Menstrual symptoms: a social cognition analysis

Physiological and psychological correlates of attention-related body sensations (tingling and warmth)

Body sensations play an essential role in the subjective evaluation of our physical health, illness, and healing. They are impacted by peripheral somatic and external processes, but they are also heavily modulated by mental processes, e.g., attention, motor control, and emotion. Body sensations, such as tingling, numbness, pulse, and warmth, can emerge due to simply focusing attention on a body part. It is however an open question, if these sensations are connected with actual peripheral changes or happen “only in the mind.” Here, we first tested whether the intensity of such attention-related body sensations is related to autonomic and somatomotor physiological processes and to psychological traits. In this study, attention-related body sensations were not significantly connected to changes in physiology, except warmth sensation, which was linked to decrease in muscle tension. Overall intensity of tingling significantly correlated with body awareness and tendentiously with body–mind practice. This strengthened the hypothesis that attention-related body sensations are more the result of top–down functions, and the connection with peripheral processes is weak. Here, we suggested a novel protocol to examine the effect of manipulating attention on body sensations, which together with our results and discussion can inspire future researches.

Changes in Moods and Activation Levels During the Menstrual Cycle in Experimentally Naive Subjects

Two experiments providing additional validity data on the Profile of Mood States and the Thayer Activation-Deactivation Adjective Check List were performed. In the third and main experiment, seven normally menstruating women filled out both questionnaires at the same time every day for 90 days. They were not aware that they were participating in a study of menstruation. Analysis of the time series records of individual women revealed relatively few significant fluctuations in moods and activation levels. Analysis of the group data showed that Fatigue, Confusion, Deactivation/Sleep, and Depression/Dejection were significantly lower in the premenstrual phase than in the periovulatory phase of the cycle, while General Activation was higher. Anger/Hostility and Confusion were both lower in the menstrual phase than in the periovulatory phase. On a retrospective menstrual distress questionnaire, these same subjects say that they experience increases in anxiety, irritability, depression, and tension in the premenstrual phase of the cycle. The differences between individual and group data and the apparent discrepancy between daily self-reports and retrospective questionnaires are discussed.

Questionnaire Studies of Paramenstrual Symptoms

A number of formal questionnaires have been devised to study paramenstrual symptomatology. It has been suggested that women's responses to these questionnaires are vulnerable to forgetting and contaminated by culturally induced expectations. Nevertheless, concurrent reports of experienced symptoms may correlate highly with retrospective judgments, even when the relevance of the menstrual cycle is disguised. They also differentiate between women with and without a self-reported history of premenstrual symptoms, although concurrent reports across several menstrual cycles are impractical to collect and may be inconsistent between successive cycles. A number of methodological criticisms have been directed toward the most commonly used device, the Menstrual Distress Questionnaire. In principle, however, retrospective questions offer a reliable and accurate indication of women's experience during the normal menstrual cycle.

Mood Fluctuations: Women Versus Men and Menstrual Versus Other Cycles

Mood fluctuations in women and men were studied both prospectively and retrospectively to determine whether cyclic changes occur over phases of the menstrual cycle, lunar cycle, and/or days of the week. The participants (15 women using oral contraceptives, 12 normally cycling women, and 15 men), who did not know the purpose of the study, recorded the pleasantness, arousal, and stability of their moods daily for 70 days (concurrent data). Later they recalled (retrospective data) their average mood for each day of the week and phase of the menstrual cycle (women only). The only evidence of mood fluctuation over the menstrual cycle in the concurrent reports was that normally cycling women reported more pleasant moods in the follicular and menstrual phase than did men and women on oral contraceptives. Women's moods fluctuated less over the menstrual cycle than over days of the week. Recollections of menstrual mood changes differed from actual changes: Women recalled more pleasant moods in the follicular phase and more unpleasant moods in the premenstrual and menstrual phases than they had reported concurrently. Bias also was evident in recollections of weekday mood fluctuations: Weekend highs were exaggerated and Monday blues were reported even though they were not reported concurrently. There was no evidence of mood fluctuations over the lunar cycle and the groups did not differ in mood stability. The retrospective reporting bias for both the menstrual cycle and days of week suggests the influence of stereotypes about moods. Implications for research and practice are discussed.

