Mood and performance changes in women with premenstrual dysphoric disorder: acute effects of alprazolam

This study determined if women with premenstrual dysphoric disorder (PMS) showed impaired mood and performance when they were experiencing their premenstrual symptoms, and if the effects of alprazolam varied as a function of menstrual cycle phase. Under double-blind conditions, the acute effects of placebo and alprazolam (0.25, 0.50, 0.75 mg) were tested during both luteal and follicular phases. Women with confirmed PMS experienced substantial changes in mood as a function of menstrual cycle phase. However, under controlled laboratory conditions, acute doses of alprazolam did not improve negative premenstrual mood, but rather increased negative mood in the follicular phase. Alprazolam impaired task performance, although this impairment was generally similar in both phases when baseline phase differences were taken into consideration. Consistent with the failure of alprazolam to improve mood premenstrually, subjective measures indicative of abuse liability were not increased following alprazolam. Taken together, these data suggest that acute administration of alprazolam doses are not clinically useful for the treatment of PMS.     

Psychophysiological, somatic, and affective changes across the menstrual cycle in women with panic disorder.

This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlation between menstrual cycle and cognitive performance in a chimpanzee (Pan troglodytes).

Extensive research on human subjects has tried to investigate whether there is a correlation between cognitive performance and the menstrual cycle. Less is known about the relationship between the menstrual cycle and task performance in other cognitive animals. We test whether the secretion of a sex hormone [luteinizing hormone(LH)] influences the performance of cognitive tasks by a female chimpanzee (Pan troglodytes) who is part of a long-term cognition research program. We focus on two cognitive tasks: an “easy task,” which consists of simple numerical ordering, and a “difficult task,” which combines numerical ordering with memorizing the numerals' spatial location. Data on the performance of these cognitive tasks, urine samples, and sexual swelling over six menstrual cycles showed that the chimpanzee's performance accuracy decreased and that the intertrial interval was longer during the LH-surge of the menstrual cycle, but only for the performance of the difficult task. These performance attributes seem to reflect a decrease in attention or motivation during ovulation. In summary, the cognitive performance of a chimpanzee was disturbed by hormonal changes despite her long-term experience in the tasks. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sex and menstrual cycle differences in the subjective effects from smoked cocaine in humans.

To investigate sex and menstrual cycle effects in response to cocaine administration, data from existing studies were analyzed. First, responses to a single delivery of 0.4 mg/kg smoked cocaine were investigated. Women reported lower ratings for measures of paranoid/suspicious and heart racing/pounding than did men. In addition, women in the luteal phase reported diminished ratings for a measure of feel high than did both women in the follicular phase of the menstrual cycle and men. Second, responses to up to 6 deliveries of 0.4 mg/kg smoked cocaine were investigated. Women, compared with men, had lower ratings on feel high, heart racing/pounding, and feel stimulated. Results suggest that there are significant sex and menstrual phase differences in the subjective effects of cocaine. (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.     

Contribution of generalized negative affect to elevated menstrual cycle symptom reporting

We investigated women's belief that they suffered from premenstrual syndrome (PMS) by monitoring patterns of symptom reporting over a 5-week period in relation to the underlying trait of negative affect. We expected that women reporting high negative affect would be more likely to report menstrual cycle distress than those reporting low negative affect. One hundred twenty-one women rated the typical occurrence and severity of premenstrual changes on a retrospective questionnaire and then made daily ratings of their changes for the duration of one cycle. In addition, they completed a questionnaire measuring positive and negative affect. Data analysis revealed a clear subgroup whose retrospective reports of premenstrual change were not substantiated by the cycle of their daily ratings. Although this subgroup also reported more negative affect, the magnitude of the effect was relatively small. The possible contribution of both negative outlook and the meaning of the self-identified label of PMS are discussed.     

