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Freemas JA, Baranauskas MN, Constantini K, Constantini N, Greenshields JT, Mickleborough TD, Raglin JS, Schlader ZJ. Exercise Performance Is Impaired during the Midluteal Phase of the Menstrual Cycle. Med Sci Sports Exerc 2021; 53:442-452. [PMID: 32694375 DOI: 10.1249/mss.0000000000002464] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to test the hypothesis that aerobic exercise performance is impaired in the midluteal (ML) compared with the midfollicular (MF) phase of the menstrual cycle. METHODS Twelve recreationally active eumenorrheic women (25 ± 6 yr) completed exercise sessions during the MF and the ML phases. Each session consisted of an 8-km cycling time trial that was preceded by 10 min of cycling performed at a constant power below and above gas exchange threshold. Heart rate, ventilation, and oxygen uptake were continuously measured. RPE and ratings of fatigue were assessed during the time trial using visual analog scales. Total mood disturbance was calculated from the POMS questionnaire administered before and 20 min postexercise. RESULTS Salivary progesterone concentration was 578 ± 515 pg·mL-1 higher in ML compared with MF phase (P < 0.01), whereas estradiol concentration did not differ between phases (167 ± 55 vs 206 ± 120 pg·mL-1, P = 0.31). Total mood disturbance before exercise was greater during the ML phase compared with the MF phase (P < 0.01), but this difference was abolished postexercise (P = 0.14). Mean power output was lower during the ML phase (115 ± 29 vs 125 ± 28 W, P < 0.01), which led to a slower time trial in the ML phase (18.3 ± 2.0 min) compared with the MF phase (17.8 ± 1.7 min, P = 0.03). Ratings of fatigue were greater during the ML phase from 2 to 8 km (P ≤ 0.01), whereas no differences in RPE were observed. Heart rate (P = 0.85), minute ventilation (P = 0.53), and oxygen uptake (P = 0.32) did not differ between phases during the time trial. CONCLUSION Aerobic exercise performance is worse in the ML phase compared with the MF phase in recreationally active women, which was accompanied by a more negative mood state preexercise and increased ratings of fatigue.
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Affiliation(s)
- Jessica A Freemas
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
| | - Marissa N Baranauskas
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
| | - Keren Constantini
- School of Public Health, Sackler Faculty of Medicine and Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, ISRAEL
| | - Naama Constantini
- Shaare Zedek Medical Center, affiliated to the Hebrew University, Jerusalem, ISRAEL
| | - Joel T Greenshields
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
| | - Timothy D Mickleborough
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
| | - John S Raglin
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
| | - Zachary J Schlader
- H.H. Morris Human Performance Laboratories, Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN
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Eisenlohr-Moul TA, Kaiser G, Weise C, Schmalenberger KM, Kiesner J, Ditzen B, Kleinstäuber M. Are there temporal subtypes of premenstrual dysphoric disorder?: using group-based trajectory modeling to identify individual differences in symptom change. Psychol Med 2020; 50:964-972. [PMID: 31010447 PMCID: PMC8168625 DOI: 10.1017/s0033291719000849] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a new Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis characterized by the cyclical emergence of emotional and physical symptoms in the luteal phase of the menstrual cycle, with symptom remission in the follicular phase. Converging evidence highlights the possibility of distinct subtypes of PMDD with unique pathophysiologies, but temporal subgroups have yet to be explored in a systematic way. METHODS In the current work, we use group-based trajectory modeling to identify unique trajectory subgroups of core emotional and total PMDD symptoms across the perimenstrual frame (days -14 to +9, where day 0 is menstrual onset) in a sample of 74 individuals prospectively diagnosed with DSM-5 PMDD. RESULTS For the total daily symptom score, the best-fitting model was comprised of three groups: a group demonstrating moderate symptoms only in the premenstrual week (65%), a group demonstrating severe symptoms across the full 2 weeks of the luteal phase (17.5%), and a group demonstrating severe symptoms in the premenstrual week that were slow to resolve in the follicular phase (17.5%). CONCLUSIONS These trajectory groups are discussed in the context of the latest work on the pathophysiology of PMDD. Experimental work is needed to test for the presence of possible pathophysiologic differences in trajectory groups, and whether unique treatment approaches are needed.
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Foster R, Vaisberg M, Bachi ALL, Dos Santos JDMB, de Paula Vieira R, Luna-Junior LA, Araújo MP, Parmigiano TR, Borges F, Di-Bella ZIKJ. Premenstrual Syndrome, Inflammatory Status, and Mood States in Soccer Players. Neuroimmunomodulation 2019; 26:1-6. [PMID: 30654383 DOI: 10.1159/000494559] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/13/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between the inflammatory profile and mood states in the different phases of the menstrual cycle in soccer players with and without premenstrual syndrome (PMS). METHODS Data on the menstrual cycle and mood states were collected using the Daily Symptom Report and the Brunel Mood Scale. Cytokine and stress hormone concentrations were measured in urine by flow cytometry before and after a game in the luteal phase and in the follicular phase of one menstrual cycle. RESULTS In all, 59.6% of the athletes had PMS. The PMS group showed higher concentrations of interleukin (IL)-1β, IL-6, and IL-8 than the athletes without PMS. After the game, IL-6 decreased in the follicular phase and the luteal phase. The tumor necrosis factor-α levels were higher in the group without PMS during the post-game follicular phase than before the game. In the PMS group, tension was higher in the follicular phase before the game and depression was higher in the pre-game luteal phase than in the group without PMS. The PMS group also presented a negative correlation between depression and IL-10 levels in the pre-game follicular phase. Finally, in the pre-game luteal phase were found positive correlations between growth hormone and IL-10. CONCLUSION PMS influences the inflammatory condition related to mood states and stress hormones in female soccer players.
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Affiliation(s)
- Roberta Foster
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil
| | - Mauro Vaisberg
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil,
| | - André Luis Lacerda Bachi
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | - Rodolfo de Paula Vieira
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
- Postgraduate Program in Sciences of Human Movement and Rehabilitation, Federal University of São Paulo, Campus Baixada Santista, Santos, Brazil
| | - Luiz Antonio Luna-Junior
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
| | - Maita Poli Araújo
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Fernanda Borges
- Nephrology Division of the Medicine Department, Federal University of São Paulo, São Paulo, Brazil
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Espin L, Villada C, Hidalgo V, Salvador A. Effects of sex and menstrual cycle phase on cardiac response and alpha- amylase levels in psychosocial stress. Biol Psychol 2018; 140:141-148. [PMID: 30552951 DOI: 10.1016/j.biopsycho.2018.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 10/30/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022]
Abstract
The impact of sex and the menstrual cycle phase on the autonomic response to psychosocial stress remains controversial. This study explored autonomic nervous system activity through salivary alpha-amylase, heart rate, and heart rate variability responses to the Trier Social Stress Test (TSST) in healthy young people. The sample was composed of 25 men, 26 women in the luteal phase, and 25 women in the follicular phase, from 18 to 25 years of age. Participants were exposed to the TSST or a control condition. The results indicate that women in their follicular phase showed a blunted alpha-amylase response to stress compared to men and women in the luteal phase. In addition, men showed higher sympatho-vagal activity in the stress condition compared to the two groups of women. These results confirm that sex and the menstrual cycle phase are potential modulators of autonomic nervous system reactivity to psychosocial stress.
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Affiliation(s)
- Laura Espin
- Department of Human Anatomy and Psychobiology, University of Murcia, 30100 Murcia, Spain; Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain.
| | - Carolina Villada
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain; Department of Cognitive and Behavioral Neurobiology, Institute of Neurobiology, National Autonomous University of Mexico, Juriquilla, Querétaro, Mexico
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain; IIS Aragón, Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain
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Apkhazava M, Kvachadze I, Tsagareli M. [CORRELATION BETWEEN HEAT PAIN THRESHOLD DEGREE AND TRPV1 RECEPTOR PROTEIN LEVEL OVER VARIOUS PHASES OF THE OVARIAN-MENSTRUAL CYCLE]. Georgian Med News 2018:117-123. [PMID: 29578437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Numerous scientific studies demonstrating differences in pain sensitivity over various phases of the ovarian-menstrual cycle (OMC) in healthy women have been published in recent decades, but the basis for these differences is however still poorly understood. The aim of the current study was to assess the correlation between the heat pain threshold degree and the dynamics of TRPV1 (Transient receptor potential channeling subfamily V member1) receptor protein level, as well as aggression degree in healthy women in the follicular and luteal phases of OMC. An increased TRPV1 receptor protein level and a decreased thermal pain threshold were found in the luteal phase of the OMC. The study revealed a correlation of the progesterone level in the luteal phase with a degree of increase of TRPV1 level, as well as with the degree of decrease of heat pain threshold. The relationship between the degree of pain threshold, as well as TRPV1 level with follicle stimulating (FSH), luteinizing (LH) hormones and prolactin levels was not found. Also, there was no correlation between TRPV1 or heat pain threshold levels and aggression degree.
