The premenstrual syndrome: Psychophysiologic concomitants of perceived stress and low back pain

Abstract

The effects of experimentally induced and personally relevant stressors on low back EMG activity during 3 phases of the menstrual cycle in women with the premenstrual syndrome (PMS) and premenstrual low back pain were examined. Thirty-nine women reporting either PMS and premenstrual severe low back pain (group 1), PMS with premenstrual moderate low back pain (group 2), or those reporting neither condition (group 3) participated. During each of 3 menstrual phase-specific assessment sessions, participants were exposed to a neutral stimulus, an experimentally induced stressor, and 2 personally relevant stressors in a randomized order. Concomitant monitoring of low back EMG activity and heart interbeat interval was undertaken. Results indicated that participants in group 1 evidenced greater EMG changes in response to personal stressors compared to the neutral stimulus and experimentally induced stress during the premenstrual phase. EMG activity in response to personal stress was also significantly higher during the premenstrual phase than during the menstrual and intermenstrual phases for group 1, and higher than EMG changes evidenced by groups 2 and 3 during the same phase. Group 2, while not reporting as severe premenstrual back pain as did group 1, reported moderate levels of back pain and evidenced greater physiological reactivity to a personal stressor than did group 3. The findings highlight the link between personally relevant stressors and concomitant physiologic responsivity and the role that this arousal may play in the maintenance and exacerbation of premenstrual low back pain.

Arousal and stress response across the menstrual cycle in women with three perimenstrual symptom patterns

“…Cycle phase differences in both stress response and recovery patterns occurred only for women with the PMS symptom pattern: both skin conductance and frontalis EMG responses to the mental task were accentuated premenstrually. This is consistent with Van den Akker and Steptoe's (1989) finding of higher poststress EMG levels among patients as compared to controls and with Dickson-Parnell and Zeichner's (1988) finding of greater EMG elevation in response to stressors during premenses versus postmenses for women with PMS and with PMS and low back pain. Cycle phase differences in SCL response to stress were not evident for the PMM and LS groups.…”

“…In addition to studying naturally occurring stressors and perimenstrual symptoms, some investigators have focused on physiologic indicators of arousal and stress response across the menstrual cycle. Arousal refers to adaptive central and peripheral responses to confronting stresses or challenges (Dienstbier, 1989). Two physiological arousal systems play central roles in adaptation.…”

Social pathways to premenstrual symptoms

“…The square of the structure coefficient indicates the proportion of the variance in the function attribut-able to that variable. Canonical correlations, which indicate the amount of variance accounted for by the function, are provided as a basis for judging the substantive value of the function (Dillon & Goldstein, 1984).…”

“…The state change hypothesis also accounts for women with premenstrual symptoms experiencing different arousal and stress reactivity patterns premenses and postmenses. Women with a PMS symptom pattern demonstrated a premenstrual increase in muscle tension and skin conductance levels at rest and in response to a cognitive stressor (Dickson-Parnell & Zeichner, 1989;Van den Akker & Steptoe, 1989), but women with a PMM pattern did not (Woods, Lentz, Mitchell, & Kogan, 1994). Women with premenstrual symptoms also respond to their environments differently during premenses than during other cycle phases.…”