Adrenergic receptors in premenstrual dysphoric disorder: I. Platelet α2 receptors: Gi protein coupling, phase of menstrual cycle, and prediction of luteal phase symptom severity

AbstractBackgroundDifficulties in regulating emotions are linked to the core symptoms of premenstrual dysphoric disorder (PMDD). We therefore investigated the neural substrates of emotion-regulation problems in women with PMDD.MethodsOn the basis of self-evaluations over 2 months on the Daily Record of Severity of Problems, eligible participants were assigned to two groups: PMDD and control (18 per group). Functional magnetic resonance imaging (fMRI) and a well-validated task were used to assess brain function during emotion regulation. Participants were tested twice, once during the follicular (asymptomatic) and once in the late luteal (symptomatic) phase of the menstrual cycle.ResultsWomen with PMDD gave higher ratings of negative affect in the luteal phase than in the follicular phase, and compared with healthy control participants during the luteal phase. A region-of-interest fMRI analysis indicated that during the late luteal phase, women with PMDD had hypoactivation in right dorsolateral prefrontal cortex (dlPFC) during all conditions of the emotion-regulation task, not only in the contrast that isolated emotion regulation. An exploratory whole-brain, voxel-wise analysis showed that women with PMDD had less activation in the precentral gyrus during the luteal phase than the follicular phase, and less activation in the postcentral gyrus compared with control participants.ConclusionsDuring the luteal phase of the menstrual cycle, women with PMDD experience difficulty regulating emotions. Hypoactivation in the right dlPFC may contribute to this problem, but may be related more generally to other affective symptoms of PMDD. Hypofunction in the right pre- and postcentral gyri warrants additional study.

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Adrenergic Receptor Function in Panic Disorder, I. Platelet α2 Receptors Gi Protein Coupling, Effects of Imipramine, and Relationship to Treatment Outcome

Neuropsychopharmacology ◽

10.1016/s0893-133x(98)00062-1 ◽

1999 ◽

Vol 20 (2) ◽

pp. 162-176 ◽

Cited By ~ 13

Author(s):

G Gurguis

Keyword(s):

Treatment Outcome ◽

Panic Disorder ◽

Adrenergic Receptor ◽

Receptor Function ◽

Coupling Effects ◽

Protein Coupling ◽

Gi Protein ◽

Α2 Receptors

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Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126192 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6192

Author(s):

Pai-Cheng Lin ◽

Chih-Hung Ko ◽

Yen-Ju Lin ◽

Ju-Yu Yen

Keyword(s):

Menstrual Cycle ◽

Functional Impairment ◽

Repeated Measures ◽

Luteal Phase ◽

Rating Scale ◽

Sleep Problems ◽

Premenstrual Dysphoric Disorder ◽

Assessment Scale ◽

Control Group ◽

Late Luteal Phase

Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD and their fluctuations during the menstrual cycle. Methods: A total of 100 women were diagnosed as having PMDD based on psychiatric interviews and a prospective investigation of three menstrual cycles. A total of 96 individuals without PMDD were recruited as controls. Their symptoms, namely insomnia, inattention, and fatigue as well as functional impairment were assessed by using the premenstrual symptoms screening tool, the Pittsburgh insomnia rating scale, the attention and performance self-assessment scale, and the fatigue-assessment scale during both premenstrual and follicular phases. Results: In both the premenstrual and follicular phases, women with PMDD experienced more severe insomnia, inattentiveness, and fatigue than did women in the control group. A paired t-test demonstrated that women with PMDD had more severe severity insomnia, inattentiveness, and fatigue in the luteal phase than in the follicular phase. A repeated-measures analysis of variance demonstrated that the interaction period of PMDD and a menstrual cycle was significantly associated with insomnia, inattentiveness, and fatigue. A further correlation analysis demonstrated that all three symptoms were positively associated with self-reported functional impairment due to PMDD. Conclusions: Our results demonstrated that women with PMDD experienced an exacerbation of insomnia, memory problems, difficulty maintaining focus, and fatigue in the premenstrual phase. These symptoms are correlated with PMDD symptoms severity and functional impairment, and as such, they should be evaluated, and interventions should be employed in the late luteal phase of women with PMDD.