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Affiliation(s)
- M Apkhazava
- Tbilisi State Medical University, department of Physiology, Georgia
| | - I Kvachadze
- Tbilisi State Medical University, department of Physiology, Georgia
| | - M Tsagareli
- Tbilisi State Medical University, department of Physiology, Georgia
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Armbruster D, Kirschbaum C, Strobel A. The not-so-bitter pill: Effects of combined oral contraceptives on peripheral physiological indicators of emotional reactivity. Horm Behav 2017; 94:97-105. [PMID: 28676251 DOI: 10.1016/j.yhbeh.2017.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 02/07/2023]
Abstract
Combined oral contraceptives (COC) are used by millions of women worldwide. Although findings are not entirely consistent, COC have been found to impact on brain function and, thus, to modulate affective processes. Here, we investigated electro-physiological responses to emotional stimuli in free cycling women in both the early follicular and late luteal phase as well as in COC users. Skin conductance response (SCR), startle reflex, corrugator and zygomaticus activity were assessed. COC users showed reduced overall startle magnitude and SCR amplitude, but heightened overall zygomaticus activity, although effect sizes were small. Thus, COC users displayed reduced physiological reactions indicating negative affect and enhanced physiological responses signifying positive affect. In free cycling women, endogenous 17β-estradiol levels were associated with fear potentiated startle in both cycle phases as well as with SCR and zygomaticus activity during the follicular phase. Testosterone was associated with corrugator and zygomaticus activity during the luteal phase, while progesterone levels correlated with corrugator activity in the follicular phase. To the contrary, in COC users, endogenous hormones were not associated with electro-physiological measures. The results further underscore the importance of considering COC use in psychophysiological studies on emotional processing.
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Affiliation(s)
- Diana Armbruster
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany.
| | - Clemens Kirschbaum
- Biological Psychology, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
| | - Alexander Strobel
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
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Diekhof EK. Be quick about it. Endogenous estradiol level, menstrual cycle phase and trait impulsiveness predict impulsive choice in the context of reward acquisition. Horm Behav 2015; 74:186-93. [PMID: 26092059 DOI: 10.1016/j.yhbeh.2015.06.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/26/2015] [Accepted: 06/11/2015] [Indexed: 11/20/2022]
Abstract
This article is part of a Special Issue "Estradiol and Cognition". Variations in the steroid hormone 17ß-estradiol (E2) may promote intra-individual differences in reward seeking behavior and temporal decision-making (Reimers et al., 2014; Front. Neurosci. 8: 401). Yet, in humans the exact role of E2 in impulsive choice still needs to be determined. The present study assessed the effect of a cycle-dependent rise in endogenous E2 on temporal response adaptation across the follicular phase (FP). For this purpose a reward acquisition paradigm was employed that is sensitive to hormone-induced changes in central dopamine (DA) level. The present data show that women acted more impulsively in the early as opposed to the late FP. Early follicular E2 further correlated with an increased capacity to speed up for reward maximization, while simultaneously the ability to wait for higher reward was compromised. This correlation was most pronounced in women with low trait impulsiveness. In contrast, E2 and optimized response speed failed to correlate in women with high trait impulsiveness and in the late FP, despite a generally higher E2 level. Collectively, these findings support the theory that E2 may act as an endogenous DA agonist. The fact that the hormone-behavior relationship was restricted to women with low trait impulsiveness and thus supposedly lower central DA level provides indirect support for this idea. Yet, choices became relatively less impulsive in the state of heightened E2 (i.e., in the late FP), suggesting that the relationship between E2 and impulsive choice may not be linear, but might resemble an inverted U-function.
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Affiliation(s)
- Esther K Diekhof
- Biocenter Grindel and Zoological Museum, Department of Human Biology, Neuroendocinology Unit, Hamburg University, Martin-Luther-King Platz 3, D-20146 Hamburg, Germany.
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Kromrey SA, Czoty PW, Nader MA. Relationship between estradiol and progesterone concentrations and cognitive performance in normally cycling female cynomolgus monkeys. Horm Behav 2015; 72:12-9. [PMID: 25921587 PMCID: PMC4466063 DOI: 10.1016/j.yhbeh.2015.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/27/2023]
Abstract
Preclinical research has demonstrated that cognitive function may be influenced by estradiol (E2) and progesterone (P4) concentrations, although few cognition studies involve normally cycling females. The present study examined cognitive performance in normally cycling female cynomolgus macaques (n = 14), a species with similarities to humans in brain organization and a nearly identical menstrual cycle to women. Initial assessments compared cognitive measures to circulating concentrations of E2 and P4 (n = 12). Once a relationship was characterized between hormones and cognitive performance, the menstrual cycle was divided into four distinct phases: early follicular (EF), late follicular (LF), early luteal (EL) and late luteal (LL), verified by the onset of menses and serum concentrations of E2 and P4. Concentrations of E2 were highest during the LF phase and P4 concentrations peaked during the EL phase. All monkeys were trained on two cognitive tasks: reversal learning, involving simple discrimination (SD) and reversal (SDR), which measured associative learning and behavioral flexibility, respectively (n = 3-4 per phase) and a delayed match-to-sample (DMS) task which assessed working memory (n = 11). P4 concentrations were positively correlated with number of trials and errors during acquisition of SD performance, but not during acquisition of the SDR task or maintenance of the reversal-learning task. Across the menstrual cycle, significantly fewer errors were made in the SDR task during the LF phase, when E2 concentrations were high and P4 concentrations low. Working memory, assessed with the DMS task, was not consistently altered based on previously characterized menstrual cycle phases. These findings demonstrate a relationship between P4, E2 and cognitive performance in normally cycling cynomolgus monkeys that is task dependent. Knowledge of these interactions may lead to a better understanding of sex-specific cognitive performance.
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Affiliation(s)
- Sarah A Kromrey
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1083, United States
| | - Paul W Czoty
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1083, United States
| | - Michael A Nader
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1083, United States; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1083, United States.
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Goletiani NV, Siegel AJ, Lukas SE, Hudson JI. The effects of smoked nicotine on measures of subjective states and hypothalamic-pituitary-adrenal axis hormones in women during the follicular and luteal phases of the menstrual cycle. J Addict Med 2015; 9:195-203. [PMID: 25783522 PMCID: PMC4449300 DOI: 10.1097/adm.0000000000000117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine the acute effects of cigarette smoking on hypothalamic-pituitary-adrenal (HPA) axis hormones and subjective states as a function of the menstrual cycle in nicotine-dependent women. METHODS Seventeen healthy nicotine-dependent women were studied during the follicular and/or luteal phase of the menstrual cycle. Because of observation of a possible bimodal distribution of progesterone levels within the luteal phase group, we performed a set of a posteriori analyses. Therefore, we divided the luteal group into a low progesterone and a high progesterone groups. RESULTS Smoked nicotine activated HPA, measured by adrenocorticotropin hormone (ACTH), cortisol, and dehydroepiandrosterone (DHEA) response and affected subjective states in both follicular and luteal phases, with increased "High," "Rush," and decreased "Craving." The HPA stimulation revealed a blunting of ACTH response. There was only modest evidence for a blunting of subjective state responses in the luteal phase. However, upon post hoc analyses, the high progesterone luteal group showed a marked blunting of measures of subjective states and a blunted ACTH response. Examining the association between hormone and measures of subjective states revealed tentative associations of ACTH stimulation with increased "Rush" and "Craving," and DHEA stimulation with increased "Craving." CONCLUSIONS This pilot study suggests that menstrual cycle phase differences in progesterone levels may attenuate nicotine's addictive effects via diminution of its reinforcing properties and augmentation of its aversive effects interfering with the pleasure associated with cigarette smoking.
