFT) and post mortem examination. Clinical features in all patients were a history of productive cough, exertional dyspnoea, wheezing and/or coarse crackles. Chest radiographs showed small nodular shadows up to 2 mm in diameter with bronchiolectasis throughout both lungs in all patients. The PFT revealed marked obstructive impairment in all patients. All patients died of progressive respiratory failure. Pathologically, two out of the three cases were confirmed as DPB, while the remaining one case was confirmed as OB, because the primary obstructive lesions were in the respiratory bronchioli in the former and in the membranous bronchioli and the proximal small bronchi in the latter. Thus, the clinical features of DPB and OB were strikingly similar, but the histopathological features revealed distinct differences. This study demonstrated that there was considerable overlap in clinical features between diffuse panbronchiolitis and obliterative bronchiolitis associated with rheumatoid arthritis, suggesting that diffuse panbronchiolitis might be a new manifestation of rheumatoid arthritis. The differentiation of these two disease entities is significant in making decisions on their therapeutic modality and is possible by analysing the precise histopathological findings of the lung.     

Interrelationship of magnesium and estrogen in cardiovascular and bone disorders, eclampsia, migraine and premenstrual syndrome

The anticonvulsive and antihypertensive values of magnesium (Mg) in eclampsia, and its antiarrhythmic applications in a variety of cardiac diseases, have caused Mg to be considered only for parenteral administration by many physicians. In contrast, nutritionists have long recognized Mg as an essential nutrient, because severe deficiencies elicit neuromuscular manifestations similar to those justifying its use in eclampsia. More recently, this element has been used to favorably influence latent tetany with and without thrombotic complications, to delay preterm birth, to influence premenstrual syndrome, and to ameliorate migraine headaches. Most of these disorders exclusively or largely afflict women. The lesions of arteries and heart caused by experimental Mg deficiency have been well documented and may contribute to human cardiovascular disease. Estrogen's enhancement of Mg utilization and uptake by soft tissues and bone may explain resistance of young women to heart disease and osteoporosis, as well as increased prevalence of these diseases when estrogen secretion ceases. However, estrogen-induced shifts of Mg can be deleterious when estrogen levels are high and Mg intake is suboptimal. The resultant lowering of blood Mg can increase the Ca/Mg ratio, thus favoring coagulation. With Ca supplementation in the face of commonly low Mg intake, risk of thrombosis increases.     

Menstrual cycle and social behavior in vervet monkeys

We assessed the relationship between social behavior and the menstrual cycle in 11 adult female vervet monkeys (Cercopithecus aethiops sabaeus) living in an established, stable social group. The findings indicated that fluctuations in ovarian steroids are accompanied by behavioral changes in vervet monkeys. A significant increase in aggressive action, avoidance of social overtures, and retreats from threat occurred during the late luteal phase. However, the social environment can greatly affect behavior independent of the phase of the menstrual cycle. The 10 nondominant (or subordinate) individuals not only exhibited behavioral changes across their own menstrual cycles, but also were responsive to the dominant female's cycle. During the dominant female's late luteal phase, subordinate females significantly increased aggression and decreased social activity. Some of behavioral patterns in female vervet monkeys are therefore relatively independent of direct hormonal modulation and support the contention of the dominant female as the driving force for behavioral changes related to aggression and social interaction. The differential effect of hormones and social status and other environmental factors on behavior has not been critically evaluated in human studies of the premenstrual syndrome. The present study suggests that it is important to assess which behavioral patterns in women are hormonally mediated and which are dependent on the environment.     

