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首页> 外文期刊>BioPsychoSocial Medicine >Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder
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Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder

机译：自主神经系统活动的改变是经前综合征和经前烦躁不安的潜在病因

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Background Premenstrual syndrome (PMS) encompasses a wide variety of cyclic and recurrent physical, emotional, and behavioral symptoms occurring during the late luteal phase of the menstrual cycle and abating shortly following the beginning of menses. Although PMS is widely recognized, its etiopathogenesis is not yet understood. The present study investigates whether the activity of the autonomic nervous system, which plays a vital role in orchestrating physiological homeostasis within the human body, is altered during the menstrual cycle of women with different degrees of premenstrual symptomatology. Methods Sixty-two women in their 20s to 40s with regular menstrual cycles participated in this study. All subjects were examined during the follicular and late luteal phases. Cycle phase was determined by the onset of menstruation and oral temperature and was verified by concentrations of ovarian hormones, estrone, and pregnanediol in a urine sample taken early in the morning. Autonomic nervous system activity was assessed by means of heart-rate variability (HRV) power spectral analysis during supine rest. The Menstrual Distress Questionnaire was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. The subjects were categorized in three groups, Control, PMS, and premenstrual dysphoric disorder (PMDD) groups, depending on the severity of premenstrual symptomatology. Results No intramenstrual cycle difference in any of the parameters of HRV was found in the Control group, which had no or a small increase in premenstrual symptoms. In contrast, Total power and high frequency power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the late luteal phase from the follicular phase in the PMS group. As for the PMDD group, which had more severe symptoms premenstrually, heart-rate fluctuation as well as all components of the power spectrum of HRV were markedly decreased regardless of the menstrual cycle compared to those of the other two groups. Conclusion Several theories have been proposed to explain the underlying mechanisms of PMS with its complex web of bio-psycho-social factors. Although causes and consequences continue to elude, the present study provides intriguing and novel findings that the altered functioning of the autonomic nervous system in the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually. In addition, when symptoms become more severe (as seen in women with PMDD), the sympathovagal function might be more depressed regardless of the menstrual cycle.
机译：背景经前综合症（PMS）涵盖在月经周期的黄体后期和月经开始后不久减轻的各种周期性和复发性身体，情绪和行为症状。尽管PMS已得到广泛认可，但其病因尚未阐明。本研究调查了在不同程度的经前症状女性的月经周期中，在协调人体内部生理稳态中起重要作用的自主神经系统的活动是否发生了改变。方法62名20至40岁，有规律的月经周期的妇女参加了这项研究。在卵泡期和黄体期后期检查所有受试者。周期阶段由月经来潮和口服温度决定，并由清晨采集的尿液样本中卵巢激素，雌酮和孕烯二醇的浓度验证。仰卧休息期间通过心率变异性（HRV）功率谱分析评估自主神经系统活动。月经困扰问卷用于评估受试者月经周期的身体，情绪和行为症状。根据经前症状的严重程度，将受试者分为三组，即对照组，PMS和经前烦躁不安症（PMDD）组。结果对照组HRV各参数均未见月经周期差异，经前症状无或有少量增加。相比之下，在PMS组中，黄体后期从卵泡期开始，总功率和高频功率分别反映了整体自主神经和副交感神经的活动，显着降低。至于经前期症状较严重的PMDD组，与其他两组相比，无论月经周期如何，心率波动以及HRV功率谱的所有分量均明显降低。结论提出了几种理论来解释PMS具有复杂的生物，心理，社会因素网络的潜在机制。尽管起因和后果仍在继续，但本研究提供了引人入胜的新颖发现，即黄体后期植物神经系统功能的改变可能与月经前出现的多种心身和行为症状有关。此外，当症状变得更加严重时（如PMDD患者所见），无论月经周期如何，交感迷走功能可能会更加低落。

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