Body image changes over the menstrual cycle in normal women

Probing corporeal awareness in women through virtual reality induction of embreathment illusion

We capitalized on the respiratory bodily illusion that we discovered in a previous study and called 'Embreathment' where we showed that breathing modulates corporeal awareness in men. Despite the relevance of the issue, no such studies are available in women. To bridge this gap, we tested whether the synchronization of avatar-participant respiration patterns influenced females' bodily awareness. We collected cardiac and respiratory interoceptive measures, administered body (dis)satisfaction questionnaires, and tracked participants' menstrual cycles via a mobile app. Our approach allowed us to characterize the 'Embreathment' illusion in women, and explore the relationships between menstrual cycle, interoception and body image. We found that breathing was as crucial as visual appearance in eliciting feelings of ownership and held greater significance than any other cue with respect to body agency in both women and men. Moreover, a positive correlation between menstrual cycle days and body image concerns, and a negative correlation between interoceptive sensibility and body dissatisfaction were found, confirming that women's body dissatisfaction arises during the last days of menstrual cycle and is associated with interoception. These findings have potential implications for corporeal awareness alterations in clinical conditions like eating disorders and schizophrenia.

The Establishment of a Mouse Model of Recurrent Primary Dysmenorrhea

Primary dysmenorrhea is one of the most common reasons for gynecologic visits, but due to the lack of suitable animal models, the pathologic mechanisms and related drug development are limited. Herein, we establish a new mouse model which can mimic the periodic occurrence of primary dysmenorrhea to solve this problem. Non-pregnant female mice were pretreated with estradiol benzoate for 3 consecutive days. After that, mice were injected with oxytocin to simulate menstrual pain on the 4th, 8th, 12th, and 16th days (four estrus cycles). Assessment of the cumulative writhing score, uterine tissue morphology, and uterine artery blood flow and biochemical analysis were performed at each time point. Oxytocin injection induced an equally severe writhing reaction and increased PGF_2α accompanied with upregulated expression of COX-2 on the 4th and 8th days. In addition, decreased uterine artery blood flow but increased resistive index (RI) and pulsatility index (PI) were also observed. Furthermore, the metabolomics analysis results indicated that arachidonic acid metabolism; linoleic acid metabolism; glycerophospholipid metabolism; valine, leucine, and isoleucine biosynthesis; alpha-linolenic acid metabolism; and biosynthesis of unsaturated fatty acids might play important roles in the recurrence of primary dysmenorrhea. This new mouse model is able to mimic the clinical characteristics of primary dysmenorrhea for up to two estrous cycles.

A Narrative Review of Sex Differences in Eating Disorders: Is There a Biological Basis?

PURPOSE

Eating disorders and their core symptoms (eg, binge eating, body weight/shape concerns) disproportionately affect females, and these sex-differentiated effects become prominent during and after puberty. Although psychosocial influences such as heightened sociocultural pressures for thinness in girls and women contribute to this sex imbalance, biological factors could also play an important role.

METHODS

This narrative review summarizes evidence of biological factors underlying the sex-differentiated prevalence of eating pathology as well as within-sex variability in risk.

FINDINGS

There are sex differences in the pubertal emergence of genetic effects on eating pathology (adrenarche in males; gonadarche in females), and at least some genetic contributions to eating pathology seem to vary between the sexes. Furthermore, sex steroid hormones (eg, testosterone, estradiol, progesterone) are leading contributors to differential risk for eating pathology in males and females across the life span. Emerging data suggest that between-sex and within-sex variability in risk might occur via hormone-driven modulation (activation/deactivation) of genetic influences and neural responsiveness to food-related cues.

IMPLICATIONS

There is a biological basis to heightened risk for eating pathology in females, relative to males, as well as unique biological influences within each sex. Findings from this review highlight the importance of studying both sexes and considering sex-specific biological mechanisms that may underlie differential risk for eating pathology.