Menstrual cycle modulation of tender points

OBJECTIVE: A summary about the final results of the Hungarian double-blind placebo controlled randomised trial of periconceptional folic acid containing multivitamin and trace element supplementation. RESULTS: The major finding is a significant prevention of the first occurrence of neural-tube defect, urinary tract and cardiovascular defects, in addition a decrease in the rate of limb deficiencies and congenital hypertrophic pyloric stenosis. Fertility was slightly improved and the rate of twins increased significantly after periconceptional multivitamin supplementation. The effect of multivitamin supplementation for fetal death is controversial, but in general there is no clinically significant change. Periconceptional multivitamin supplementation can reduce the occurrence of nausea and vomiting. PRACTICAL IMPLEMENTATIONS: Consumption of foods which are rich in folate may not be the best way to prevent neural-tube defects and other congenital abnormalities. Periconceptional multivitamin supplementation is part of the periconceptional care in Hungary and it is an appropriate forum for the practical delivery for this primary prevention action. However, as a large proportion of pregnancies are unplanned, the widespread use of bread fortified with folic acid, vitamin B12 and B6 may decrease a considerable part of neural-tube defects and some other congenital abnormalities, in addition to vascular diseases due to hyperhomocysteinemia.     

Gender and ethnicity in children's cardiovascular reactivity: 7 years of study.

A total of 295 children (127 White boys, 15 Black boys, 133 White girls, and 20 Black girls) participated in reactivity examinations in 1987 (all were in 3rd grade; age, M?=?9.1 years), 1988, 1989, 1991, 1992, and 1993 (all were in 9th grade; age, M?=?15.1 years). An analysis of residualized reactivity change values indicated consistent and significant ethnicity effects (Blacks greater than Whites) for systolic and diastolic blood pressure and for heart rate. Gender effects were also apparent for both systolic and diastolic blood pressure (boys greater than girls). These data suggest that the transition from childhood to adolescence is associated with a significant pattern of ethnic differences in reactivity, although the association of this pattern with the development of cardiovascular risk and disease remains to be ascertained. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perimenstrual complaints in women complaining of PMS, menorrhagia, and dysmenorrhea: toward a dismantling of the premenstrual syndrome

Four groups of women were compared in terms of their perimenstrual symptoms, reported menstrual blood loss and period pain, and neuroticism scores: three patient groups were referred to a Gynaecology Outpatient Clinic because of menorrhagia (N = 101), PMS (N = 104), dysmenorrhea (N = 56), and a control group (N = 105). The three patient groups showed considerable overlap in a number of symptoms. This has led us to postulate three factors contributing to perimenstrual complaints: a) a 'timing factor' linked to the ovarian cycle; b) a 'menstruation factor,' associated with the buildup of the endometrium and its shedding; and c) a 'vulnerability factor,' one aspect of which, 'neuroticism,' was measured in this study. Depressive symptoms, which were the most important in leading women to seek help for their PMS, were related to all three factors. Depressive mood changes seemed to be linked to the 'timing factor' but were noticeably worse and more prolonged in women with high neuroticism, heavy bleeding, or severe pain. One premenstrual symptom, food craving, was of considerable interest. This was weakly related to neuroticism, not apparently affected by the 'menstruation factor' and differed in severity between those in the PMS group and the other three groups. It is potentially relevant that both carbohydrate craving and depression are linked to serotonergic changes in the brain, which may prove to be particularly marked in the late luteal phase.     

Menstrual cycle influences on operant behavior of female rhesus monkeys.

Nine female rhesus monkeys were paired with males throughout 63 menstrual cycles. The females' motivation to approach males was studied with an operant conditioning paradigm that required the female to press a lever 250 times to gain access to the male. Sexual behavior was scored during standard 60-min tests that followed the attainment of access (17 pairs; 1,440 tests). In the overall data, mean times to access were shortest at mid-cycle and longest just before and after the onset of menstruation, and a model-fitting method showed that 45% of cycles from individual pairs were significantly correlated with a V-shaped model of the overall pattern. Male sexual activity was highest at mid-cycle and lowest in the last quarter of the cycle, but the changes in access times could not be attributed entirely to the rewarding effects of the ejaculations. In the combined data from 5 females (9 pairs; 33 cycles), high estradiol levels and low progesterone levels were statistically associated with short access times and short ejaculation times. The overall effect was for operant performance and sexual activity to be synchronized and maximized in the periovulatory period of the menstrual cycle. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of short-term suppression of ovarian hormones on cardiovascular and neuroendocrine reactivity to stress in women

