Dysregulation of cardiovascular and neuroendocrine responses to stress in premenstrual dysphoric disorder

Twelve women with prospectively confirmed premenstrual dysphoric disorder ( PMDD or PDD) were compared with 12 healthy control subjects for cardiovascu lar and neuroendocrine responses to speech and mental arithmetic (Paced Aud itory Serial Addition Task) stressors during both the follicular and luteal phases of the menstrual cycle. Structured clinical interview was used to a ssess psychiatric and abuse histories, and standardized questionnaires were administered to assess current life stress. Results revealed that PMDD wom en had significantly lower stroke volume, cardiac output and cortisol level s but significantly elevated norepinephrine and total peripheral resistance at rest and also during mental stressors compared with control subjects. T hese effects were evident in both cycle phases. Significantly more women wi th PMDD had histories of sexual abuse, and they also reported greater curre nt life stress than control subjects. Consistent with a history of trauma, the PMDD women exhibited significantly greater ratios of norepinephrine to cortisol at rest and during stress. These results are interpreted as reflec ting dysregulation of the stress response and may be related to histories o f severe and/or chronic exposure to stress for a subgroup of PMDD women. (C ) 1998 Elsevier Science Ireland Ltd. All rights reserved.