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Affiliation(s)
- Nathalie V Goletiani
- From the McLean Imaging Center (NVG, SEL) and Biological Psychiatry Laboratory (JIH), McLean Hospital, Belmont, MA; Department of Psychiatry (NVG, SEL, JIH), Harvard Medical School, Boston, MA; and Department of Internal Medicine (AJS), McLean Hospital and Harvard Medical School, Boston, MA
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Pletzer B, Petasis O, Cahill L. Switching between forest and trees: opposite relationship of progesterone and testosterone to global-local processing. Horm Behav 2014; 66:257-66. [PMID: 24874173 PMCID: PMC4139269 DOI: 10.1016/j.yhbeh.2014.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 11/19/2022]
Abstract
Sex differences in attentional selection of global and local components of stimuli have been hypothesized to underlie sex differences in cognitive strategy choice. A Navon figure paradigm was employed in 32 men, 41 naturally cycling women (22 follicular, 19 luteal) and 19 users of oral contraceptives (OCs) containing first to third generation progestins in their active pill phase. Participants were first asked to detect targets at any level (divided attention) and then at either the global or the local level only (focused attention). In the focused attention condition, luteal women showed reduced global advantage (i.e. faster responses to global vs. local targets) compared to men, follicular women and OC users. Accordingly, global advantage during the focused attention condition related significantly positively to testosterone levels and significantly negatively to progesterone, but not estradiol levels in a multiple regression model including all naturally cycling women and men. Interference (i.e. delayed rejection of stimuli displaying targets at the non-attended level) was significantly enhanced in OC users as compared to naturally cycling women and related positively to testosterone levels in all naturally cycling women and men. Remarkably, when analyzed separately for each group, the relationship of testosterone to global advantage and interference was reversed in women during their luteal phase as opposed to men and women during their follicular phase. As global processing is lateralized to the right and local processing to the left hemisphere, we speculate that these effects stem from a testosterone-mediated enhancement of right-hemisphere functioning as well as progesterone-mediated inter-hemispheric decoupling.
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Affiliation(s)
- Belinda Pletzer
- Department of Neurobiology & Behavior, University of California, Irvine, USA; Center for Neurobiology of Learning & Memory, University of California, Irvine, USA; Department of Psychology, University of Salzburg, Austria; Center for Cognitive Neuroscience, University of Salzburg, Austria.
| | - Ourania Petasis
- Department of Neurobiology & Behavior, University of California, Irvine, USA; Center for Neurobiology of Learning & Memory, University of California, Irvine, USA
| | - Larry Cahill
- Department of Neurobiology & Behavior, University of California, Irvine, USA; Center for Neurobiology of Learning & Memory, University of California, Irvine, USA
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Allen SS, Allen AM, Tosun N, Lunos S, al'Absi M, Hatsukami D. Smoking- and menstrual-related symptomatology during short-term smoking abstinence by menstrual phase and depressive symptoms. Addict Behav 2014; 39:901-6. [PMID: 24594903 DOI: 10.1016/j.addbeh.2014.01.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/16/2014] [Accepted: 01/29/2014] [Indexed: 12/01/2022]
Abstract
Menstrual phase and depressive symptoms are known to minimize quit attempts in women. Therefore, the influence of these factors on smoking- and menstrual-related symptomatology during acute smoking cessation was investigated in a controlled cross-over lab-study. Participants (n=147) completed two six-day testing weeks during their menstrual cycle with testing order randomly assigned (follicular vs. luteal). The testing week consisted of two days of ad libitum smoking followed by four days of biochemically verified smoking abstinence. Daily symptomatology measures were collected. Out of the 11 total symptoms investigated, six were significantly associated with menstrual phase and nine were significantly associated with level of depressive symptoms. Two significant interactions were noted indicating that there may be a stronger association between depressive symptoms with negative affect and premenstrual pain during the follicular phase compared to the luteal phase. Overall, these observations suggest that during acute smoking abstinence in premenopausal smokers, there is an association between depressive symptoms and symptomatology whereas menstrual phase appears to have less of an effect. Further study is needed to determine the effect of these observations on smoking cessation outcomes, as well as to define the mechanism of menstrual phase and depressive symptoms on smoking-related symptomatology.
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Affiliation(s)
- Sharon S Allen
- Department of Family Medicine & Community Health Medical School, University of Minnesota, 420 Delaware Street SE, Room A682, Minneapolis, MN 55455, United States
| | - Alicia M Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN 55414, United States
| | - Nicole Tosun
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street SE, Suite 132, Minneapolis, MN 55414, United States
| | - Mustafa al'Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota, Duluth 1035 University Drive, 236 SMed, D601A, Duluth, MN 55812, United States
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414, United States
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Suschinsky KD, Bossio JA, Chivers ML. Women's genital sexual arousal to oral versus penetrative heterosexual sex varies with menstrual cycle phase at first exposure. Horm Behav 2014; 65:319-27. [PMID: 24486567 DOI: 10.1016/j.yhbeh.2014.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/16/2014] [Accepted: 01/21/2014] [Indexed: 11/25/2022]
Abstract
Reproductive-aged women show increased interest in sexual activity during the fertile phase of the menstrual cycle that can motivate sexual behavior and thereby increase the likelihood of conception. We examined whether women demonstrated greater sexual responses (subjective and genital sexual arousal) to penetrative versus oral sexual activities during the fertile versus non-fertile phases of their cycles, and whether women's arousal responses were influenced by the phase during which they were first exposed to these sexual stimuli (e.g., Slob et al., 1991; Wallen and Rupp, 2010). Twenty-two androphilic women completed two identical sexual arousal assessments in which genital responses were measured with a vaginal photoplethysmograph and their feelings of sexual arousal were recorded. Women viewed an array of 90s films varying by couple type (female-female, male-male, female-male) and sexual activity type (oral or penetrative), during the fertile (follicular) and non-fertile (luteal) phases of their menstrual cycle, with the order of cycle phase at the first testing session counter-balanced. Women tested first in the fertile phase showed significantly greater genital arousal to female-male penetrative versus oral sex in both testing sessions, whereas self-reports of sexual arousal were not affected by cycle phase or testing order. These results contribute to a growing body of research suggesting that fertility status at first exposure to sexual stimuli has a significant effect on subsequent sexual responses to sexual stimuli, and that this effect may differ for subjective versus genital sexual arousal.
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Affiliation(s)
| | - Jennifer A Bossio
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Meredith L Chivers
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.
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Allen SS, Allen AM, Kotlyar M, Lunos S, Al'absi M, Hatsukami D. Menstrual phase and depressive symptoms differences in physiological response to nicotine following acute smoking abstinence. Nicotine Tob Res 2013; 15:1091-8. [PMID: 23155122 PMCID: PMC3646649 DOI: 10.1093/ntr/nts236] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 09/29/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Accumulating evidence has linked depressive symptoms and sex hormones to risk for relapse; however, the specific mechanisms involved in these associations remain unknown. This randomized crossover study assessed physiological response to nicotine by menstrual phase in female smokers with and without depressive symptoms following acute smoking abstinence. METHODS Females, ages 18-40 years with regular menstrual cycles, not on exogenous hormones or psychotropic medications, who reported smoking ≥ 5 cigarettes/day were enrolled. Participants were stratified into 2 groups: no depressive symptoms (NDS; n = 23) and depressive symptoms (DS; n = 24). After 4 days of biochemically verified smoking abstinence, participants completed 2 laboratory sessions in the follicular (F) and luteal (L) phases. Participants used nicotine nasal spray at Time 0, and blood pressure, heart rate, and serum nicotine were measured at Time -1, 5, 10, 20, 30, 45, 60, and 90 min. RESULTS Participants (n = 47) were 29.1 ± 6.8 years old and smoked an average of 12.5 ± 5.1 cigarettes/day. The NDS group had more pronounced menstrual phase differences (F > L) in diastolic blood pressure, heart rate, and maximum concentrations of nicotine compared with the DS group (p < .05). CONCLUSIONS This study observed an interaction between sex hormones and depressive symptoms such that those without depressive symptoms had a greater menstrual phase difference in the physiological response to nicotine. These data offer additional support for the role of sex hormones in the physiological response to nicotine, which may play a role in menstrual phase effects on smoking cessation.
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Affiliation(s)
- Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, Minneapolis, MN 55414, USA.
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14
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Allen AM, Allen SS, Lunos S, Pomerleau CS. Severity of withdrawal symptomatology in follicular versus luteal quitters: The combined effects of menstrual phase and withdrawal on smoking cessation outcome. Addict Behav 2010; 35:549-52. [PMID: 20167436 DOI: 10.1016/j.addbeh.2010.01.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 12/04/2009] [Accepted: 01/21/2010] [Indexed: 11/18/2022]
Abstract
Women are at an increased risk of relapse after a smoking cessation attempt. While the reasons for this phenomenon are not fully understood, recent research indicates that both the menstrual cycle and negative symptomatology may play a role. The goal of this study was to describe the association between withdrawal symptoms during attempted smoking cessation, and to investigate the impact of these symptoms on smoking cessation outcomes as defined by 7-day point prevalence at 14 and 30 days. Negative symptoms associated with the premenstrual period were also assessed. Participants (n = 202) were 29.8 (SD +/- 6.6) years old and smoked 16.6 (SD +/- 5.6) cigarettes per day. They were randomly assigned to quit smoking in the follicular (n = 106) or luteal (n = 96) menstrual phase. We observed several significantly more severe premenstrual and withdrawal symptoms in the luteal phase. Regardless of quit phase, most withdrawal symptoms were associated with an increased risk of relapse at 14 and 30 days post quit date. Participants attempting to quit smoking in the follicular phase who had higher levels of Anger and Craving were more likely to relapse to smoking at 14-days (OR = 2.00, p-value = 0.026; OR = 2.63, p-value = 0.006; respectively). These data suggest that the menstrual cycle may play a role in smoking cessation outcome, as well as in the symptomatology experienced during a cessation attempt.