The present study reduced the levels of ovarian hormones to early postmenopausal levels by a GnRH agonist and evaluated the effects of a temporary suppression of ovarian hormones on premenopausal women's cardiovascular and neuroendocrine responses to laboratory challenges. The stress responses of 24 healthy young women were evaluated during three tasks during the early follicular phase and then after three monthly injections of Lupron, which suppressed their levels of estradiol, FSH, and LH. Thereafter, half the group resumed menstrual cycles (labeled Cycle), and half continued having Lupron injections in combination with transdermal estradiol (labeled Patch) and all were reevaluated a third time. A third group (labeled Control) of 12 women had four monthly injections of Lupron first and then were evaluated the first time. After their cycles resumed, they were reevaluated twice 3 months apart. Results showed that the magnitude of the blood pressure and catecholamine changes declined over the three evaluations, suggesting that the women's stress responses habituated. Although the suppression of ovarian hormone levels led to alterations in ovarian hormones for several months, which were accompanied by typical menopausal symptoms, cardiovascular and neuroendocrine responses to stress did not vary. This study did not test the effects of current estrogen exposure or of long term suppression of ovarian hormones upon cardiovascular and neuroendocrine responses.     

Conjoint monitoring of symptoms of premenstrual syndrome: Impact on marital satisfaction.

30 women who met criteria for late luteal phase dysphoric disorder (premenstrual syndrome [PMS]) were randomly assigned to either a control group or a conjoint monitoring group. Following 3 mo of prospective charting to confirm the existence of PMS, the control group women continued to monitor menstrual cycle symptoms, while the conjoint monitoring group involved both the wife and the husband in charting cyclic symptoms. A 2 (control vs conjoint monitoring)?×?2 (pretest vs posttest) multivariate analysis of variance (MANOVA) with 9 dependent variables from the Marital Satisfaction Inventory (MSI) revealed significant effects. Follow-up analyses showed that MSI scores predicted group membership (treatment or control) and that the conjoint monitoring treatment resulted in significantly greater improvement on specific MSI scores (Global Distress, Affective Communication, Problem-Solving Communication, Disagreement About Finances, and Sexual Dissatisfaction) than in the wives-only condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cynicism, social support, and cardiovascular reactivity.

This study examined whether highly cynical individuals benefit less from social support during an acute stressor than individuals low in cynicism. College students (52 men, 52 women) performed a stressful speech task alone or in the presence of a supportive confederate. There was an interactive effect of social support and cynicism on cardiovascular reactivity: Low cynicism participants who received support had smaller increases in blood pressure during the speech than low cynicism participants without support and high cynicism participants with or without support. Participants' psychological stress appeared to mediate the main effects of support on blood pressure reactivity, but not the Support?×?Cynicism interaction. Results suggest that cynical attitudes may undermine the stress buffering potential of interpersonal support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Circadian changes in body temperature during the menstrual cycle of healthy adult females and patients suffering from premenstrual syndrome

The biological rhythm of females is closely related to the menstrual cycle, and this rhythm is believed to influence circadian changes in body temperature. This study investigated and compared the patterns of circadian changes in the body temperature of healthy adult females and patients suffering from premenstrual syndrome or major depression. Body temperature was measured both rectally and sublingually in healthy subjects, and only sublingually in the patients. During the luteal phase in healthy adult females, both the average and lowest nocturnal body temperatures increased, the amplitude of the circadian changes decreased, and the times of the lowest and highest temperatures within a 24-hour period were delayed by 2-3 h. In the patients, the amplitude decreased during disease periods, especially in the follicular phase, whereas in the luteal phase, circadian changes showed great variation each day, although the decrease in amplitude was not as remarkable. The results show that (i) the biological rhythm of females is intrinsically unstable in the luteal phase, although this rhythm is stable in the follicular phase; and, (ii) symptoms were often aggravated with the decreases in amplitude experienced in the luteal phase.