Effects of menstrual cycle phases and reproductive aging stages on arousal symptoms: observations from the Seattle Midlife Women's Health Study.

Abstract

Objective: Although investigators have devoted significant effort to understanding women's experiences of depressed mood and clinical depression during the menopausal transition and early postmenopause, they have focused less on women's experiences of emotional arousal, including emotions such as anxiety, irritability, and anger during these reproductive aging stages. The purpose of these analyses was to examine the influence of menstrual cycle phases and reproductive aging stages on women's reports of symptoms reflecting emotional arousal.

Methods: A subset of Seattle Midlife Women's Health Study (SMWHS) participants (N=301) in late reproductive stages 1 or 2 (LRS1, LRS2) or early menopausal transition (EMT) rated the severity of symptoms daily for a complete menstrual cycle during the first year of SMWHS. They rated symptom severity daily on a 1-4 scale (least to most severe) in a health diary for anxiety symptoms (anxiety, out of control, tension, nervousness, panic, and palpitations) and anger symptoms (anger, hostility, impatience, and irritability). A two-way mixed ANOVA was used to test the cycle phase (postmenses/premenses) and reproductive aging stages on each symptom for LRS1, LRS2, and EMT and also for LRS2 versus EMT.

Results: When all three groups were included in the analyses, only anger and irritability differed by menstrual cycle phase and were significantly more severe during premenses than during postmenses. There were no significant effects of reproductive aging stages and no interactions between cycle phases and stages. When analyses focused only on women in LRS2 versus EMT, anger, irritability, and feeling out of control were significantly more severe premenses than postmenses. Women in EMT versus LRS2 experienced more severe irritability, impatience, and out-of-control feelings. There were no significant interaction effects of the cycle phase and reproductive aging stages on any of the symptoms.

Conclusions: Although there were no significant differences in the severity of the arousal or anxiety symptoms when comparing LRS1, LRS2, and EMT, comparison of LRS2 versus EMT ratings revealed significant stage effects on irritability, impatience, and feeling out of control and significant cycle phase effects on anger, irritability, and feeling out of control.