Evolution, the Menstrual Cycle, and Theoretical Overreach

A considerable amount of recent psychological research has attributed a variety of menstrual-cycle-related changes in social behavior to evolutionarily adaptive functions. Although these studies often draw interesting and unusual conclusions about female emotion and behavior within evolutionary theory, their significant limitations have not yet been addressed. In this article, we outline several methodological and conceptual issues related to the menstrual cycle that constitute threats to the internal validity and theoretical integrity of these studies. We recommend specific guidelines to address these issues and emphasize the need to apply more comprehensive and sophisticated theoretical structures when considering menstrual-cycle-related changes in emotion and behavior.

“I feel fat and ugly and hate myself”: Self-objectification through negative constructions of premenstrual embodiment

The body is central to women’s construction of premenstrual change as premenstrual syndrome (PMS), and to experiences of premenstrual distress. Embodied change, such as bloating or breast tenderness, can act as a marker of PMS. Within biomedical models, PMS is located within the body. Women’s dissatisfaction with their bodies is also reported to be higher in the premenstrual phase of the cycle. What is absent from this analysis is the meaning and experience of embodied change, in the context of broader constructions of femininity and embodiment. In this paper, we adopt a feminist material-discursive theoretical framework to examine the role of premenstrual embodiment in women’s premenstrual distress, drawing on open-ended survey responses and interviews with 83 women who self-diagnose as “PMS sufferers”. We theorize premenstrual body hatred as subjectification, wherein women take up cultural discourse associated with idealized femininity and the stigmatization of the fat body, resulting in self-objectification, distress and dehumanization. However, women can resist negative cultural constructions of premenstrual embodiment. We describe the impact of psychological therapy which increases awareness of emotional and embodied change, resulting in greater acceptance of the premenstrual body and self-care, serving to reduce premenstrual distress and self-objectification.

Menstrual attitude dimensions, Anxiety and Body Esteem in adolescent girls

One of the horrifying experiences that adolescent girls endure is menstruation. Understanding how some individual-related factors affect menstrual attitudes has substantial implications for coping with difficulties that come with it. We tested the direct and interactive effect of anxiety and body esteem dimensions (attribution, weight & appearance) on dimensions of menstrual attitudes (debilitating, bothersome, natural, prediction & denial) among adolescent girls in Ibadan, Nigeria. This is a cross- sectional survey of 276 secondary schools girls aged 12-19 years (M= 14.89, SD= 1.46). Multivariate Analysis of Variance results revealed adolescent girls with lower anxiety reported positive menstrual attitude by anticipating the onset of menstruation. Body esteem-appearance directly influenced both debilitating and bothersome dimensions of menstrual attitude; suggesting girls with higher body esteem for appearance positively accept menstrual experience as weakening and inconvenient. Interactively, anxiety and appearance dimension of body esteem influenced prediction dimension; likewise anxiety, weight and attribution dimensions of body esteem. It is concluded that body esteem and less anxiety are important for adolescent girls' positive menstrual attitudinal change. Thus, reduced apprehension and high self-respect for body appearance and weight are recommended for accepting menstruation as a normal bodily function occurrence during a woman's reproductive lifespan.

Hormones Matter? Association of the Menstrual Cycle With Selective Attention for Liked and Disliked Body Parts

Body dissatisfaction is wide spread among women and is considered a risk factor for eating pathology. Therefore, it is clinically relevant to investigate potential influencing factors. While previous research has mainly revealed inconsistent findings for attentional processes in body perception, the present study aimed to investigate the association of menstrual cycle phase with body satisfaction and its perception. In a within subject design, 16 women with a natural menstrual cycle (NC) and 19 women who used hormonal contraception (HC) rated their bodily attractiveness and underwent a 3-minute mirror exposure while their eye movements were recorded at two different times during their cycle (NC: ovulation vs. late luteal phase; HC: mid vs. end of cycle). At ovulation, NC women felt more attractive and gazed less at unattractive body parts in contrast to the late luteal phase, where they felt less attractive and gazed more at unattractive body parts. There was no difference in the gaze pattern for the attractive body parts at ovulation and late luteal phase. Notably, HC women showed a balanced gazed pattern at attractive and unattractive body at both times. The menstrual cycle phase is associated with women's self-rated attractiveness and selective attention when looking at their own body. It should therefore be taken into account in clinical research addressing body image.

