Approximately 2.5 million U.S. women experience severe symptoms of premenstrual syndrome (PMS) which contribute to dysfunctional social relationships and, in some, depression with suicidal ideation. Women with PMS report a heightened responsiveness to stress during their symptom days, but not in their non-symptom days. Physiologically, there is a common stress-response link in reproductive and adrenal hormonal pathways: cortisol releasing factor (CRF). The effects of increased CRF on these pathways can be examined by applying a stress challenge and measuring the responses in selected hormone pulsatile release patterns. If transient, episodic alterations in the reproductive or adrenal hormonal pathways are demonstrated in response to a stress challenge, our knowledge of the physiology of PMS will be advanced and nursing therapeutic strategies directed at symptom management can be explored. The purpose of this study is to provide evidence for a significantly greater responsiveness to an applied stress challenge, compared to rest conditions, in the luteal phase of the menstrual cycle in women with PMS (n=20), compared to normal controls (n=20), using a repeated measures, between group design.
Specific aims of the study are to determine whether women with PMS as compared to controls demonstrate 1) heightened stress-challenge responsiveness in the pulsatile release patterns of serum luteinizing hormone (reproductive pathway), cortisol (adrenal pathway), and somatic stress indicators (e.g. heart rate, urinary epinephrine), 2) relationships among the indicators of stress-challenge responsiveness, and 3) heightened perception of stress in the luteal phase. Hormone release patterns will be evaluated through frequent blood sampling (every 10 minutes for 12 hours) on two luteal phase days; on stress challenge day the Stroop Color Word Test will be applied, on rest conditions day, restful reading). Somatic stress indicators will be measured before, during, and after stress challenge conditions and rest conditions. Daily Likert-format ratings of stress will be used to assess perceived stress.
