Menstrual Cycle Phase, Hormonal Contraception, and Alcohol Consumption in Premenopausal Females: A Systematic Review

Women may be particularly vulnerable to alcohol harm, but many current theories fail to acknowledge the unique factors that influence female alcohol use. The biological mechanisms underlying female alcohol consumption have largely been unexplored, although recently the menstrual cycle has been highlighted as a potentially important factor. This systematic review, using a narrative synthesis, examined the association between the menstrual cycle phases on alcohol consumption and aimed to determine whether hormonal contraception influences this association. The review follows PRISMA and SWiM guidelines, registration number: CRD42018112744. Electronic searches were conducted in the relevant databases with keyword (e.g., “menstrua*”; “alcohol”). Thousand six hundred and sixty-two titles were identified, 16 of which were included in the review. Results were inconsistent regarding whether an association between menstrual cycle phase and alcohol consumption was found. Furthermore, there was inconsistency regarding which phase was associated with higher consumption, and different factors were reported to have moderated the direction, e.g., family history of alcohol use disorder (AUD), premenstrual syndrome (PMS). These conflicting results may be partly explained by variability in both study quality and design, and differences in measurement of cycle phase and alcohol consumption. More robust research is needed before conclusions can be drawn with regard to the role of the menstrual cycle and hormonal contraception on female drinking behavior. This review provides recommendations to strengthen research in this area.

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Menstrual cycle phase, alcohol consumption, alcohol cravings, and mood among women in outpatient treatment for alcohol use disorder.

Psychology of Addictive Behaviors ◽

10.1037/adb0000576 ◽

2020 ◽

Vol 34 (6) ◽

pp. 680-689

Author(s):

Jumi Hayaki ◽

Cathryn G. Holzhauer ◽

Elizabeth E. Epstein ◽

Sharon Cook ◽

Ayorkor Gaba ◽

...

Keyword(s):

Menstrual Cycle ◽

Alcohol Consumption ◽

Alcohol Use ◽

Outpatient Treatment ◽

Alcohol Use Disorder ◽

Cycle Phase ◽

Menstrual Cycle Phase ◽

Alcohol Cravings

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Comment on: “The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis” and “The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis”

Sports Medicine ◽

10.1007/s40279-020-01384-8 ◽

2020 ◽

Cited By ~ 1

Author(s):

Tze-Huan Lei ◽

Huixin Zheng ◽

Claire E. Badenhorst ◽

Toby Mündel

Keyword(s):

Systematic Review ◽

Menstrual Cycle ◽

Oral Contraceptives ◽

Exercise Performance ◽

Meta Analysis ◽

Cycle Phase ◽

Menstrual Cycle Phase

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Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

Schizophrenia Bulletin ◽

10.1093/schbul/sbz030 ◽

2019 ◽

Vol 46 (1) ◽

pp. 78-90 ◽

Cited By ~ 3

Author(s):

Thomas J Reilly ◽

Vanessa C Sagnay de la Bastida ◽

Dan W Joyce ◽

Alexis E Cullen ◽

Philip McGuire

Keyword(s):

Systematic Review ◽

Menstrual Cycle ◽

Random Effects ◽

Psychotic Disorders ◽

Meta Analysis ◽

Psychotic Symptoms ◽

Cycle Phase ◽

Menstrual Cycle Phase ◽

Psychiatric Admission ◽

Admission Rates

Abstract Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31–1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

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Computed tomography contrast enhancement pattern of the uterus in premenopausal women in relation to menstrual cycle and hormonal contraception

Acta Radiologica ◽

10.1177/0284185120958404 ◽

2020 ◽

pp. 028418512095840

Author(s):

Konstantinos Angelopoulos ◽

Magnus Palmér ◽

Berit Gull ◽

Niklas Lundqvist ◽

Linda Kopelia ◽

...

Keyword(s):

Computed Tomography ◽

Menstrual Cycle ◽

Contrast Enhancement ◽

Luteal Phase ◽

Hormonal Contraception ◽

Premenopausal Women ◽

Follicular Phase ◽

Cycle Phase ◽

Homogeneous Type ◽

Menstrual Cycle Phase

Background There are different types of computed tomography (CT) contrast enhancement patterns of the uterus. It is not known whether these are hormonally dependent. Purpose To assess the relationship between these patterns and the menstrual cycle in non-users of hormonal contraception, and the possible impact of hormonal contraception. Material and Methods Prospective observational study of abdominal CT scans of 53 premenopausal women of whom 28 were non-users and 25 users of hormonal contraception. The non-users were divided according to menstrual cycle phase: follicular (n = 12); ovulatory (n = 1); and luteal (n = 12). The pattern and intensity of contrast enhancement of the uterine myometrium were assessed. Results The dominant pattern of contrast enhancement of the myometrium was the diffuse homogeneous type in both non-users and users. The intensity of the enhancement measured in Hounsfield units (HU) was higher in the follicular phase (median 102, range 73–130) compared to the luteal phase in non-users (median 92, range 57–130); however this was not statistically significant ( P = 0.2). The HU values observed in users (median 95, range 45–160) were at the same levels compared to those of the luteal phase in non-users. Conclusion The dominant pattern of contrast enhancement in the portal venous phase of the myometrium in fertile ages is the diffuse homogeneous type and is independent of menstrual cycle phase or the use of hormonal contraception. However, these factors seem to play a role in the intensity of contrast enhancement, with a tendency of higher HU values in the follicular phase of non-users.

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