The menstrual cycle and response to erotic literature

133 undergraduate females responded to a pre-experimental questionnaire assessing their contraceptive use (28% on contraceptive pills), sexual experience (71% had had sexual intercourse), and present phase of menstrual cycle. Ss then read an erotic story intended to induce sexual arousal. Results of a self-report postexperimental questionnaire assessing sexual arousal and genital stimulation show no significant response differences based on menstrual cycle phases for Ss not using contraceptive pills. Greatest degree of arousal and sensation was experienced by Ss on contraceptive pills who were in the menstrual phase of the cycle; least arousal and sensation was experienced by Ss on contraceptive pills who were in the premenstrual phase of the cycle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ischemic but not thermal pain sensitivity varies across the menstrual cycle

OBJECTIVE AND METHOD: Findings from both animal and human research suggest that pain sensitivity changes across the menstrual cycle; however, among humans the nature of these menstrual cycle effects remains unclear. The present study used a repeated-measures design to evaluate changes in thermal and ischemic pain responses during three phases of the menstrual cycle, midfollicular (postmenstrual), ovulatory, and mid-to-late luteal (premenstrual), in 11 healthy women. The cycle phase during which subjects began their participation was determined randomly. Plasma levels of estrogen, progesterone, luteinizing hormone (LH), testosterone, and beta-endorphin were determined at each experimental session. Participants also completed a daily diary of physical and emotional symptoms for two complete menstrual cycles before the experimental sessions. RESULTS: The results indicated that women showed less ischemic pain sensitivity during the midfollicular compared with the ovulatory and mid-to-late luteal phases, but thermal pain responses did not vary significantly across menstrual cycle phases. Physical and emotional symptoms were minimal and did not change significantly across the menstrual cycle. CONCLUSIONS: These findings indicate greater ischemic but not thermal pain sensitivity among women after the midcycle LH surge. The practical relevance and potential mechanisms of these findings are discussed.     

The menstrual cycle and punitiveness.

Studied the levels of punishment and reliability of punishments/judgments made by menstruating or premenstrual women by having Ss read vignettes of 7 different college disciplinary cases and select a level of punishment. 12 menstrual, 10 premenstrual, and 13 intermenstrual women participated, as did 10 males of comparable age and background. Two additional groups of 7 women each were led to believe they were (1) in the premenstrual phase or (2) still several days away from it. Findings show that punitiveness and reliability of judgments did not differ across menstrual phases or between males and females. The task was perceived as more difficult by males and by females led to believe they were premenstrual. A relationship was found between severity of menstrual symptoms and punitiveness. (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)     

Sleep and the menstrual cycle.

To evaluate changes in sleep across the phases of the menstrual cycle, sleep-wake diaries were completed by 32 healthy women twice daily for 2 menstrual cycles. There was a significant increase in sleep onset latency and a significant decrease in sleep efficiency and sleep quality during the luteal phase. This increase in sleep disturbance was observed in the entire sample and was not related to the severity of other premenstrual symptoms. However, women having increased severity of other premenstrual symptoms reported greater luteal increase in daytime sleepiness. Thus, although menstruating women are likely to show increased sleep disturbance during the luteal phase, those with other, more severe premenstrual symptoms are more likely to experience a luteal increase in daytime sleepiness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of race effects in objective indices and subjective evaluations of performance: A meta-analysis of performance criteria.

Used meta-analytic techniques to examine the race effect for objective measures of performance and to compare the relative effect sizes for objective indices and subjective ratings. 53 samples from both published and unpublished studies were located that included at least 1 objective index of actual performance, absenteeism, or cognitive test performance and 1 subjective measure of performance for the same group of Black and White employees. Ss were firefighters, police officers, bank tellers, skilled technicians, production workers, nurses, or clerical workers. The corrected average effect sizes across the 53 samples were low but similar for the objective ad subjective criteria. Moderating effects for the objective criteria were found, as race effects were much higher for cognitive than for performance criteria. Subjective ratings had a lower effect size than objective cognitive test scores but were higher than comparable objective performance indices. Implications for personnel research practices are discussed, and the need for a better understanding of the constructs underlying criterion measures is emphasized. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Premenstrual Assessment Form typological categories: Classification of self-defined premenstrually symptomatic and asymptomatic women.

