A comparison of the psychological and hormonal factors in women with and without premenstrual syndrome.

Abstract

Women with premenstrual syndrome (PMS; n = 14) were compared with women without premenstrual syndrome (n = 14). The diagnosis was based on the volunteers' responses to the Premenstrual Assessment Form, their medical history, a physical examination, and the Utah PMS Calendar. After assignment to the non-PMS or PMS group, each subject was studied for one menstrual cycle and was evaluated, once during the follicular phase and twice during the luteal phase. On each of these occasions, circulating concentrations of estradiol and progesterone were determined, and the Depression Adjective Checklist (DACL), the Minnesota Multiphasic Personality Inventory (MMPI), and the Attributional Style Questionnaire were completed. Each subject recorded daily her physical symptoms on the Utah PMS Calendar. During the luteal phase, women with PMS had significantly higher levels of depression as measured by the DACL and MMPI than women without PMS. The two groups did not differ in the follicular phase. The women with PMS reported significantly more physical symptoms on the Utah PMS Calendar during the luteal phase, but reported no significant differences in symptoms during the follicular phase. These findings suggest a luteal phase disorder superimposed on a background free of psychiatric or physiological illness.A number of etiological causes have been proposed for premenstrual syndrome (PMS). An area of continuing interest involves the abnormal levels of the ovarian steroid hormones estradiol or progesterone, or an imbalance between the two hormones as the factor or factors responsible for premenstrual symptoms (Rubinow & Roy-Byrne, 1984). Some investigators have suggested that women with PMS have abnormalities of thyroid, adrenal, pituitary, or hypothalamus function, whereas others have proposed a number of psychological factors as being influential, predisposing, or essential factors in the etiology of PMS (for a review see Keye & Trunnell, 1988). Recently, because certain PMS symptoms are characteristic of learned helplessness, it has also been suggested as important in the development of PMS (Hamilton, Alagna, & Sharpe, 1985).Previous attempts to characterize the hormonal and psychological profiles of women with PMS have been flawed by methodologic deficiencies: First, an operational definition of the syndrome has been lacking (Rubinow & Roy-Byrne, 1984). Second, researchers have failed to use both retrospective and prospective assessments (Parlee, 1973). Finally, earlier attempts This article is based on Eric P. Trunnell's doctoral dissertation, which was supervised by

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