Ovulatory Shifts in Sexual Desire But Not Mate Preferences: An LH-Test-Confirmed, Longitudinal Study

The presented data are part of a longitudinal within-subject study designed to examine ovulatory shifts in human sexuality in a diverse German sample using validated questionnaires. The final sample consists of 78 individuals (76 female, 2 agender) who declared to be mainly or exclusively attracted to males. Questionnaires were completed anonymously online at three cycle phases. Following the gold standard, the fertile window was calculated through the reverse cycle day method and confirmed via urinary tests detecting luteinizing hormone. The questionnaire included the Sexual Desire Inventory, Dresdner Body Image Inventory, the Revised Sociosexual Orientation Inventory, and an adjective list to measure mate preferences. One hundred eighty-four questionnaires were included in the data analysis using linear mixed models. Findings support previous research reporting heightened sexual desire and an improved body image during the fertile window. No shifts were found for mate preference or sociosexual orientation, thus adding to a growing body of literature contesting parts of the ovulatory shift hypothesis.

Reproductive and Appetite Hormones and Bulimic Symptoms during Midlife

Eating disorders and related symptoms occur during midlife; however, little is known about their aetiology. It has been hypothesised that perimenopause represents a window of vulnerability for the development or exacerbation of eating disorder symptomatology because, like puberty, perimenopause is a period of reproductive hormone change. We compared symptoms of bulimia nervosa (bulimic symptomatology) assessed via mean scores on a self-report questionnaire in premenopausal and perimenopausal women. We also examined the association between hormone concentrations (reproductive/appetite) and bulimic symptomatology. No mean differences in bulimic symptomatology were observed between premenopause and perimenopause. However, there was a significant positive association between leptin and binge eating. Although no significant associations between reproductive hormones and bulimic symptomatology were observed, additional research is needed to provide definitive information. It is essential to learn more about the aetiology of eating disorders and related symptomatology across the lifespan in order to develop age-relevant treatment and prevention programs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

THE ASSOCIATION BETWEEN MENSTRUAL CYCLE CHARACTERISTICS AND PERCEIVED BODY IMAGE: A CROSS-SECTIONAL SURVEY OF POLISH FEMALE ADOLESCENTS

The increasing prevalence of negative body perceptions among adolescent girls and the tendency towards wishing to be thinner have become a cultural norm in Western culture. Adolescent girls are particularly vulnerable to developing a negative body image due to physical and sexual changes occurring during puberty. This study aimed to evaluate the association between different measures of body image perceptions and different phases of the menstrual cycle after controlling for weight status and other potential confounders in Polish adolescent girls aged 12-18 years. Three-hundred and thirty participants of a cross-sectional survey conducted in 2009, normally cycling and with no eating disorders, completed a background questionnaire and the Stunkard Figure Rating Scale, and their anthropometric measurements were collected. The dependent outcome variables were measures of body image (actual body image, ideal body image and ideal-self discrepancy) and dichotomous body image perception (satisfied versus dissatisfied) adjusted for other predictor factors: socio-demographic variables, menstrual history and cycle phases, and weight status. One-way ANOVA indicated that weight status, age at menarche and menstrual cycle phase were associated with actual body image and rate of ideal-self discrepancy. Ideal body image was associated with weight status and menstrual cycle phase. General logistic regression models were constructed to evaluate associations of body dissatisfaction and all potential predictor variables. The final selected model of the multiple logistic regression analysis using the backward elimination procedure revealed that adjusted for other factors, negative body image was significantly associated with different phases of the menstrual cycle (p trend=0.033) and increasing body weight status (p trend=0.0007). The likelihood of body dissatisfaction was greatest during the premenstrual phase of the menstrual cycle (OR=2.38; 95% CI 1.06, 5.32) and among girls in obesity class I (OR=8.04; 95% CI 2.37, 27.26). The study confirmed the association between body image dissatisfaction in adolescent girls and different phases of the menstrual cycle after controlling for weight status. The issue of negative body self-image is not only of cognitive, but also of practical value as understanding better the factors contributing to the formation of a negative body image may be instrumental in developing preventive health programmes targeted at young people.