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Affiliation(s)
- Alicia M Allen
- Department of Family Medicine & Community Health, University of Minnesota, Medical School, Minneapolis, MN 55414, United States.
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15
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Konishi K, Kumashiro M, Izumi H, Higuchi Y, Awa Y. Effects of the menstrual cycle on language and visual working memory: a pilot study. Ind Health 2009; 47:560-568. [PMID: 19834266 DOI: 10.2486/indhealth.47.560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study aimed to examine the effects on language and visual working memory of the follicle, luteal, and menstruation phases. The subjects were 12 female students. We added visual information and the assignment of experimental tasks, which requires the faculty of sight, to the previous study; therefore, this study has an index of visual and linguistic working memory. Computer-based tasks formulated by the authors, using the working memory that actively retains the information as the index, were used for experiments of 30 min during the follicle, luteal, and menstruation phases. After completion of the experiment of each phase, blood samples were collected in order to clearly distinguish the three phases of the subjects' menstrual cycle, and the session order was counter-balanced. The results showed that mental workload was higher in the luteal phase and stress was more easily felt. Indefinite complaints were most frequent during the menstruation phase, but task performance was good regardless of the indefinite complaint. It suggested that when the same tasks were performed during three phases, the sympathetic nerve was ascendant.
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Affiliation(s)
- Kiyomi Konishi
- Department of Sciences in Nursing, Faculty of Human Health Sciences, Meio University, 1220-1 Bimata, Nago city, Okinawa 905-8585, Japan.
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Gonda X, Lazáry J, Telek T, Pap D, Kátai Z, Bagdy G. Mood parameters and severe physical symptoms of the female reproductive cycle. Neuropsychopharmacol Hung 2008; 10:91-96. [PMID: 18959140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The cyclic variation of physical and psychological phenomena has been accepted as a natural consequence of the cyclicity of the human female reproductive function. The exact nature of these changes, however, has not been fully understood. The aim of our study was to investigate the fluctuation of psychological and physical symptoms throughout the female reproductive cycle in healthy, non-PMDD women. METHOD 63 psychiatrically healthy, non-PMDD women with normal regular menstrual cycles and not using hormonal contraceptive methods participated in the study. Participants completed the PRISM calendar every night for three consecutive cycles and on three predefined days of the first cycle they completed several other psychometric measures (SCL-51, STAI, ZSDS, EAT and Mind and Body Cathexis Scale). Based on an at least 66% increase in physical symptoms from the late follicular to the late luteal phase on the PRISM, subjects were assigned to LPPS (luteal phase physical symptoms) and nonLPPS (no luteal phase physical symptoms) groups. Average of psychometric scores obtained at the three predefined days were compared between the two groups. RESULTS There was a significant difference between the two groups only in case of the interpersonal sensitivity subscale of the SCL-51. CONCLUSION Our results indicate that the appearance of severe physical symptoms in the late luteal phase of the female reproductive cycle is not accompanied by a worsening of psychological symptoms. The appearance of enhanced psychological symptomatology attributed to the luteal phase of the female reproductive cycle thus seems to be independent of the appearance of severe physical symptoms.
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Affiliation(s)
- Xenia Gonda
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Faculty of Medicine, Budapest, Hungary.
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Craig MC, Fletcher PC, Daly EM, Rymer J, Brammer M, Giampietro V, Murphy DGM. Physiological variation in estradiol and brain function: a functional magnetic resonance imaging study of verbal memory across the follicular phase of the menstrual cycle. Horm Behav 2008; 53:503-8. [PMID: 18279872 DOI: 10.1016/j.yhbeh.2007.11.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 11/02/2007] [Accepted: 11/02/2007] [Indexed: 11/29/2022]
Abstract
Women frequently complain of memory problems at times in their reproductive lives that are associated with changes in estrogen concentration (e.g. around menopause and childbirth). Further, behavioural studies suggest that memory performance may fluctuate across the menstrual cycle. For example, performance on verbal tasks has been reported to be greatest during phases associated with high estrogen concentrations whereas the opposite has been reported with visuo-spatial tasks. The biological basis of these reported effects remains poorly understood. However, brain imaging studies into the effects of estrogen therapy in postmenopausal women suggest that estrogen modulates the metabolism and function of brain regions sub-serving memory. Furthermore, we have recently reported that acute suppression of ovarian function in young women (with a Gonadotropin Hormone Releasing Hormone agonist) is associated with decreased activation in left prefrontal cortex, particularly the left inferior frontal gyrus (LIFG), during successful verbal memory encoding. We therefore investigated whether physiological variation in plasma estradiol concentration is associated with differences in activity of the LIFG during successful verbal encoding. We hypothesised that higher plasma concentrations of estradiol would be associated with increased brain activity at the LIFG and improved recall performance. Although we did not find a significant relationship between plasma estradiol concentration and verbal recall performance, we report a positive correlation between brain function and estradiol concentration at the LIFG.
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Affiliation(s)
- Michael C Craig
- Section of Brain Maturation (PO50), Department of Psychological Medicine, Institute of Psychiatry, Kings College, London, SE5 8AF, UK.
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18
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Abstract
OBJECTIVE This study examined women's mood responsiveness associated with patterns of stress hormone levels in everyday situations. METHODS Self-reports of negative, positive, and energy dimensions of mood were obtained from 203 nurses throughout the day on a workday and on an off-work day during the luteal and follicular phases of the menstrual cycle. Individual differences in daytime norepinephrine and cortisol were assessed. RESULTS Patterns of norepinephrine and cortisol levels were associated with ratings of the following moods: tired, sad, and happy. Phase of the menstrual cycle and the day factor (workday, off-work day) modified the association of mood ratings and stress hormone patterns. CONCLUSION The experience of negative mood is associated with both hypoarousal and hyperarousal conditions. A homeostatic arousal-related concept of mood regulation is discussed.
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Affiliation(s)
- Dmitry M Davydov
- Department of Neurophysiology, Moscow Research Center of Narcology, Moscow, Russia
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Caperton L, Eddy C, Leland MM, Carey KD, McCarrey JR. Alteration of the menstrual cycle in baboons placed on tethering devices and moved to individual housing--a stress model for a follicular phase defect. J Med Primatol 2007; 35:341-5. [PMID: 17214661 DOI: 10.1111/j.1600-0684.2006.00185.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND During an attempt to identify endocrine characteristics in the baboon that would more precisely predict ovulatory status for assisted reproductive techniques, we observed severe alterations in the menstrual cycle length upon introducing an environmental stress. This environmental stress involved moving animals from their baseline gang cage environment to individual indoor caging and placing them on a tethering apparatus. METHODS Five adult female baboons were followed for changes in sex skin indicative of menstrual cycle timing and move from outdoor gang gages to individual indoor cages during the early follicular phase of their cycle. A tether device including a surgically implanted cannula was then installed to facilitate daily blood draws without sedation. Radioimmuonoassays were performed to monitor serum estradiol levels and lapraroscopic surveillance was used to confirm time of ovulation. RESULTS Complete data sets were collected from four of the female baboons. In each case, a prolongation of the menstrual cycle was noted either during the cycle during which the females were moved to indoor caging or during the cycle immediately following the move. This prolongation was isolated to the follicular phase of the affected cycle. CONCLUSIONS We conclude that otherwise normal handling procedures, including movement to new caging, and/or installation of a tether device, can impart a stress effect on reproductively cycling adult female baboons, such that folliculogenesis is delayed.
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Affiliation(s)
- L Caperton
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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20
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Abstract
In a previous study, we showed that the positive subjective effects of cocaine were higher during the follicular phase compared to the luteal phase of the menstrual cycle. The purpose of the present study was to determine if exogenously administered progesterone during the follicular phase in females would attenuate the response to cocaine compared to the normal follicular phase, thus making the response to cocaine similar to the luteal phase. To address the role of sex differences, males were also administered exogenous progesterone during one inpatient stay. In all, 11 female and 10 male non-treatment-seeking cocaine smokers participated. Females had three inpatient stays: one during a normal follicular phase, one during a normal luteal phase, and one during a follicular phase when exogenous progesterone was administered. Males had two inpatient stays: one when exogenous progesterone was administered and the other when placebo was administered. During each inpatient admission, there were four smoked cocaine administration sessions: participants were administered six doses of cocaine (0, 6, 12, or 25 mg cocaine base) at 14 min intervals. Smoked cocaine increased heart rate, blood pressure and several subjective effects such as 'good drug effect' and 'drug quality' cluster scores. Administration of progesterone during the follicular phase in women attenuated the positive subjective effects of cocaine, whereas only minimal changes were observed in men. These results indicate that progesterone modulates the response to cocaine in women and suggests that fluctuations in endogenous progesterone levels account for some of the sex differences observed in humans.
