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Schmalenberger KM, Tauseef HA, Barone JC, Owens SA, Lieberman L, Jarczok MN, Girdler SS, Kiesner J, Ditzen B, Eisenlohr-Moul TA. How to study the menstrual cycle: Practical tools and recommendations. Psychoneuroendocrinology 2021; 123:104895. [PMID: 33113391 PMCID: PMC8363181 DOI: 10.1016/j.psyneuen.2020.104895] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 02/08/2023]
Abstract
Despite decades of research on the physiological and psychological effects of the menstrual cycle, studies have not sufficiently adopted consistent methods for operationalizing the menstrual cycle. This has resulted in substantial confusion in the literature and limited possibilities to conduct systematic reviews and meta-analyses. In order to facilitate more rapid accumulation of knowledge on cycle effects, the present paper offers a set of integrative guidelines and standardized tools for studying the menstrual cycle as an independent variable. We begin with (1) an overview of the menstrual cycle and (2) premenstrual disorders, followed by (3) recommendations and tools regarding data collection in cycle studies. These recommendations address selecting the appropriate study design and sampling strategy, managing demand characteristics, identifying a sample of naturally-cycling individuals, and measuring menstrual bleeding dates, ovarian hormones, and ovulation. We proceed with suggestions for (4) data preparation and coding of cycle day and phases, as well as (5) data visualization, statistical modeling, and interpretation of menstrual cycle associations. We also provide (6) recommendations for using menses start day and ovulation testing to schedule visits in laboratory studies and end with a (7) comprehensive summary and conclusion. Regardless of whether the influence of the menstrual cycle is of central interest in a study or should be controlled to accurately assess the effects of another variable, the use of these recommendations and tools will help make study results more meaningful and replicable.
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Affiliation(s)
- Katja M Schmalenberger
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Hafsah A Tauseef
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Jordan C Barone
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sarah A Owens
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Lynne Lieberman
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Marc N Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at chapel Hill, Chapel Hill, NC, USA.
| | - Jeff Kiesner
- Department of General Psychology, University of Padua, Padua, Italy.
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Tory A Eisenlohr-Moul
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
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Martel MM, Eisenlohr-Moul T, Roberts B. Interactive effects of ovarian steroid hormones on alcohol use and binge drinking across the menstrual cycle. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 126:1104-1113. [PMID: 29154570 DOI: 10.1037/abn0000304] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patterns and features of substance use and abuse vary across the menstrual cycle in humans. Yet, little work has systematically examined the within-person relationships between ovarian hormone changes and alcohol use across the menstrual cycle. Our study was the first to examine the roles of within-person levels of estradiol (E2) and progesterone (P4) in relation to daily alcohol use and binge drinking in young women. Participants were 22 naturally cycling women, ages 18-22, recruited through a university subject pool who reported any alcohol use and who completed a screening visit assessing study eligibility, followed by 35 subsequent days of data collection. E2 and P4 were obtained via enzyme immunoassay of saliva samples collected by participants each morning, 30 min after waking. Presence and degree of daily substance use were obtained using an adaptation of the Timeline FollowBack Interview completed daily. Results indicated that elevated E2 in the context of decreased P4 levels were associated with higher risk of drinking and binge drinking. These effects were present only on weekend days. Results are suggestive of a dual risk model in which both ovulatory E2 increases and perimenstrual P4 decreases increase risk for drinking. Differential associations of steroids with drinking across the menstrual cycle may suggest the need for clinical assessment of substance use to take into account hormone dynamics and menstrual cycle phase. (PsycINFO Database Record
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The effect of the menstrual cycle on dichotic listening. PLoS One 2019; 14:e0212673. [PMID: 30794649 PMCID: PMC6386373 DOI: 10.1371/journal.pone.0212673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/07/2019] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to determine the effect of the menstrual cycle on responses to a dichotic listening task. It was hypothesized that participants would exhibit a stronger right ear advantage during the menstrual cycle days when estrogen levels are at their peak. It was also hypothesized that the women not taking oral contraceptives would exhibit greater variations in ear advantage over the course of their menstrual cycle than those taking oral contraceptives. Finally, it was hypothesized that the error response rates would remain similar across different listening conditions and over the menstrual cycle. The participants were 30 women who took oral contraceptives and 15 who did not. They completed nine listening sessions comprised of three dichotic listening tasks: forced-left, forced-right, and open. The data were analyzed using a mixed effects models. The participants exhibited a reduction in right ear responses on the days that corresponded to when the level of estrogen would begin to increase. This response was different from what had been hypothesized. The analysis also indicated no response differences between the two groups of women. In addition, the women exhibited fewer errors over the course of the sessions, implying that they adapted to the task. The results indicate that the women’s hormone fluctuation across the menstrual cycle affected their responses to the forced-left, cognitive control, task only.
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