The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle

Abstract

Recent studies have indicated an increased incidence of female athletic injuries during the luteal phase and the first days of the menstrual period. The purpose of this study was to investigate whether postural sway and knee-joint kinesthesia very during the menstrual cycle, and whether premenstrual syndrome (PMS) influences postural balance and kinesthesia. A total of 13 subjects with regular menstrual cycles participated in the study. Postural sway and kinesthesia were measured in the early follicular phase, in the ovulation phase and in the mid-luteal phase. Postural sway was measured with an ankle disc placed on a Statometer, and kinesthesia was measured with a specially designed device. Menstrual cycle phases were determined by sex hormone analyses in serum and by luteinizing hormone (LH) detection in urine. The diagnosis of PMS was made prospectively using validated daily symptom ratings. Eight of 13 women were classified as having PMS. These women had a significantly greater postural sway (p = 0.002) and a greater threshold for detection of passive motion in the knee joints (p = 0.05) than women without PMS. A tendency (p = 0.06) towards greater postural sway in the mid-luteal phase was detected among women with PMS. This may explain the finding of an increased incidence of athletic injuries in the luteal phase, reported previously.

Sex Hormones and Neuromuscular Control System

“…There is also evidence that estrogen influences electrical activity of neurons both centrally and peripherally (Lee et al, 2002;Papka et al, 2001;. Furthermore, postural control impairments have been demonstrated in females with premenstrual symptoms in the mid-luteal phase (Friden et al, 2003). These findings support the hypothesis that lower extremity neuromuscular performance may be influenced by circulating sex hormones.…”

“…It was discovered that there is an increase in postural sway during single limb stance and threshold for detection of passive knee motion in the mid-luteal phase of the cycle (Friden et al, 2003(Friden et al, , 2005. Improved neuromuscular coordination may occur in women taking OC with a reduced number of premenstrual symptoms.…”

Fluctuations of state anxiety, spinal structure, and postural stabilityacross the menstrual cycle in active women

“…However, in one-legged stance, there was a significant increase in postural displacement in the midluteal phase. In another study by Fridén et al (13), a tendency towards greater postural sway in the midluteal phase was detected among women with premenstrual syndrome. Darlington et al (53) found that the menstrual cycle phase had no significant effect on anterior-posterior sway, but it did significantly affect lateral sway.…”

“…Although the overall postural changes were underestimated in the literature, knee and lower extremity alignment (51), knee joint position sense (25), knee joint laxity and loading (12), gait parameters (52), postural control, kinesthesia, and balance (13,14) have all been relevant since the menstrual cycle might be a potential risk factor for anterior cruciate ligament injuries in active women. Postural stability parameters were assessed in our study.…”

“…In some studies, increased levels of progesterone in the luteal phase were related to increased intensity of premenstrual complaints (anxiety, tension, irritability) (6,7), while in other studies decreased progesterone levels were found to be related to more pronounced negative mood changes (8,9). Moreover, the neuromusculoskeletal effects relating to muscle strength and stretch reflex (10), ligament laxity (11), biomechanical characteristics (12), and postural control (13,14) throughout the menstrual cycle have been investigated in the literature in order to determine the relationship between injury mechanisms in women and the differences between the sexes. Menarche itself was declared to be a risk factor in some sports and conditions (15).…”