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Affiliation(s)
- Suzette M Evans
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
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Protopopescu X, Pan H, Altemus M, Tuescher O, Polanecsky M, McEwen B, Silbersweig D, Stern E. Orbitofrontal cortex activity related to emotional processing changes across the menstrual cycle. Proc Natl Acad Sci U S A 2005; 102:16060-5. [PMID: 16247013 PMCID: PMC1276043 DOI: 10.1073/pnas.0502818102] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2005] [Accepted: 09/15/2005] [Indexed: 11/18/2022] Open
Abstract
The orbitofrontal cortex (OFC) has been implicated in the representation of emotional stimuli, assignment of emotional valence/salience to stimuli, stimulus-reinforcement association learning, motivation, and socio-emotional control. Using functional magnetic resonance imaging in female subjects without premenstrual mood symptoms, we found that OFC activity to emotional linguistic stimuli varies depending on the menstrual cycle phase. Specifically, anterior-medial OFC activity for negative vs. neutral stimuli was increased premenstrually and decreased postmenstrually. The inverse pattern was seen in the lateral OFC. These findings suggest that specific subregional OFC activity to emotional stimuli is modulated across the menstrual cycle. The data also demonstrate that menstrual cycle phase is an important consideration in further studies attempting to elucidate the neural substrates of affective representation.
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Affiliation(s)
- Xenia Protopopescu
- Functional Neuroimaging Laboratory, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY 10021, USA
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De Ronchi D, Ujkaj M, Boaron F, Muro A, Piselli M, Quartesan R. Symptoms of depression in late luteal phase dysphoric disorder: a variant of mood disorder? J Affect Disord 2005; 86:169-74. [PMID: 15935236 DOI: 10.1016/j.jad.2005.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2004] [Revised: 01/05/2005] [Accepted: 01/10/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND In premenstrual syndrome, depressed mood in the luteal phase of the menstrual cycle is acknowledged, whereas the presence of symptoms of depression during the follicular phase remains in debate. METHODS On the basis of prospective daily recording of the presence and severity of symptoms for at least two menstrual cycles, 43 women were diagnosed with Late Luteal Phase Dysphoric Disorder (LLPD) according to the criteria of the third edition revision of the Diagnostic and Statistical Manual of Mental Disorders. They were compared to a group of 85 women who showed no evidence of LLPD for two menstrual cycles. Structured psychiatric interviews were administered during the follicular phase. Only those subjects without Axis I disorders were subsequently included in the study. RESULTS Those women with minor/moderate symptoms of depression had an odds of suffering from LLPD of 1.9 (95% CI=1.5-2.4, p<0.001) in relation to increasing severity of symptoms of depression at the total MADRS scale (1-point increase). The ORs of LLPD in relation to each dimension (1-point increase) of the emotional/affective, cognitive, and neurovegetative symptoms were 1.6 (95% CI=1.2-2.3, p=0.003), 2.8 (95% CI=0.9-8.5, p=0.077) and 3.3 (95% CI=1.9-5.9, p<0.001), respectively. LIMITATIONS No hormonal changes that may be associated with symptoms of LLPD were determined in this study. CONCLUSIONS LLPD is likely to represent a variant of a depressive disorder, where premenstrual psychobiological changes seem to exacerbate mild depressive symptoms and signs to which LLPD women are otherwise predisposed. This hypothesis opens new perspectives for prevention and of even treatment for LLPD. Further longitudinal studies with larger populations and evaluation of hormonal changes are needed to confirm these data.
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Affiliation(s)
- Diana De Ronchi
- Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
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Yonkers KA, Pearlstein T, Fayyad R, Gillespie JA. Luteal phase treatment of premenstrual dysphoric disorder improves symptoms that continue into the postmenstrual phase. J Affect Disord 2005; 85:317-21. [PMID: 15780701 DOI: 10.1016/j.jad.2004.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2004] [Accepted: 10/14/2004] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite the proven efficacy of luteal phase medication dosing for women with premenstrual dysphoric disorder (PMDD), it is not known whether this approach adequately treats symptoms that linger into the first 2-3 days of the follicular phase, a time when up to one-third of women diagnosed with PMDD report residual symptoms. Furthermore, no previous study has explored whether abruptly stopping medication after 2 weeks of treatment is associated with discontinuation symptoms. METHODS To evaluate the efficacy of luteal phase medication dosing, symptom data from the Daily Record of Severity of Problems (DRSP) during first few days of menses were compared from two studies with similar designs but different treatment strategies. The first study used continuous dosing of sertraline, 50-150 mg/day, throughout the menstrual cycle, while the second study used intermittent dosing with sertraline, 50-100 mg/day in the 14-16 days prior to onset of menses. To investigate whether abruptly stopping pills led to discontinuation symptoms, DRSP data for the first 5 days after the onset of menses were analyzed in the second (intermittent dosing) study. Symptom scores were compared for subjects who took either sertraline or placebo premenstrually and ceased taking pills at the onset of menses. RESULTS The baseline (pretreatment) to on-treatment effect sizes were similar for continuous vs. luteal phase dosing on the first day of menses (0.73 vs. 0.89), second day of menses (0.40 vs. 0.55), and third day of menses (0.42 vs. 0.44), respectively. Subjects who abruptly discontinued sertraline had fewer symptoms indicative of withdrawal at Day 3 (p < 0.01) and no difference during Days 4-5 compared to subjects abruptly discontinuing placebo. CONCLUSION Patients given active medication during the luteal phase demonstrate reductions in DRSP total scores into the first few days of menses regardless of whether active treatment was continuous throughout the menstrual cycle or was discontinued at the onset of menses. This analysis finds no support for discontinuation symptoms following abrupt cessation of sertraline after 2 weeks of treatment for two cycles.
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Abstract
OBJECTIVE This study examined women's mood responsiveness on work and off days during different phases of the menstrual cycle. METHODS Self-reports of negative, positive, and energy dimensions of mood were obtained throughout the day on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 women nurses. Individual differences in daytime and nighttime epinephrine, norepinephrine, and cortisol were assessed. RESULTS High daytime norepinephrine, epinephrine, and cortisol levels were associated with higher ratings of stress and tired, and with lower ratings of happy. The phase of the menstrual cycle and the day factor (workday, off day) were also associated with mood differences, and the direction of the effects depended on hormone levels and hormone sampling period. CONCLUSION The experience of moods is affected by the arousal-related interaction of hormone levels with the phase of the menstrual cycle and occupational stress.
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Affiliation(s)
- Dmitry M Davydov
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA 90095, USA.
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25
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Abstract
This study was designed to investigate whether there is a relationship between the menstrual cycle and suicide attempts, and to determine the factors affecting suicide attempts in different phases of the menstrual cycle. The study sample included 52 women who were admitted to the emergency room because of a suicide attempt. The incidence of suicide attempts in menstrual follicular phase (MFP) was significantly higher than in other phases. No significant difference of socio-demographic and clinical characteristics was observed between MFP and the other phases. Also, hormone levels of patients who attempted suicide were not different from those of healthy control subjects. In spite of the fact that suicide attempts were often made in MFP, there was substantial difficulty in explaining why this frequency was different than other phases. Furthermore, the event may be linked to low estrogen and progesterone levels in this phase. It has, however, been thought that hormonal effects cannot be responsible alone for suicide attempts.
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Affiliation(s)
- Ali Cayköylü
- Department of Psychiatry, Atatürk University, School of Medicine, Erzurum, Turkey.
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Abstract
AIMS/OBJECTIVES To evaluate lamotrigine in a woman with a 30-year history of treatment-resistant menstrually-entrained rapid cycling bipolar II disorder with follicular phase depressive and luteal phase mood elevation symptoms. METHODS Lamotrigine was started at 5 mg/day and gradually increased up to 300 mg/day, while venlafaxine was tapered gradually and discontinued, and divalproex sodium 500 mg/day and levothyroxine 175 mcgm/day were continued. Daily self-reported mood ratings were obtained from the patient, using ChronoRecord software. RESULTS As lamotrigine was increased gradually, mood cycle amplitude attenuated. There was notable decrease in the severity and duration of depressive symptoms specifically during the follicular phase of the menstrual cycle. At the time of submission of this paper, the subject had remained euthymic for a total of 12 months. CONCLUSION This case suggests the potential utility of lamotrigine in treatment-resistant menstrually-related rapid cycling bipolar disorder, and raises the possibility that lamotrigine might be able to treat pathological entrainment of mood with the menstrual cycle. Both of these issues merit systematic assessment.