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Mood, neuropsychological function and cognitions in premenstrual dysphoric disorder

Psychological Medicine ◽

10.1017/s0033291798007715 ◽

1999 ◽

Vol 29 (3) ◽

pp. 727-733 ◽

Cited By ~ 31

Author(s):

M. S. MAN ◽

I. MacMILLAN ◽

J. SCOTT ◽

A. H. YOUNG

Keyword(s):

Working Memory ◽

Menstrual Cycle ◽

Luteal Phase ◽

Small Sample Size ◽

Random Order ◽

Premenstrual Dysphoric Disorder ◽

Small Sample ◽

Neuropsychological Function ◽

Cognitive Correlates ◽

And Control

Background. Neuropsychological function and cognitive correlates of depression have not previously been examined in a rigorously defined population of patients suffering from premenstrual dysphoric disorder (PMDD).Method. Mood, neuropsychological function and cognition were measured in 10 PMDD patients and 10 age-matched controls in both phases of the menstrual cycle in a random order, counter-balanced design.Results. The BDI was significantly elevated in the luteal phase of PMDD patients only while other cognitive measures showed no significant differences. Working memory was impaired in the luteal phase of the menstrual cycle with no significant differences between PMDD and control subjects.Conclusion. Despite the small sample size, these results show that the BDI is sensitive to the mood fluctuations of PMDD patients. An impairment in working memory was also found although this is a general menstrual cycle effect.

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Premenstrual syndrome

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738012467442 ◽

2013 ◽

Vol 6 (5) ◽

pp. 302-306

Author(s):

Shiva Shanmugaratnam ◽

Hari Shanmugaratnam ◽

Miss Maryam Parisaei

Keyword(s):

Quality Of Life ◽

General Practice ◽

Menstrual Cycle ◽

Premenstrual Syndrome ◽

Luteal Phase ◽

Psychological Symptoms ◽

Premenstrual Dysphoric Disorder ◽

Current Evidence ◽

Behavioural And Psychological Symptoms

Premenstrual syndrome (PMS) is characterised by cyclical physical, behavioural and psychological symptoms occurring during the luteal phase of the menstrual cycle (the time between ovulation and the onset of menstruation). The symptoms disappear or significantly regress by the end of menstruation. Premenstrual dysphoric disorder (PMDD) is a more severe variant of premenstrual syndrome. PMS is common and severe symptoms can have detrimental effects on a woman's quality of life. GPs play a key role in the diagnosis and management of these conditions. This article aims to provide an overview of the current evidence and guidelines for recognising and managing PMS in general practice.

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Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224352 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4352

Author(s):

Yen ◽

Lin ◽

Liu ◽

Long ◽

...

Keyword(s):

Empirical Evidence ◽

Symptom Severity ◽

Luteal Phase ◽

Premenstrual Dysphoric Disorder ◽

Ovarian Hormone ◽

Hormone Concentration ◽

Estrogen Level ◽

Late Luteal Phase ◽

Interaction Term

: Objective/introduction: The dynamics of ovarian hormone fluctuations during the luteal phase of the menstruation cycle were previously suggested to contribute to the development of premenstrual dysphoric disorder (PMDD) symptoms, but adequate empirical evidence has not been obtained from hormone concentration studies. We prospectively evaluated estrogen and progesterone levels in the early luteal (EL) and late luteal (LL) phases in women with PMDD and the association of these levels with PMDD symptom severity. Methods: 63 women with PMDD and 53 controls without such severe symptoms were evaluated for the estrogen and progesterone levels, and PMDD severity in the EL and LL phases. Results: The results demonstrated that the women with PMDD had a lower EL-phase estrogen level than the controls. Covariant analysis demonstrated that the interaction term between EL-phase estrogen and EL-phase progesterone level was associated with PMDD severity. Among women with lower EL estrogen levels, higher EL-phase progesterone was observed among the women with PMDD versus controls. These results suggest that low EL-phase estrogen level could moderate the provoking effect of EL progesterone in women with PMDD. Overall, these data suggest a possible role of estrogen and progesterone in the development of PMDD symptoms.