Newly developed assessment instruments for premenstrual syndrome include the Premenstrual Assessment Form (PAF) and associated PAF typological categories. This study investigates the use of the PAF as a retrospective assessment instrument and the use of PAF subtypes as accurate reflectors of subjective premenstrual symptomatology. Nineteen self-defined severely premenstrually symptomatic women and 26 self-defined premenstrually asymptomatic women completed the PAF to designate premenstrual changes experienced during the previous three menstrual cycles and, subsequently, changes experienced in the previous 24 hr during the premenstrual, menstrual, and intermenstrual phases of three menstrual cycles. All women were classified in PAF subtypes according to their responses on all PAF administrations. Results partially supported the use of the PAF with concurrently obtained data. The limitations of retrospective data in diagnosing premenstrual syndrome and the consideration of additional, nonpremenstrual data in diagnosis are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of patients'' global assessment of arthritis impact. A 2-year study of 216 patients with RA

The dominant ideology of the premenstrual woman is that of a person who has no control over her moods, cognition and behaviour because of her fluctuating hormone levels. The social influence of this stereotype has been put forward as an explanation for discrepancies between retrospective and prospective accounts of premenstrual experiences. However, recent research has found that women can and do distinguish between their own experience and that of the stereotype. What their own experience is (positive as well as negative) was the question that we set out to answer in this study. Nine undergraduate women were interviewed about their menstrual cycle experiences. Using qualitative analysis of their subjective accounts, a clear distinction between self and other premenstrual experiences emerged. While the women did experience premenstrual symptoms, they considered them to be relatively minor in comparison to what they defined as premenstrual syndrome. Furthermore, none of them had previously considered any positive menstrual cycle related experiences but the management of menstruation was emphatically viewed as a 'hassle'. We conclude that women can and do distinguish their own experience from the premenstrual stereotype and this needs to be recognized in the treatment setting; there is a lack of positive discourse for the menstrual cycle which needs to be developed and more attention needs to be paid to menstrual management because it is of great concern to women but is currently not discussed openly.     

Measuring amount of symptom change in the diagnosis of premenstrual syndrome.

Agreement was computed between 3 methods of measuring prospectively rated symptom change in premenstrual syndrome. Ss were 87 women, ranging in age from 21 to 50 years (M?=?34.8), who visited a premenstrual syndrome clinic seeking treatment for their symptoms. All Ss made daily symptom ratings for 2 menstrual cycles. The ratings were analyzed according to 3 methods: percentage change from post- to premenstrual phases, computed with reference to an individual's minimum and maximum ratings; the effect size of post- to premenstrual change; and the analysis of trend by time series analysis. Results indicated good agreement between all methods in diagnosing premenstrual syndrome, especially between percentage change and effect size. Within each method, agreement between cycles was low. It is concluded that the choice of a method probably should depend on the investigator's circumstances rather than on the method itself. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Menstrual cycle and premenstrual syndrome: Modifiers of cardiovascular reactivity in women.

15 women prospectively diagnosed with premenstrual syndrome (PMS) and 15 non-PMS women were each tested twice for cardiovascular stress reactivity and behavioral performance, once during the follicular phase and once during the luteal phase of their cycle. Although blood pressure and heart rate responses to stress did not differ across the menstrual cycle in either group of women, for the non-PMS women, differences in hemodynamic responses were observed across the 2 phases. The luteal phase was associated with greater stroke volume responses and lesser vascular tone. For the PMS women, none of their cardiovascular measures differed across their cycle. Instead, these women showed significantly attenuated blood pressure and heart rate responses compared with non-PMS women, irrespective of cycle phase. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Perimenstrual symptom prevalence rates: an Italian-American comparison