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Affiliation(s)
- O V Becker
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA
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Landén M, Wennerblom B, Tygesen H, Modigh K, Sörvik K, Ysander C, Ekman A, Nissbrandt H, Olsson M, Eriksson E. Heart rate variability in premenstrual dysphoric disorder. Psychoneuroendocrinology 2004; 29:733-40. [PMID: 15110922 DOI: 10.1016/s0306-4530(03)00117-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2003] [Revised: 04/04/2003] [Accepted: 05/29/2003] [Indexed: 11/26/2022]
Abstract
Measuring heart rate variability (HRV) is a way to assess the autonomic regulation of the heart. Decreased HRV, indicating reduced parasympathetic tone, has previously been found in depression and anxiety disorders. The objective of this study was to assess HRV in women with premenstrual dysphoric disorder (PMDD). To this end, time domain variables and frequency domain variables were assessed in 28 women with PMDD and in 11 symptom-free controls during both the symptomatic luteal phase and the non-symptomatic follicular phase of the menstrual cycle. Two variables reflecting vagal activity in the time domain, the root mean square of differences of successive normal RR intervals (rMSSD) and standard deviation of normal RR intervals (SDNN) were lower in PMDD patients, but this difference was statistically significant in the follicular phase only. The most important vagal measure in the frequency domain, supine high frequency (HF), also appeared lower in PMDD subjects during the follicular phase. It is suggested that PMDD may be associated with reduced vagal tone compared to controls and that this difference is most apparent in the non-symptomatic follicular phase of the menstrual cycle.
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Affiliation(s)
- Mikael Landén
- Section of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden.
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Paoletti AM, Lello S, Fratta S, Orrù M, Ranuzzi F, Sogliano C, Concas A, Biggio G, Melis GB. Psychological effect of the oral contraceptive formulation containing 3 mg of drospirenone plus 30 microg of ethinyl estradiol. Fertil Steril 2004; 81:645-51. [PMID: 15037415 DOI: 10.1016/j.fertnstert.2003.08.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2003] [Revised: 08/07/2003] [Accepted: 08/07/2003] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate in healthy eumenorrheic young women whether an oral contraceptive (OC) containing drospirenone (DRSP) (3 mg) + ethinyl estradiol (EE) (30 microg) (DRSP + EE) could modify psychological symptoms and whether it could modify steroids interfering with the gamma-aminobutyric acid (GABA)-A receptors. DESIGN Clinical study of treated subjects and nontreated controls. SETTING Healthy volunteers in the Department of Obstetrics and Gynecology at Cagliari University. PATIENT(S) Control group (n = 12) and OC group (n = 10) women with similar age, body mass index, and main outcome measures. INTERVENTION(S) The control group was studied during the first menstrual cycle at the follicular phase (FP) and at the luteal phase (LP) and during the third cycle at the LP; the OC group was studied during the first cycle, as described above, and on day 16-18 of the third cycle of treatment with DRSP + EE. MAIN OUTCOME MEASURE(S) Psychometric scale (SCL-90), DHEAS, P, allopregnanolone (AP), and allotetrahydrodeoxy-corticosterone (THDOC). RESULT(S) SCL-90 and DHEAS did not vary throughout the menstrual cycle. P, AP, and THDOC values were higher during the LP than the FP. At the third cycle, in the control group the main outcome measures were similar to those at LP. In the OC group, the SCL-90 global score, the intensity of anxiety and phobic anxiety, the levels of anxiolytic steroids (P, AP, THDOC) and the anxiety-inducing steroid DHEAS were reduced. CONCLUSION(S) The results suggest beneficial effects of DRSP + EE on psychological symptoms by decreasing DHEAS.
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Affiliation(s)
- Anna Maria Paoletti
- Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.
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Abstract
BACKGROUND Neurocognitive functioning may be impaired in the luteal phase of the menstrual cycle due to associated changes in hypothalamic-pituitary adrenal (HPA) axis function. This study examines the relationship between changes in neurocognition and HPA axis function in different phases of the menstrual cycle. METHOD Fifteen female volunteers, free from psychiatric history and hormonal medication were tested twice, during mid-follicular and late-luteal phases in a randomized, crossover design. Mood, neurocognitive function, and basal cortisol and dehydroepiandrosterone (DHEA) were profiled. RESULTS Relative to the follicular phase, verbal fluency was impaired in the luteal phase and reaction times speeded on a continuous performance task, without affecting overall accuracy. 'Hedonic' scores on the UWIST-MACL scale were decreased in the luteal phase. There was also evidence of changes in the function of the HPA axis, with 24 h urinary cortisol concentrations and salivary DHEA levels being significantly lower during the luteal phase. CONCLUSIONS These data suggest that luteal phase HPA axis function is lower than in the follicular phase in premenopausal healthy women. This putative biological difference may be important for our understanding of the aetiopathogenesis of menstrually related mood change and neurocognitive disturbance.
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Affiliation(s)
- C S Symonds
- Psychobiology Research Group, School of Neurology, Neurobiology and Psychiatry, University of Newcastle upon Tyne
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Miner C, Brown E, McCray S, Gonzales J, Wohlreich M. Weekly luteal-phase dosing with enteric-coated fluoxetine 90 mg in premenstrual dysphoric disorder: a randomized, double-blind, placebo-controlled clinical trial. Clin Ther 2002; 24:417-33. [PMID: 11952025 DOI: 10.1016/s0149-2918(02)85043-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Because the symptoms of premenstrual dysphoric disorder (PMDD) are limited to the luteal phase of the menstrual cycle, the potential benefit of luteal-phase dosing has been hypothesized. OBJECTIVE This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial evaluated the efficacy and tolerability of enteric-coated fluoxetine 90 mg given once or twice during the luteal phase for the treatment of PMDD. METHODS Study drug was given 14 and 7 days before expected menses during the luteal phase of 3 menstrual cycles. After a screening period and single-blind placebo lead-in period, eligible women were randomized to I of 3 treatment groups: enteric-coated fluoxetine 90 mg on both days (LPWDx2); placebo 14 days before menses and enteric-coated fluoxetine 90 mg 7 days before menses (LPWDx1); or placebo on both days (PLC). The primary efficacy measure was change from baseline in mean luteal-phase scores on the Daily Record of Severity of Problems (DRSP). Secondary efficacy measures included scores on the Rating Scale for Premenstrual Tension Syndrome, Clinician-Rated (PMTS-C); the Clinical Global Impression (CGI)-Severity scale; and the Patient Global Impression (PGI)-Improvement scale. Quality of life was assessed using the Sheehan Disability Scale. RESULTS Two hundred fifty-seven women were randomized to treatment. At the end of the study, the LPWDx2 group had statistically significant improvements in DRSP total, DRSP mood subtotal, DRSP social functioning subtotal, PMTS-C, CGI-Severity, PGI-Improvement, and Sheehan Disability Scale work and family life scores compared with LPWDx1 and PLC (each measure, P < 0.05). There was also a statistically significant improvement in the score on the social life section of the Sheehan Disability Scale with LPWDx2 compared with PLC (P = 0.037). Across all treatment groups, 5 patients discontinued due to nonserious adverse events. Rates of discontinuation for any reason did not differ between the 3 treatment groups. CONCLUSION The findings of this study support the efficacy and tolerability of enteric-coated fluoxetine 90 mg given twice during the luteal phase of the menstrual cycle for the treatment of PMDD.
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Affiliation(s)
- Cherri Miner
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana 46285, USA.
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Abstract
Evidence that ovarian steroid hormones such as estrogen and progesterone affect cognition comes from studies of memory in older women receiving estrogen replacement therapy and studies of sexually dimorphic skills in young women across the menstrual cycle. Sixteen women (ages 18-28) completed tests of memory (implicit category exemplar generation, category-cued recall, implicit fragmented object identification) and sexually dimorphic skills (fine motor coordination, verbal fluency, mental rotations) at the early follicular (low estrogen and progesterone) and midluteal (high estrogen and progesterone) phases of the menstrual cycle. Performance on category exemplar generation, a test of conceptual implicit memory, was better at the midluteal than the follicular phase. In contrast, performance on a test of explicit memory, category-cued recall, did not vary across the menstrual cycle. At Session 1, women in the follicular phase performed better on the fragmented object identification task than did those in the midluteal phase. This unexpected finding suggests that high levels of ovarian hormones might inhibit perceptual object priming. Results confirmed previous reports of decreased mental rotations and improved motor skills and fluency in the midluteal phase. Estradiol levels correlated positively with verbal fluency and negatively with mental rotations and perceptual priming, which suggest that estrogen, and not progesterone, was responsible for the observed changes in cognition. Mood did not vary across the cycle phases. Overall, the findings suggest that estrogen may facilitate the automatic activation of verbal representations in memory.