Suppression of Menstrual Distress Symptoms

The present study examined Type A and Type B women's reporting of chronic recurring symptoms of menstrual distress, which are culturally defined as interfering with daily activities. Based on previous laboratory experiments, it was expected that Type A women would be motivated to ignore symptoms during menstruation in order to carry on daily activities. Consequently, they would report less intense symptoms during menstruation relative to the intensity of the same symptoms reported when Type As would not be motivated to ignore symptoms. This hypothesis was supported and subsidiary analyses showed that both positive and negative sensations associated with menstruation were relatively underreported by Type As. Thus, it appears that Type As' suppression of acute symptoms during performance of specific tasks extends to suppression of menstrual distress.

Placing Premenstrual Syndrome in Perspective

In a longitudinal prospective study, mood fluctuations were assessed for evidence of premenstrual syndrome (PMS) as well as other menstrual, day of week, and lunar cyclicity. Volunteer participants from the community (60 women and 10 men) provided daily data for 12 to 18 weeks. Significant mood fluctuation was determined by a new nonparametric method using each individual's own standard deviation as a measure of “marked” change. Cyclicity was the norm; two thirds of both the women and men had one or more menstrual or lunar phases or days of the week that were markedly positive and/or negative, relative to their own range, but few experienced stereotypical cyclicity (PMS, Monday blues, full moon). About half the women whose prospective data met conservative criteria for PMS, met liberal criteria, or met neither criteria said they had PMS, and half in each group said they did not.

Social Stimulus Perception and Self-Evaluation: Effects of Menstrual Cycle Phase

Women in different phases of the menstrual cycle were compared to each other and to men in their responses to a social interaction stimulus: a videotape depicting a female nurse interacting with a hospitalized patient. Sex differences and cycle-phase differences were found for both affective and cognitive dimensions. Premenstrual women reported feeling more dominant, energetic, indifferent, negative, and somewhat more tense than women menstruating or women in the intermenstrual cycle phase. However, they did not differ from men in their affective ratings. Premenstrual women evaluated the nurse as less attractive than did men and they attributed greater responsibility for the nurse's behavior to the patient than men and intermenstrual women. Women in all groups evaluated the nurse as nicer and more pleasant, interesting, concerned and self-assured than did men. All women also felt more friendly toward the nurse and reported that they would be more comfortable asking her questions than the men did. The implications of these findings are discussed.

Prevalence and Predictors of Cyclic and Noncyclic Affective Change

The prevalence of cyclic and week-to-week affective change was prospectively assessed over two consecutive menstrual cycles in a nonclinical sample of 101 employed women. Although 40% perceived themselves to have premenstrual syndrome (PMS), none showed a recurrent pattern of marked premenstrual affective change. Marked affective change was as likely to occur in the postmenstrual as the premenstrual phase. Weekly marked change was as prevalent as cyclic change. Although social health (perceived quantity and quality of interpersonal relationships) and subjective stress consistently predicted both cyclic and weekly affective states, the contribution of social health was 10 times greater than that of stress. The role of social health requires further examination, as does the widespread misuse of the PMS label to account for occasional changes in affect.

Effects of Expectations and Bodily Sensations on Self-Reports of Premenstrual Symptoms

Two experiments examined expectations and bodily sensations in premenstrual symptom reports. Women took a fictitious test that indicated they were either “premenstrual” or “intermenstrual.” In Experiment 1, 48 women were studied during their premenstrual phase. In Experiment 2, 82 women were studied during either their premenstrual or intermenstrual phase. Individual differences in retrospective premenstrual distess were assessed prior to the experiments. Both experiments revealed that the higher the woman's retrospective reports of premenstrual distress, the more symptoms she reported in the lab during her premenstrual phase, regardless of what the test indicated. However, women who were told they were premenstrual reported greater symptoms than women who were told they were intermenstrual. In summary, although expectations affect women's symptom reports regardless of their actual phase and history of reported symptoms, premenstrual symptom reports cannot be dismissed as simply expectations, because some women do experience greater symptoms as they approach menstruation.

The biomedical standardization of premenstrual syndrome

This essay traces the history of premenstrual syndrome (PMS) in French, British, and American medical literature from 1950 to 2004. Aetiological theories, treatments and diagnostic criteria have varied over time and place, reflecting local conditions and changing notions of objectivity and evidence. During the 1970s researchers in each nation utilised different research strategies to overcome variation and contradictory results characteristic of PMS research. Since the 1980s, attempts have been made to standardise research internationally through prospective daily rating questionnaires that diagnose and measure PMS. Amidst controversy, a psychiatric reformulation of the syndrome was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). While the diagnostic criteria for this psychiatric category, now called premenstrual dysphoric disorder (PMDD), are widely accepted for research purposes, efforts to transfer them to medical practice have been less successful. PMDD remains a contested disease construct.