The purposes of this study were to determine the prevalence of perimenstrual symptoms among a randomly selected group of Italian women by using a standardized menstrual symptom instrument and to compare them with those from a census-based sample of free-living American women in the study by Woods et al. (Am J Public Health 1982;72:1257-64). Italian menstrual symptom prevalence rates were obtained as part of a 1984 national health screening project using the Moos Menstrual Distress Questionnaire translated into Italian. A total of 306 of the 426 randomly invited women between ages 20 and 49 years participated (71.8% participation rate). After determination of ineligible participants (those who were postmenopausal, posthysterectomy, and pregnant), a total of 239 subjects were interviewed. Italian women reported the highest prevalence of symptoms during the menstrual phase and the lowest prevalence during the remainder of the cycle. The cross-cultural comparison indicates that, overall, Italian women reported higher prevalence of symptoms across the three phases of the cycle than did the American women, even though this difference was the smallest during the premenstrual phase. Prevalence rates of a number of classic premenstrual symptoms (e.g., breast tenderness) and affective symptoms (e.g., tension and avoid social activities) were found to be similar for the Italian and American samples. This study, while it identifies a sociocultural component to symptom reporting, indicates the presence of premenstrual distress symptoms in diverse cultural settings, even in women who are generally unaware of premenstrual syndrome. These findings lend support to the validity of the premenstrual phase distress experience and suggest the existence of the premenstrual syndrome across diverse cultures.     

Sex hormones affect spatial abilities during the menstrual cycle.

The aim of this study was (a) to show that different measures of spatial cognition are modulated by the menstrual cycle and (b) to analyze which steroid is responsible for these cognitive alterations. The authors collected blood samples in 3-day intervals over 6 weeks from 12 young women with a regular menstrual cycle to analyze concentrations of estradiol, progesterone, testosterone, luteinizing hormone, and follicle-stimulating hormone. The performance on 3 spatial tests was measured during the menstrual and the midluteal phases. A significant cycle difference in spatial ability as tested by the Mental Rotation Test was found, with high scores during the menstrual phase and low scores during the midluteal phase. Testosterone had a strong and positive influence on mental rotation performance, whereas estradiol had a negative one. These results clearly indicate that testosterone and estradiol are able to modulate spatial cognition during the menstrual cycle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of gender, menstrual phase and practice on the perceived location of the midsagittal plane

Women show menstrual phase-related cognitive changes that suggest altered hemispheric activation for a particular task, such that they demonstrate the greatest lateral performance differences on prototypical left hemisphere tasks during the luteal phase and on prototypical right hemisphere tasks during menstruation. Additionally, menstrual phase may alter total cerebral responsiveness, such that response times and performance accuracy for many tasks are best during the luteal phase and most impaired during the menstrual phase. We evaluated the effect of menstrual phase on spatial bisection (a perceptuospatial task) to help further understand hormonally-mediated changes in interhemispheric dynamics. Healthy young adult women and men blindly pointed to their midsagittal plane with either hand. Women were repeatedly tested according to menstrual phase, and men were tested at similar intervals. The mean pointing error in the luteal phase differed significantly from that of all other phases and did not differ significantly from those of men, who pointed significantly to the left across test sessions. These findings suggest that, in space bisection tasks, women are more likely to have asymmetric hemispheric activation during the luteal phase than during the menstrual phase. Thus, space bisection did not resemble other prototypical right hemisphere behaviors. The luteal phase may have nonspecifically activated both hemispheres on this task instead of suppressing right hemisphere function, and a slight functional asymmetry favoring the right hemisphere may have been promoted. In addition, intermanual pointing discrepancies in both subject groups decreased over repeated sessions. This suggests that, while practice alters an internal kinesthetic reference, it does not influence an imaginal extrapersonal spatial reference.