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Affiliation(s)
- Pauline M Maki
- Gerontology Research Center Box 03, Laboratory of Personality and Cognition, National Institute on Aging, National Institutes of Health, 5600 Nathan Shock Drive, Baltimore, MD 21224, USA.
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Berlin RE, Raju JD, Schmidt PJ, Adams LF, Rubinow DR. Effects of the menstrual cycle on measures of personality in women with premenstrual syndrome: a preliminary study. J Clin Psychiatry 2001; 62:337-42. [PMID: 11411814 DOI: 10.4088/jcp.v62n0505] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies suggest that women with premenstrual syndrome (PMS) differ from those without PMS in measures of personality. The purpose of this study was to measure the effect of menstrual cycle phase on personality variables in women with and without PMS. METHOD The Personality Diagnostic Questionnaire-Revised (PDQ-R) was administered in both the follicular and luteal phases to women with PMS (according to National Institute of Mental Health PMS Workshop Diagnostic Guidelines) (N = 40). An asymptomatic control group (N = 20) as well as a symptomatic group of women with DSM-IV-diagnosed recurrent, non-menstrual-cycle-related brief depression (N = 20) also completed the questionnaire in both phases. RESULTS Only women with PMS demonstrated a significant increase in total PDQ-R score (reflecting overall personality disorder) from the follicular to the luteal phase (p < .01). Women with PMS had significantly higher total PDQ-R scores than the asymptomatic controls during both the follicular (p < .05) and luteal (p < .01) phases, whereas there was no significant difference between women with PMS and symptomatic controls during either phase. Subscale scores fit similar patterns, as did the number of women in each group meeting a cutoff score indicative of the presence of personality dysfunction. CONCLUSION In this preliminary study, women with PMS were unique in demonstrating a menstrual cycle phase effect on PDQ-R score, while their scores in both phases were closer to symptomatic controls than asymptomatic controls. These findings suggest that personality disorder in women with PMS may have both state- and trait-related components.
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Affiliation(s)
- R E Berlin
- Behavioral Endocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1276, USA
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Parry BL, Javeed S, Laughlin GA, Hauger R, Clopton P. Cortisol circadian rhythms during the menstrual cycle and with sleep deprivation in premenstrual dysphoric disorder and normal control subjects. Biol Psychiatry 2000; 48:920-31. [PMID: 11074230 DOI: 10.1016/s0006-3223(00)00876-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND In this study we extended previous work by examining whether disturbances in the circadian rhythms of cortisol during the menstrual cycle distinguish patients with premenstrual dysphoric disorder (PMDD) from normal control (NC) subjects. In addition, we tested the differential response to the effects of early and late partial sleep deprivation on cortisol rhythms. METHODS In 15 PMDD and 15 NC subjects we measured cortisol levels every 30 min from 6:00 PM to 9:00 AM during midfollicular (MF) and late luteal (LL) menstrual cycle phases and also during a randomized crossover trial of early (sleep 3:00 AM-7:00 AM) versus late (sleep 9:00 PM-1:00 AM) partial sleep deprivation administered in two subsequent and separate luteal phases. RESULTS In follicular versus luteal menstrual cycle phases we observed altered timing but not quantitative measures of cortisol secretion in PMDD subjects, compared with NC subjects: in the LL versus MF phase the cortisol acrophase was a mean of 1 hour earlier in NC subjects, but not in PMDD subjects. The effect of sleep deprivation on cortisol timing measures also differed for PMDD versus NC subjects: during late partial sleep deprivation (when subjects' sleep was earlier), the cortisol acrophase was almost 2 hours earlier in PMDD subjects. CONCLUSIONS Timing rather than quantitative measures of cortisol secretion differentiated PMDD subjects from NC subjects both during the menstrual cycle and in response to early versus late sleep deprivation interventions.
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Affiliation(s)
- B L Parry
- Department of Psychiatry, University of California, San Diego, California 92093-0804, USA
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34
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Abstract
Recent preclinical evidence indicates that ovarian hormones, such as estrogen and progesterone, may influence the behavioral effects of psychoactive drugs by interacting directly with neurotransmitter systems in the central nervous system. However, few studies have examined the effects of ovarian hormones on subjective or behavioral responses to psychoactive drugs in humans. In the present study, we assessed the subjective and physiological effects of d-amphetamine during the early and late follicular phases of the menstrual cycle. Nineteen healthy, regularly-cycling women participated in four sessions receiving doses of d-amphetamine (AMPH; 15 mg oral) or placebo during the early and late follicular phases of two menstrual cycles. During the early follicular phase levels of both estrogen and progesterone are low, whereas during the late follicular phase estrogen levels are higher while progesterone remains low. Dependent measures included self-report questionnaires, physiological measures and plasma hormone levels. Most of the subjective and physiological effects of AMPH were not affected by menstrual cycle phase. However, subjects reported greater Unpleasant Stimulation after AMPH, and less Unpleasant Sedation, during the late follicular phase than during the early follicular phase. These results provide limited evidence that higher levels of estrogen during the late follicular phase alter the subjective effects of AMPH in normal, healthy women.
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Affiliation(s)
- A J Justice
- The University of Chicago, Chicago, IL 60637, USA
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Perkins KA, Levine M, Marcus M, Shiffman S, D'Amico D, Miller A, Keins A, Ashcom J, Broge M. Tobacco withdrawal in women and menstrual cycle phase. J Consult Clin Psychol 2000; 68:176-180. [PMID: 10710853 DOI: 10.1037/0022-006x.68.1.176] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Because negative mood is a characteristic of both tobacco withdrawal and menstrual discomfort, withdrawal may vary by menstrual cycle phase. Tobacco withdrawal, mood, and menstrual discomfort were assessed in premenopausal women who quit smoking during either the follicular (Days 1-14 postmenstrual onset; n = 41) or luteal (Day 15 or longer postmenstrual onset; n = 37) phase of the menstrual cycle and maintained biochemically verified smoking abstinence during the postquit week. Women quitting during the luteal phase reported significantly greater increases in tobacco withdrawal and self-reported depressive symptoms than women quitting during the follicular phase. These results indicate that selecting a quit-smoking day early in the follicular phase may attenuate withdrawal and negative affect in premenopausal female smokers.
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Abstract
RATIONALE Little is known about the interactions between ovarian hormones across the menstrual cycle and responses to psychoactive drugs in humans. Preclinical studies suggest that ovarian hormones such as estrogen and progesterone have direct and indirect central nervous system actions, and that these hormones can influence behavioral responses to psychoactive drugs. OBJECTIVES In the present study, we assessed the subjective and behavioral effects of d-amphetamine (AMPH; 15 mg orally) at two hormonally distinct phases of the menstrual cycle in women. METHODS Sixteen healthy women received AMPH or placebo capsules during the follicular and mid-luteal phases of their cycle. During the follicular phase, estrogen levels are low initially and then rise while progesterone levels remain low. During the midluteal phase, levels of both estrogen and progesterone are relatively high. Dependent measures included self-report questionnaires, physiological measures and plasma hormone levels. RESULTS Although there were no baseline differences in mood during the follicular or luteal phase, the effects of AMPH were greater during the follicular phase than the luteal phase. During the follicular phase, subjects reported feeling more "High", "Energetic and Intellectually Efficient", and "Euphoric" after AMPH than during the luteal phase, and also reported liking and wanting AMPH more. Further analyses showed that during the follicular phase, but not the luteal phase, responses to AMPH were related to levels of estrogen. Higher levels of estrogen were associated with greater AMPH-induced increases in "Euphoria" and "Energy and Intellectual Efficiency". During the luteal phase, in the presence of both estrogen and progesterone, estrogen levels were not related to the effects of AMPH. CONCLUSIONS These findings suggest that estrogen may enhance the subjective responses to a stimulant drug in women, but that this effect may be masked in the presence of progesterone.