Attitudes toward menstruation in premenstrual dysphoric disorder: a preliminary report in an urban Turkish population

The manner in which menstruation, femininity and the role of the mother are perceived, along with the social influences, are emphasized in the psychosocial dimension of premenstrual syndrome. This study attempts to investigate the perception of mothers and attitudes toward menstruation of a group of women diagnosed with premenstrual dysphoric disorder (PMDD) in a secular Muslim country. Thirty women with PMDD and 24 healthy women were studied using a semi-structured questionnaire. Menstrual attitude and the way the mother was perceived in the childhood-to-puberty period by women with PMDD, were significantly negative in comparison to the control group. In conclusion, menstrual attitudes and premenstrual experiences of women should be investigated cross-culturally and prospectively.

Belief and feeling: evidence for an accessibility model of emotional self-report

This review organizes a variety of phenomena related to emotional self-report. In doing so, the authors offer an accessibility model that specifies the types of factors that contribute to emotional self-reports under different reporting conditions. One important distinction is between emotion, which is episodic, experiential, and contextual, and beliefs about emotion, which are semantic, conceptual, and decontextualized. This distinction is important in understanding the discrepancies that often occur when people are asked to report on feelings they are currently experiencing versus those that they are not currently experiencing. The accessibility model provides an organizing framework for understanding self-reports of emotion and suggests some new directions for research.

Positively reframing perceptions of the menstrual cycle among women with premenstrual syndrome

OBJECTIVE

To positively reframe perceptions of menstrual cycle experiences to diminish reports of negative perimenstrual symptoms among women with premenstrual syndrome (PMS).

DESIGN/SAMPLE

A longitudinal quasi-experimental research design; data were collected on 28 women.

SETTING

Treatment sessions were conducted in a university classroom in the northeastern United States.

INTERVENTION

The intervention consisted of a health promotion program that provided social support and a psychoeducational intervention with a positive reframing psychotherapeutic maneuver.

MAIN OUTCOME MEASURES

To describe (a) perceptions of biologic, psychologic, and social outcomes related to perimenstrual changes and (b) compare biologic, psychologic, and social outcomes of women participating in a health promotion intervention with women not participating.

RESULTS

Negative perimenstrual symptom reports decreased for women in the experimental group. In addition, the participants' personal resources increased significantly.

CONCLUSIONS

Participation in a peer support group that provides women with information on positive concomitants of the menstrual cycle can benefit women with PMS.

Primary dysmenorrhea and physical activity

It has been widely claimed that exercise is beneficial to dysmenorrhea, yet solid evidence is lacking. Studies investigating this relationship have been reviewed for this paper. Most showed decreased prevalence and/or improved symptomatology with exercise. However, controlled longitudinal studies involving women with confirmed primary dysmenorrhea who are sufficiently blinded to the study objectives are necessary before a definite relationship between exercise and dysmenorrhea can be established.

Premenarcheal expectations and postmenarcheal experiences of positive and negative menstrual related changes

PURPOSE

Longitudinal examination of early adolescent girls' premenarcheal expectations and postmenarcheal experiences of positive and negative menstrual related changes.

METHOD

Ratings of 14 positive and negative changes were made by 80 girls on three occasions: (1) in grade 6 when girls were premenarcheal, (2) at the test occasion within six months after each girls' own menarche, and (3) in grade 9 when girls were postmenarcheal. Premenarcheal girls rated expectations of changes, and postmenarcheal girls rated experiences of changes, for both premenstrual and menstrual phases. Girls also rated preparation for, and emotional response to, menarche and mothers' helpfulness on the first two occasions.

RESULTS

Ratings for positive and negative changes were at similar levels premenarcheally and decreased at menarche; once menstruation became established, ratings of negative changes increased while those of positive changes decreased. Ratings for negative changes were higher in the menstrual phase, while ratings for positive changes were higher in the premenstrual phase. Premenarcheal expectations of changes contributed to the prediction of menarcheal experiences of changes. Premenarcheal expectations and menarcheal experiences, along with anticipated emotional response to menarche, contributed to the prediction of longer-term experience of negative changes; menarcheal experiences, along with preparation for and emotional response to menarche, contributed to the prediction of longer-term experience of positive changes.

