Menstrual Cycle Premenstrual Disorders

Effects of menstrual cycle phase on associations between the error-related negativity and checking symptoms in women

Mulligan EM, Hajcak G, Klawohn J, Nelson B, Meyer A

Published May 2019 Psychoneuroendocrinology, 103, 233-240
DOI 10.1016/j.psyneuen.2019.01.027 PMID 30721837 PMC PMC6450738

RRM Academy Synopsis

Luteal-phase brain error signal is linked to checking symptoms

In a within-subject study of 40 young women with regular cycles, a stronger brain response to errors went with more checking symptoms in the luteal phase. Each woman was tested once in the mid-follicular phase and once in the mid-luteal phase. Average checking and brain-response scores did not differ between the two phases.

Key Findings

  • Checking symptoms and the error-related negativity (ERN) did not differ between the mid-follicular and mid-luteal phases (checking: p = .85).
  • In the mid-luteal phase, a larger ERN went with higher checking symptoms (r(40) = −.47, p < .01). In the mid-follicular phase the link was nonsignificant (r(40) = −.23, p = .15).
  • Women whose checking rose from the mid-follicular to the mid-luteal phase also showed a rise in ERN (r(40) = −.38, p < .05).
  • An exploratory mediation model placed the mid-luteal ERN between mid-luteal progesterone and checking (indirect effect 95% CI [.0002 to .0046]).

Interpretation

This observational study followed 40 college women with regular cycles. None had used hormonal birth control in the past 4 months. The authors suggest the error signal may be tied to checking only in the luteal phase, and that luteal-phase progesterone could shape checking symptoms by changing sensitivity to errors. They note the results may not generalize to older or younger women, to women on hormonal contraceptives, or to clinical samples.

RRM Context

Progesterone rises only after ovulation, so an effect in the luteal phase follows an ovulatory cycle. Studies that time testing to cycle phase show how cycle charting and fertility awareness can help research on mood and anxiety.

Abstract

The menstrual cycle is known to impact mood and cognitive function and has been shown to lead to variability in symptoms of obsessive-compulsive disorders and anxiety. Using a within-subject design, the present study examined ovarian hormones, the error-related negativity (ERN), and self-reported checking symptoms in both the mid-follicular and mid-luteal phases of the menstrual cycle. ERN amplitude and checking symptom severity did not vary between the follicular and luteal phases. However, a more negative ERN was associated with greater checking symptoms in the luteal phase of the menstrual cycle, even when controlling for ERN amplitude in the follicular phase. Moreover, changes in checking symptoms between phases were associated with phase-related changes in the ERN. Finally, a significant mediation model was found such that the ERN measured in the luteal phase mediated the association between progesterone in the luteal phase and checking symptoms in the luteal phase. Collectively, the present findings suggest that levels of progesterone in the luteal phase could impact checking symptoms by modulating response monitoring and sensitivity to errors, and that fluctuation in the ERN between menstrual cycle phases may play an important role in the expression of anxious and obsessive-compulsive symptoms.

Topics

Related research

Menstrual Cycle › Premenstrual Disorders › Cyclical Symptom Patterns · Reproductive Endocrinology › Neuroendocrinology › Hypothalamic Pituitary Axis
Elizabeth M Mulligan, Greg Hajcak, Julia Klawohn, Brady Nelson, Alexandria Meyer
Liz Mulligan, Beth Mulligan, Betsy Mulligan, E Mulligan, Gregory Hajcak, G Hajcak, J Klawohn, B Nelson, A Meyer
PMID 30721837 30721837 DOI 10.1016/j.psyneuen.2019.01.027 10.1016/j.psyneuen.2019.01.027 Mulligan et al. 2019, Mulligan 2019