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Affiliation(s)
- A J Justice
- Department of Psychiatry, The University of Chicago, IL 60637, USA
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Gehlert S, Chang CH, Hartlage S. Symptom patterns of premenstrual dysphoric disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders-IV. J Womens Health (Larchmt) 1999; 8:75-85. [PMID: 10094084 DOI: 10.1089/jwh.1999.8.75] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Premenstrual dysphoric disorder was included in an appendix of DSM-III-R (revised third edition of the Diagnostic and Statistical Manual of Mental Disorders) and DSM-IV to facilitate systematic research. Items contained in its set of research criteria were considered tentative. Only one previous study of premenstrual symptoms specifically addressed symptoms of premenstrual dysphoric disorder, and it did not use DSM-IV criteria. In the present study, prospectively measured symptoms of 99 women were analyzed using exploratory principal components analysis with orthogonal rotation on all 24 items derived from the 11 symptoms listed in DSM-IV. Variation was found across phases of cycle and groups, with five factors predominating: (1) anger/irritability, (2) depressed mood, (3) anxiety/tension, (4) decreased energy and interest with physical symptoms, and (5) eating problems.
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Affiliation(s)
- S Gehlert
- School of Social Service Administration, the University of Chicago, Illinois 60637, USA
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Abstract
BACKGROUND Prior neurophysiological studies on patients with premenstrual syndrome (PMS) have revealed sleep electroencephalographic alterations in both cycle phases. We report on a study evaluating saccadic eye movements in PMS patients. METHODS Saccadic eye movements were examined in 21 women with and 21 women without PMS on two occasions in the midfollicular and late luteal phase, respectively. On each occasion, plasma levels for estradiol, progesterone, and neuroactive progesterone metabolites were determined. RESULTS PMS patients had decreased saccadic eye velocity (SEV) compared to control subjects. This finding was most evident in the luteal phase, whereas the difference between groups approached significance in the follicular phase. Saccade accuracy and saccade latency were not different between the two groups. Control subjects increased their SEV in the luteal phase compared to the follicular phase, whereas PMS patients did not. PMS patients rated themselves more sedated than control subjects on the testing days in both phases of the menstrual cycle. Plasma levels of gonadal hormones and neuroactive steroids did not differ between the study groups. CONCLUSIONS The findings of a decreased SEV in PMS patients could be due to poor sleep and consequently increased sedation, but might also indicate that gamma-aminobutyric acidergic inhibition is different in patients with premenstrual syndrome.
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Affiliation(s)
- I Sundström
- Department of Obstetrics and Gynecology, University Hospital of Umeå, Sweden
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Gurguis GN, Yonkers KA, Phan SP, Blakeley JE, Williams A, Rush AJ. Adrenergic receptors in premenstrual dysphoric disorder: I. Platelet alpha 2 receptors: Gi protein coupling, phase of menstrual cycle, and prediction of luteal phase symptom severity. Biol Psychiatry 1998; 44:600-9. [PMID: 9787884 DOI: 10.1016/s0006-3223(98)00097-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abnormal alpha 2-adrenergic receptor (AR) function is implicated in anxiety and depressive disorders. Premenstrual dysphoric disorder (PMDD) is characterized by anxiety and depressive symptoms, which may be associated with changes in alpha 2AR function. Previous studies on alpha 2AR function during phases of the menstrual cycle in controls and PMDD patients are inconsistent. METHODS alpha 2AR function was examined in 16 PMDD patients and 15 controls during the follicular phase, and in 10 PMDD patients during late luteal phase. Antagonist-measured maximum binding capacity, agonist-measured receptor density in high- and low-conformational states, and agonist affinity to both states were measured. Coupling efficiency to Gi protein was estimated. RESULTS There were no significant differences in coupling efficiency. PMDD patients had significantly low antagonist affinity; there were no differences in other binding parameters. There were no changes in alpha 2AR binding parameters between phases of menstrual cycle in PMDD women. alpha 2AR density and symptom severity were inversely related during the follicular phase in controls and patients. During luteal phase, alpha 2AR density correlated positively with symptom severity in patients. High follicular alpha 2AR density predicted more severe luteal symptoms in PMDD patients. CONCLUSIONS These findings are discussed in view of the molecular biology of alpha 2AR, and their role in PMDD, anxiety, and depressive disorders.
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Affiliation(s)
- G N Gurguis
- Laboratory of Clinical Neuroscience, Department of Veterans Affairs Medical Center, Dallas, TX 75216, USA
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Parry BL, LeVeau B, Mostofi N, Naham HC, Loving R, Clopton P, Gillin JC. Temperature circadian rhythms during the menstrual cycle and sleep deprivation in premenstrual dysphoric disorder and normal comparison subjects. J Biol Rhythms 1997; 12:34-46. [PMID: 9104689 DOI: 10.1177/074873049701200106] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim of this study was to test the hypothesis that the circadian rhythm of core body temperature is altered in premenstrual dysphoric disorder (PMDD) subjects compared to that in normal comparison (NC) subjects and that it is normalized in PMDD subjects after treatment with early night partial sleep deprivation (ESD) or late night partial sleep deprivation (LSD). A total of 23 subjects meeting DSM-IV criteria for PMDD and 18 NC subjects had 24-h core body temperature recordings taken during the following conditions: (1) baseline midfollicular (preovulatory) and (2) late luteal (postovulatory) menstrual cycle phases and after a randomized crossover trial in subsequent luteal phases of (3) ESD, in which subjects slept from 03:00 to 07:00 h, followed by (4) a night of recovery sleep (ESD-R: sleep 22:30 to 06:30 h), and (5) LSD, in which subjects slept from 21:00 to 01:00 h, also followed by (6) a night of recovery sleep (LSD-R: sleep 22:30 to 06:30 h). Temperature amplitudes were significantly decreased in the luteal phase compared to those in the follicular menstrual cycle phase and increased after nights of recovery sleep. Compared to the baseline late luteal phase, during LSD, temperature amplitude increased in PMDD subjects but decreased in NC subjects. During ESD, the temperature acrophase was delayed in PMDD subjects but was advanced in NC subjects; during LSD, the temperature acrophase was advanced in PMDD subjects but was delayed in NC subjects compared to the late luteal baseline. Nocturnal temperature and temperature maxima and mesors tended to be higher in PMDD subjects than in NC subjects; when not reduced during sleep deprivation interventions, these were not associated with therapeutic effects. Alterations in both phase and amplitude of temperature circadian rhythms characterize PMDD subjects as contrasted with NC subjects in response to sleep deprivation. The changes in phase reflected more shifts in temperature acrophase in response to shifts in sleep in PMDD subjects. This realignment of the timing of sleep and temperature in addition to the enhancement of blunted amplitude rhythms during recovery nights of sleep may provide corrective mechanisms that contribute to the therapeutic effects of sleep deprivation.
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Affiliation(s)
- B L Parry
- Department of Psychiatry, University of California, San Diego, La Jolla 92093, USA
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Berger CP, Presser B. Alprazolam in the treatment of two subsamples of patients with late luteal phase dysphoric disorder: a double-blind, placebo-controlled crossover study. Obstet Gynecol 1994; 84:379-85. [PMID: 8058235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess the efficacy of alprazolam in the treatment of two groups of patients diagnosed with late luteal phase dysphoric disorder (LLPDD). The first group met only the diagnostic criteria for LLPDD. The second group experienced LLPDD and mild symptoms of anxiety and depression during the follicular phase. METHODS A double-blind, placebo-controlled crossover design was used. Patients were treated with alprazolam and placebo for 3 months each and completed daily measures of anxiety, tension, depression, irritability, and feelings of being out of control. RESULTS The response to alprazolam differed significantly by group. For the first group, alprazolam (0.25 mg three times a day) relieved the severity of tension (P = .001), irritability (P = .005), anxiety (P = .008), and feelings of being out of control (P = .012) more than placebo. Few side effects were reported; the incidence (P = .001) and severity (P = .001) of side effects were dose-related. Alprazolam and placebo did not differ for the second group, and the incidence and severity of side effects were unrelated to dose. CONCLUSIONS Alprazolam benefits women diagnosed solely with LLPDD. It is not recommended for patients who experience LLPDD as well as symptoms of mild anxiety or depression during the follicular phase.
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Affiliation(s)
- C P Berger
- Department of Obstetrics and Gynaecology, Montreal General Hospital, Quebec, Canada
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Abstract
During the premenstrual and follicular phases of the menstrual cycle, 41 women who had generalized anxiety disorder (GAD) plus premenstrual syndrome (PMS) were assessed with psychiatric rating scales and compared with 21 GAD patients without PMS and 19 controls. The latter two groups were rated only once, in the typical open-ended manner. Symptoms during both phases of the menstrual cycle were more severe in the GAD + PMS patients than in the controls and were more severe during the premenstruum. For the GAD + PMS patients, ratings obtained in the typical open-ended manner were influenced by how patients felt during the premenstruum. Thus, the assessment of women with GAD + PMS may be complicated by cyclical fluctuations in symptom severity, and ratings obtained in the typical manner may be influenced disproportionately by how these patients feel premenstrually.
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Affiliation(s)
- D R McLeod
- Department of Psychiatry, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287-7144
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