Hemodynamic and psychological responses to laboratory stressors in women: Assessing the roles of menstrual cycle phase, premenstrual symptomatology, and sleep characteristics

Abstract

This study assessed whether premenstrual symptomatology and/or sleep characteristics explain increased luteal phase psychophysiological reactivity to laboratory stressors. We hypothesized that: (1) premenstrual symptoms and sleep characteristics would explain greater luteal versus follicular phase psychophysiological reactivity, (2) symptoms and sleep characteristics would differentially predict psychophysiological reactivity within each cycle phase, and (3) symptoms and sleep characteristics would interact to affect luteal but not follicular reactivity. Freely cycling women (N=87) completed two laboratory sessions, one follicular (cycle days 5–9) and one luteal (days 7–10 post-ovulation). We employed two stressors: one physical (cold pressor task) and the other cognitive in nature (Paced Auditory Serial Addition Task). During testing, electrocardiography monitored heart rate (HR) while a timed and auto-inflatable sphygmomanometer assessed blood pressure (BP). Participants also completed a one-time self-report measure of sleep characteristics and premenstrual symptomatology as well as a measure of state anxiety pre-post stressor. Results revealed greater luteal HR and systolic BP reactivity compared to follicular reactivity (p<0.001 for both analyses), however neither premenstrual symptoms nor sleep characteristics explained this luteal increase. Within cycle analyses revealed that symptoms and sleep characteristics interacted to affect luteal phase state anxiety reactivity (R2=.32, p=.002) with negative affect being associated with more reactivity when sleep hours were low (β=.333, p=.04). Overall, significant relationships existed during the luteal phase only. Findings are discussed in terms of clinical utility and methodological challenges related to performing laboratory stress testing in women.

Stress and Premenstrual Symptoms in Reproductive-Aged Women

“…Women with neuroticism-related personality traits (Gingnell et al, 2010) and those with altered perception of life events who tend to overinterpret negative life events (Gonda et al, 2010) were shown to have greater sensitivity to stress. Stress was sometimes intentionally induced under laboratory settings through various methods, including cold stimuli, tourniquet ischemic tasks, and tasks to evoke cognitive stress to generate objective stressors and compare different perceptions and reactions among women through various physiological responses (Girdler et al, 2001;Klatzkin et al, 2006;Lustyk et al, 2012).…”

“…The SPAF is Downloaded by [University of Otago] at 03:44 03 July 2015 a 10-item measure that asks about physical and emotional symptoms related to affect, water retention, and pain (Lustyk et al, 2007;Masho, Adera, & South-Paul, 2005). This is a shortened version of the 95-item Premenstrual Assessment Form; its psychometric properties have been well tested, and it is more effective in assessing changes than other symptom checklists (Lustyk et al, 2007(Lustyk et al, , 2012Masho et al, 2005). The Prospective Record of the Impact and Severity of Menstrual Symptoms (PRISM) was used in three studies (Girdler et al, 2001;Gonda et al, 2010;Klatzkin et al, 2006).…”

“…Various studies have explored factors associated with stress and PMS, including age; race; BMI; marital, educational, employment, and socioeconomic status; smoking; alcohol consumption; caffeine intake; contraceptive use; gravidity; age of first menarche; menstrual patterns; psychological comorbidity; history of abuse; type of diet; degree of physical activity; sleep quality; and perception of general health (Bunevicius et al, 2012;Da Silva, Gigante, & Minten, 2008;Gollenberg et al, 2010;Lustyk et al, 2012;Masho et al, 2005;Pilver, Levy, Libby, & Desai, 2011;Sadler et al, 2010;Yamamoto et al, 2009). Although an ovulatory menstrual cycle is considered important to manifest PMS symptoms, only six studies discussed the ovulatory cycle and documented hormonal ovulation (Girdler et al, 2001;Klatzkin et al, 2006;Laessle et al, 1990;Lustyk et al, 2012;Woods et al, 1998).…”

“…Although an ovulatory menstrual cycle is considered important to manifest PMS symptoms, only six studies discussed the ovulatory cycle and documented hormonal ovulation (Girdler et al, 2001;Klatzkin et al, 2006;Laessle et al, 1990;Lustyk et al, 2012;Woods et al, 1998). Most of the studies did not specify an ovulatory or anovulatory menstrual cycle;…”

“…The definitions of PMS from the American College of Obstetricians and Gynecologists (ACOG) and the International Society for Premenstrual Disorders (ISPMD) have been cited as balanced and frequently are used to describe the group of premenstrual symptoms in the literature (Kadian & O'Brien, 2012). In this study, the term "PMS" is used based on their definitions: the symptoms may be either somatic and psychological or both, must peak at 5 to 7 days prior to menstruation and remit during the follicular phase or the onset of menstruation, must recur in at least two cycles, must significantly affect women's lives, and should be prospectively rated (Lustyk, Douglas, Shilling, & Woods, 2012;Potter et al, 2009;Shulman, 2010). Although PMS commonly occurs about a week before the next menstrual flow, it may or may not occur during the luteal phase (following ovulation) (Prior, Vigna, Schechter, & Burgess, 1990).…”