The effects of ovarian hormones and emotional eating on changes in weight preoccupation across the menstrual cycle

OBJECTIVE

Previous research has shown that fluctuations in ovarian hormones (i.e., estradiol and progesterone) predict the changes in binge eating and emotional eating across the menstrual cycle. However, the extent to which other eating disorder symptoms fluctuate across the menstrual cycle and are influenced by ovarian hormones remains largely unknown. This study sought to examine whether the levels of weight preoccupation vary across the menstrual cycle and whether the changes in ovarian hormones and/or other factors (i.e., emotional eating and negative affect) account for menstrual cycle fluctuations in this eating disorder phenotype.

METHOD

For 45 consecutive days, 352 women (age, 15-25 years) provided daily ratings of weight preoccupation, negative affect, and emotional eating. Saliva samples were also collected on a daily basis and assayed for levels of estradiol and progesterone using enzyme immunoassay techniques.

RESULTS

Weight preoccupation varied significantly across the menstrual cycle, with the highest levels in the premenstrual and menstrual phases. However, ovarian hormones did not account for within-person changes in weight preoccupation across the menstrual cycle. Instead, the most significant predictor of menstrual cycle changes in weight preoccupation was the change in emotional eating.

DISCUSSION

Fluctuations in weight preoccupation across the menstrual cycle appear to be influenced primarily by emotional eating rather than ovarian hormones. Future research should continue to examine the relationships among ovarian hormones, weight preoccupation, emotional eating, and other core eating disorder symptoms (e.g., body dissatisfaction, compensatory behaviors) in an effort to more fully understand the role of these biological and behavioral factors for the full spectrum of eating pathology.

Association between Different Phases of Menstrual Cycle and Body Image Measures of Perceived Size, Ideal Size, and Body Dissatisfaction

The association between phases of the menstrual cycle and body image was investigated. 44 university women ( M age = 23.3 yr., SD = 4.7) judged their perceived and ideal body size, and body dissatisfaction was calculated at each phase of the menstrual cycle, including premenstrual, menstrual, and intermenstrual. Participants selected one of nine figural drawings ranging from very thin to obese that represented their perceived size and ideal size. Body dissatisfaction was measured as the absolute difference between scores on perceived and ideal figural drawings. During each menstrual phase, anthropometric measures of weight, height, body mass index, circumference of waist and abdomen, and body composition were taken. There were no significant differences in any anthropometric measures between the three menstrual cycle phases. Perceived body size and body dissatisfaction were significantly different between menstrual phases, with the largest perceived body size and highest body dissatisfaction occurring during the menstrual phase. Ideal body size did not differ between menstrual phases, although participants desired a significantly smaller ideal size as compared to the perceived size.

Differential associations between ovarian hormones and disordered eating symptoms across the menstrual cycle in women

OBJECTIVE

We examined changes in drive for thinness, body dissatisfaction, and dietary restraint across the menstrual cycle and associations between these symptoms and ovarian hormones in two independent samples of women (N = 10 and 8 women, respectively) drawn from the community.

METHOD

Daily self-report measures of disordered eating and negative affect were completed for 35-65 days. Daily saliva samples were assayed for estradiol and progesterone in Study 2 only.

RESULTS

Levels of body dissatisfaction and drive for thinness were highest during the mid-luteal/pre-menstrual phases in both studies and were negatively associated with estradiol, and positively associated with progesterone. By contrast, dietary restraint showed less variation across the menstrual cycle and weaker associations with ovarian hormones.

DISCUSSION

Differential associations between ovarian hormones and specific disordered eating symptoms point to distinct etiological processes within the broader construct of disordered eating.

