High nocturnal body temperatures and disturbed sleep in women with primary dysmenorrhea

Abstract

Primary dysmenorrhea is characterized by painful uterine cramps, near and during menstruation, that have an impact on personal life and productivity. The effect on sleep of this recurring pain has not been established. We compared sleep, nocturnal body temperatures, and hormone profiles during the menstrual cycle of 10 young women who suffered from primary dysmenorrhea, without any menstrual-associated mood disturbances, and 8 women who had normal menstrual cycles. Dysmenorrheic pain significantly decreased subjective sleep quality, sleep efficiency, and rapid eye movement (REM) sleep but not slow wave sleep (SWS), compared with pain-free phases of the menstrual cycle and compared with the controls. Even before menstruation, in the absence of pain, the women with dysmenorrhea had different sleep patterns, nocturnal body temperatures, and hormone levels compared with the controls. In the mid-follicular, mid-luteal, and menstrual phases, the dysmenorrheics had elevated morning estrogen concentrations, higher mean in-bed temperatures, and less REM sleep compared with the controls, as well as higher luteal phase prolactin levels. Both groups of women had less REM sleep when their body temperatures were high during the luteal and menstrual phases, implying that REM sleep is sensitive to elevated body temperatures. We have shown that dysmenorrhea is not only a disorder of menstruation but is manifest throughout the menstrual cycle. Furthermore, dysmenorrheic pain disturbs sleep, which may exacerbate the effect of the pain on daytime functioning.

Effect of transcutaneous electric nerve stimulation (TENS) on hormones profile in subjects with primary dysmenorrhoea - a preliminary study

“…The mean menstrual phase cortisol and prolactin levels in this study were above normal range for premenopausal women. This result is contrary to the study of Baker et al, (1999), who reported that only in the luteal phase does the mean prolactin secretion for dysmenorrhoeic subjects rise above the normal range. Elevated prolactin and cortisol recorded in this study may be due to the discomfort of venepuncture pre and post TENS application apart from the menstrual pain, since the two hormones are stress related (Stromberg et al, 1981;Kaplan et al, 1991) CONCLUSION This study concluded that high frequency TENS significantly reduced the pain levels in dysmenorrhoeic women without significantly affecting serum levels of cortisol and prolactin level.…”

“…Also hormonal imbalance has been linked as contributing factors to the pain experienced during menstruation (Baker et al, 1999). Considering the recent popularity of TENS in managing PD because of its efficacy and minimal side-effect and the hormonal imbalance reported to be a contributing factor to menstrual pain.…”

Sleep, Circadian Rhythms, and Fertility

“…Spindle frequency is also increased during the luteal phase but an association with progesterone has not been found [10]. Although stage REM sleep is reduced during the luteal phase [9,10,85,94,97], a direct association between REM sleep amounts and progesterone is less clear [10,96].…”

Cycling time trial performance during different phases of the menstrual cycle

“…They were asked to give a written comment on any special or distressing event that had occurred during the day. This method of mood assessment has been used previously in premenopausal women (Baker et al 1999). Certain individuals are susceptible to mood changes that are dependent on variations in the concentration of ovarian hormones (Reilly 2000).…”