CONCLUSIONS

Both expectations about, and initial experiences of, menstrual cycle-related changes were associated with longer-term menstrual experiences. The different outcomes for positive and negative changes have implications for menstrual socialization, and provide the basis for some optimism about facilitating a more complex and multidimensional understanding of menstruation.

Theory and methodology in premenstrual syndrome research

Premenstrual Syndrome (PMS) is a controversial and ill-defined phenomenon, the aetiology of which remains an enigma, despite considerable research effort. In this paper, four meta-theoretical approaches to PMS are described and evaluated. Approaches to PMS can be criticised on three inter-related grounds. They have failed to describe women's experiences in detail before explaining them; they have not placed experience within its socio-cultural context; and they have assumed a linear relationship between biology or culture and behaviour. Future research can address these issues in two ways. Biopsychosocial models of PMS may integrate a variety of approaches and improve our understanding of individual experiences but are unlikely to offer new insights into the phenomenon of PMS. These are more likely to emerge from anthropological and sociological studies which question the cultural and individual meaning of PMS.

Social pathways to premenstrual symptoms

The purpose of this study was to explore feminine and menstrual socialization, expectations about experiencing symptoms, and the stressful nature of women's lives among women with three perimenstrual symptom patterns. Social learning and stress theory provided a theoretical framework for understanding why some menstruating women experience premenstrual syndrome or premenstrual magnification symptom patterns. Data about socialization, stressful life context, expectations about symptoms, depressed mood, and other health-related and demographic indicators were obtained from an interview. Subsequent daily recordings in a health diary for two or more menstrual cycles provided data with which to classify women's symptoms across the menstrual cycle as a low severity symptom (LS, n = 73), premenstrual syndrome (PMS, n = 36), or premenstrual magnification (PMM, n = 62) pattern. Stepwise discriminant function analysis demonstrated that stressful life context, menstrual socialization, and expectations about symptoms related to menstruation differentiated women with an LS from those with a PMS or PMM symptom pattern. In addition, depressed mood differentiated the three groups.

Menstrual-cycle effects on mood and perceptual-motor performance

Fifty-four participants took part in a study to evaluate the effects of the menstrual cycle on mood and the performance of a perceptual-motor task. The task involved tracking a randomly-moving circle on a computer screen with a joystick-controlled dot. Women were tested on three occasions, during the premenstrual, menstrual and ovulatory phases. Each testing session involved completing the Menstrual Distress Questionnaire, the monopolar Profile of Mood States questionnaire and performing five, timed trials on the task. A control group of male participants completed the Profile of Mood States questionnaire on three separate occasions over 28 days according to a pseudo-menstrual cycle experimental protocol. Results revealed that females experienced low energy and impaired cognitive function, both premenstrually and during menstruation. Task performance did not vary with menstrual-cycle phase, suggesting that they either tried to compensate for a lack of well being, or that negative mood was of insufficient magnitude to manifest a performance change. The findings suggest that when the purpose of an assessment is disguised, typically-reported menstrual-cycle and mood-related effects on performance are not observed reliably.

Course and outcome in panic disorder: a review of recent follow-up studies

This paper reviews the methodologic considerations that are important in evaluating and interpreting panic disorder outcome studies and the results of the most well-designed of these studies. Sixteen studies that used modern diagnostic criteria and interviewed at least 25 patients on at least two occasions over a minimum follow-up period of one year are reviewed. Results show that, despite the availability of effective anti-panic treatments, panic disorder remains a chronic illness. While most patients improve, few are "cured." The presence of agoraphobia, major depression and personality disorder seems to predict poorer outcome. The importance of measuring multiple clinical dimensions of panic is emphasized, along with the need to reach a consensus about the definition of "outcome" and the particular instruments to use to measure it.

Cycle-phase changes in perceived stress in women with varying levels of premenstrual symptomatology

Stress has been documented as a critical factor in understanding a variety of health problems. This study was designed to examine the relationships between symptom severity and perceived stress in women with varying severity levels of premenstrual symptoms. Perceived stress was evaluated before and after menstruation in 104 women. Women who had high levels of premenstrual symptomatology demonstrated significantly greater perceived stress in the premenstrual phase compared to the postmenstrual phase, while women with low levels of premenstrual symptomatology showed no cycle-phase difference.