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Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women and Women with Premenstrual Dysphoric Disorder

International Journal of Endocrinology ◽

10.1155/2010/259345 ◽

2010 ◽

Vol 2010 ◽

pp. 1-17 ◽

Cited By ~ 52

Author(s):

Ari Shechter ◽

Diane B. Boivin

Keyword(s):

Menstrual Cycle ◽

Circadian Rhythms ◽

Sex Hormones ◽

Luteal Phase ◽

Sleep Disturbances ◽

Hormone Secretion ◽

Premenstrual Dysphoric Disorder ◽

Healthy Women ◽

Female Sex Hormones ◽

Nonpharmacological Treatments

A relationship exists between the sleep-wake cycle and hormone secretion, which, in women, is further modulated by the menstrual cycle. This interaction can influence sleep across the menstrual cycle in healthy women and in women with premenstrual dysphoric disorder (PMDD), who experience specific alterations of circadian rhythms during their symptomatic luteal phase along with sleep disturbances during this time. This review will address the variation of sleep at different menstrual phases in healthy and PMDD women, as well as changes in circadian rhythms, with an emphasis on their relationship with female sex hormones. It will conclude with a brief discussion on nonpharmacological treatments of PMDD which use chronotherapeutic methods to realign circadian rhythms as a means of improving sleep and mood in these women.

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Differences in Free Estradiol and Sex Hormone-Binding Globulin in Women with and without Premenstrual Dysphoric Disorder

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-1726 ◽

2008 ◽

Vol 93 (1) ◽

pp. 96-102 ◽

Cited By ~ 20

Author(s):

Susan Thys-Jacobs ◽

Don McMahon ◽

John P. Bilezikian

Keyword(s):

Menstrual Cycle ◽

Steroid Hormones ◽

Luteal Phase ◽

Premenstrual Dysphoric Disorder ◽

Sex Hormone Binding Globulin ◽

Self Assessment ◽

Ovarian Steroid ◽

Cross Sectional ◽

Symptom Screening ◽

Hormonal Evaluation

Abstract Context: Over the years, different hypotheses involving the ovarian steroid hormones have been proposed to explain the luteal phase occurrence of severe premenstrual syndrome symptoms. Although it had been strongly suspected that differences in the concentrations of the ovarian steroids may underlie the mood and psychological imbalance of this disorder, the evidence for this hypothesis has been inconsistent and remains controversial. Objective: Our objective was to measure the ovarian steroid hormones across the menstrual cycle in women with and without luteal phase symptoms consistent with premenstrual dysphoric disorder (PMDD). Design: We measured estradiol (E2), progesterone, and SHBG in women with and without PMDD using a cross-sectional and prospective experimental design. Participating women underwent 2-month self-assessment symptom screening and 1-month hormonal evaluation. Results: Overall means for LH, progesterone, E2, peak E2, and free E2 were not different between groups. Across the menstrual cycle, overall percent free E2 was significantly lower and SHBG significantly greater in the PMDD group compared with controls (1.39 ± 0.26 vs. 1.50 ± 0.28, P = 0.03; 61.4 ± 25.1 vs. 52.4 ± 21.3 nmol/liter, P = 0.046, respectively). During the luteal phase, free E2 was significantly lower in the PMDD group compared with controls (PMDD 7.6 ± 7.0 vs. controls 8.9 ± 8.4 pmol/liter; P = 0.032). For both follicular and luteal phases, SHBG was significantly higher in the PMDD group (follicular phase 60.5 ± 31.7 vs. 51.4 ± 38.2 nmol/liter, P = 0.047; luteal phase 65.1 ± 32.3 vs. 55.1 ± 38.9 nmol/liter, P =0.03). In both groups, SHBG significantly increased from the follicular to luteal phase. Conclusion: Luteal phase concentrations of free E2, percent free E2, and SHBG differ significantly between women with and without PMDD.

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