Body-Image Perception and Dissatisfaction Throughout Phases of the Female Menstrual Cycle

This pilot study investigated the association between the menstrual cycle and participants' body-size perception, judgments of ideal body size, detection of changes in body size, and body dissatisfaction. Thirty participants ( M age = 23.3 yr., SD = 3.9), who did not have eating disorders, viewed digital images of their bodies. Judgments on all tasks were made during premenstrual, intermenstrual, and menstrual phases of the menstrual cycle. Participants expressed a desire for a smaller ideal body size for themselves in all three phases. Body dissatisfaction was significantly greater during the premenstrual and menstrual phases. The menstrual cycle was not associated with significant changes in body-size perception, ideal size judgments, or detection of changes in body size.

Body dissatisfaction and irrational beliefs

To test the hypothesis that the irrational evaluative beliefs, postulated by Rational-Emotive Behavior Therapy, are associated with body dissatisfaction, 94 women (21 diagnosed with an eating disorder, 38 with high body dissatisfaction but without an eating disorder, and 35 with low body dissatisfaction) completed the Survey of Personal Beliefs and the Eating Disorders Inventory. Analysis showed no significant difference in body dissatisfaction between the Eating Disordered and High Body Dissatisfaction subgroups. No significant correlations between body dissatisfaction and irrational beliefs were found for the Eating Disordered subgroup. For the High Body Dissatisfaction subgroup, significant but low correlations were found between scores on body dissatisfaction and irrational standards for self and others and with negative self-rating. In terms of irrational beliefs the Eating Disordered and High Body Dissatisfaction subgroups showed a significantly greater tendency towards Catastrophizing, Low Frustration Tolerance, and Negative self-rating, compared to the controls, without any significant difference between the former two groups. The Eating Disordered subgroup but not the High Body Dissatisfaction subgroup differed significantly from the controls in terms of more Self-directed demands.

Reconceptualization of body image and drive for thinness

OBJECTIVE

This study examined the nature of body image and drive for thinness as multidimensional constructs. Subjects included 111 early adolescent (ages 11-13) girls in Grades 7 and 8 from a private school in Melbourne.

METHOD

The participants completed a suite of perceptual, affective/attitudinal, and behavioral measures that included assessment of body mass index, self-concept, body parts, silhouette discrepancy, self-worth, multidimensional body image, body image dissatisfaction, social physique anxiety, eating attitudes and behaviors, and physical activity.

RESULTS

The sample reported moderate levels of body image dissatisfaction and a significant association of body image dissatisfaction with drive for thinness. Findings verified the important contribution of the affective/attitudinal components of body image.

DISCUSSION

A multidimensional scale devised to test the value of a combined index of self-perceived size, shape, weight, tone, and appearance proved the most effective predictor among the alternative affective/attitudinal scales of body image dissatisfaction. Drive for thinness, as central to this study, was found to be related to, yet distinct from, body image on the basis of behavioral elements such as dieting and activity levels. These findings have ramifications for the design of future research in the body image, drive for thinness, and disordered eating domains. 2000 by John Wiley & Sons, Inc.

Body image disturbances and their change with videofeedback in anorexia nervosa

Disturbance in the way the body is experienced is a diagnostic criterion for anorexia nervosa, and impedes recovery. A method relatively free of external prompts, to reduce the potential for experimentally induced biases, evaluated body image distortions (BID) in 18 patients with anorexia nervosa soon after admission to an inpatient unit, and 18 normal controls, before and after a videofeedback session. The BID were assessed in the affective and self/social domains by visual analogue scales in which the instructional set oriented subjects to (a) the sensation of fatness (Affective Response, AR), and (b) size compared with other young women (Comparative Size Response, CSR). The AR and CSR were significantly greater than normal in anorexia but decreased significantly with videofeedback, while values for controls were stable. The AR and CSR were only partially independent, indicating overlap of the domains. In anorexia only, the responses were related to two DSM-IV diagnostic criteria for anorexia, fear of gaining weight and health-weight concerns, as well as to drive for thinness and body dissatisfaction. Fear of gaining weight occupied a central position in determining the magnitudes of BID and the other measures, including anxiety and depression.