Random-number generation and the menstrual cycle: preliminary evidence for a premenstrual alteration of frontal lobe functioning

20 women (M age = 30.4 yr.) were given the "Mental Dice Task" (randomization of the numbers from 1 to 6) once during the preovulatory and once during the premenstrual phases of their menstrual cycles. In addition, for both test sessions a premenstrual-symptom score was assessed reflecting self-rated severity of cognitive, affective, and somatic complaints during the preovular and the premenstrual phases. In comparison to series of real dice throws, the Mental Dice sequences of all the subjects showed a relative lack of repetitions and an excess of counting at both times of testing. Counting bias was significantly enhanced in the sequences generated during the premenstrual testing and the size of this bias was positively correlated with the self-rated severity of premenstrual symptoms. Pronounced counting despite the instruction to randomize was interpreted as reflecting decreased ability to suppress task-irrelevant cues and indicating a relative impairment of frontal lobe functioning. Resistance of the Mental Dice Task towards expectation biases renders a sociopsychological interpretation of these results improbable. We conjecture that, like other cognitive processes, frontal lobe functions also fluctuate with hormonal changes.

The attitudes towards menstruation among Icelandic nursing students--their relationship with menstrual preparation and menstrual characteristics

The purpose of this study was to describe the attitudes towards menstruation of Icelandic female nursing students and see if a relationship exists between the attitudes with recollection of menarche and characteristics of present menstruation. Findings show that the students (N = 178) view menstruation as natural, not very predictable or debilitating, even though they do not deny that menstruation can effect behaviour in some way. Findings also indicate that the heavier the menstrual flow, the less likely the student is to deny all affects of menstruation as well as finding menstruation more debilitating and more predictable; the longer the menstrual period the more predictable is the coming of the next menstrual period and the less likely is the student to deny all effects of menstruation. It is suggested that inconveniences brought about by menstruation influence the formation of menstrual attitudes.

Cultural variations in attitudes toward menstruation

Attitudes towards menstruation play an important role in the perception of menstrual distress. The influence of cultural and social factors was studied in a group of 48 Indian women using the Menstrual Attitudes Questionnaire (modified version). Women over 25 years of age were significantly more likely to consider menstruation as being "natural". No other significant relationships were found between menstrual attitudes and demographic variables. The menstrual attitudes of Indian and American college women (from a previous study) were also compared.

Sociocultural aspects of menstrual attitudes and premenstrual experiences in India

Menstrual attitudes were studied in a group of 48 Indian women using the Menstrual Attitude Questionnaire, modified and adapted for Indian background. Attitudinal factors of menstruation being a natural, bothersome and debilitating event were studied, as also denial of the event and healthy/unhealthy attitudes. High rating was seen in menstruation being perceived as a natural event and least as a debilitating one. Older women considered menstruation as a natural event. Relating premenstrual experiences to attitudes, it was observed that distressful symptoms correlated significantly with debilitating and unhealthy attitudes. Similarly, premenstrual well-being correlated highly with naturalness attitudes, thereby suggesting that the personal experiences are likely to influence the menstrual attitudes.

Premenstrual syndrome

The Premenstrual Syndrome (PMS) was described as a unique entity meriting therapeutic attention in 1931. Although researchers in the area have failed to develop a widely accepted definition of PMS, substantial progress has been made in describing the variety of psychobiological profiles encompassed by this syndrome, particularly with respect to its typical symptoms, cyclical nature, symptoms recurrence and severity. Therapies ranging from diet and exercise to vitamin, hormone and drug treatment have been proposed. While none is more efficacious than placebo, several have been popularized. Our failure to develop adequate treatment may reflect our lack of understanding of either the psychosocial or biological factors involved in PMS. This, in turn, may reflect inadequate theoretical development in this research area. We provide a critical assessment of research on PMS, suggest a framework for theoretical development and advocate research strategies that might provide insights into the etiology of the premenstrual syndrome.

Psychological and physical determinants of premenstrual symptoms before and after hysterectomy

The aim was to study women before and after hysterectomy (with conservation of the ovaries), in order to discover how far premenstrual symptoms are caused physically and how far psychologically. In such women both physical and psychological factors can influence premenstrual symptoms before hysterectomy; after the operation, in the absence of menstruation, only physical factors can do so. The subjects were 56 women awaiting hysterectomy for menorrhagia of benign origin. During three pre-operative months these women made daily self-ratings on a check-list in which typical premenstrual symptoms were interspersed with atypical symptoms; in this way their awareness of the premenstrual focus was minimized. Starting six months after hysterectomy, the women again kept daily check-lists for three months; over the same period their serum progesterone levels were measured to identify the premenstruum. After hysterectomy, levels of premenstrual symptoms fell significantly in the whole group, indicating that psychological factors were important determinants of such symptoms before hysterectomy.

Mood changes and physical complaints during the normal menstrual cycle in healthy young women

Significant emotional and physical symptoms have been linked to hormonal changes during the menstrual cycle. A critical evaluation of the available studies questions the commonly held belief in menstrual-cycle-related complaints in the majority of normal women. The present study investigated changes in mood, somatic complaints and vegetative variables during the menstrual cycle in 30 healthy young women. Normal cycle function was evaluated and cycle phases were defined according to endocrine data. For all subjects, blood samples were taken at least three times a week to measure estradiol and progesterone. Daily ratings of psychological variables revealed no significant changes in global mood or depression over the cycle. Somatic complaints such as abdominal pain and breast tenderness were significantly related to the luteal, premenstrual, and menstrual phases. Appetite increased in the periovulatory and premenstrual phases. There was a tendency for sexual interest to be highest in the post-menstrual period. Affect and vegetative variables showed no association with hormone levels but were significantly correlated with subjective stress ratings. We conclude that in most healthy young women, cycle-related hormone fluctuations are not accompanied by marked affective changes. Specific physical complaints, however, do occur, particularly in the luteal, premenstrual, and menstrual phases.

Positive changes in the premenstrual period

Positive or creative changes in the premenstrual week have been described. This study examines the perceptions of 100 healthy women as to whether they experience positive premenstrual changes and to what extent these occur alone or in combination with negative changes. Sixty-six percent of the women reported at least one positive premenstrual change, most frequently increased sexual interest and enjoyment, tendency to clean and tidy, tendency to get things done, more attractive breasts, more energy and more creative ideas. There was a weak negative correlation between the number of negative premenstrual changes and the number of positive changes reported. There were no statistically significant associations for age (under or over 30 years), marital status, oral contraceptive use or cycle regularity for positive, negative or total number of premenstrual changes. To complement the current interest in negative symptoms, further studies of positive premenstrual changes are required.

Correlates of confirmed premenstrual dysphoria

This study found that women with prospective reports of premenstrual dysphoria could be significantly differentiated from others on self-report measures of anxiety, depression and negative self-statements. Women who reported premenstrual dysphoria retrospectively but not prospectively did not significantly differ from controls on any of these measures using the State-Trait Anxiety Inventory, the Beck Depression Inventory and the Automatic Thoughts Questionnaire. Issues for further investigation are highlighted.

PMS AND THE WORKPLACE

Surprisingly, few studies have been reported regarding the effects of premenstrual syndrome (PMS) in the workplace. Given the increasing number of working women, it is important to ask whether PMS has any significant effect on work behavior. The purpose of this review is to consider selected PMS research in order to integrate the more relevant work-related findings and suggest how employers might best use this knowledge.

The possible relation of the menstrual cycle to susceptibility to fear acquisition

Biological changes due to the menstrual cycle may account for the fact that fears are not equally distributed between the sexes. In a differential, classical conditioning paradigm, women in premenstrual phase of their menstrual cycles were compared with a control group of women at other points in their cycles except within seven days before menstruation. Electric shock and pictures of natural scenes were used as UCS and CS respectively. Premenstrual women showed an enhanced susceptibility to the acquisition of a conditioned skin conductance response and to delayed extinction, while control women did not. The possible role of an altered physiological state during the premenstrual phase in the acquisition of fear responses is discussed.

A simple method for the diagnosis of premenstrual syndrome by use of a self-assessment disk

A diagnostic disk based on the obstetric calculator was developed for the self-assessment of menstrual cycle symptoms. The instrument, called the PMT-Cator (Rocket of London, Watford, England) can be used to monitor five symptoms for up to 6 weeks. A set of simple calculations are described inside the disk to determine whether the symptom scores are suggestive of premenstrual syndrome. Results of the PMT-Cator correlate well with those of more complex analysis. The PMT-Cator may have other uses as well.

Mood across the menstrual cycle and number of menstrual symptoms reported: a cross-sectional study

This study assessed mood among 110 women at three phases of the menstrual cycle and its relationship with the number of reported menstrual symptoms. Women who reported fewer menstrually-related symptoms tended to have generally higher mood scores, but specific depression of mood during menses was found among the subgroup of women who reported fewer menstrual symptoms. Contraceptive pill usage was not related to mood variation across the menstrual cycle. The findings raise questions about the validity of self-reports of menstrually-related symptoms.