Perceived stress, physiologic stress arousal, and premenstrual symptoms: Group differences and intra-individual patterns

The purpose of this study was to examine evidence for perceived stress, hyp othalamic-pituitary-adrenal, and autonomic nervous system involvement in pr emenstrual symptoms. Women with a low severity (LS, n = 40), premenstrual s yndrome (PMS, rr = 22), and premenstrual magnification symptom patterns (PM M, n = 26) rated perceived stress, turmoil, and fluid retention symptoms fo r one entire cycle. Daily late afternoon urine samples were assayed for epi nephrine, norepinephrine, and cortisol. Using multivariate analysis of vari ance analyses, we found significant group and cycle phase and group by phas e interaction effects for perceived stress. There were no group or cycle ph ase differences in cortisol, epinephrine, and norepinephrine. Intraindividu al analyses using cross-correlation techniques revealed a positive time lag ged relationship between perceived stress and norepinephrine and cortisol l evels across all groups. Only women with a PMS pattern demonstrated perceiv ed stress leading epinephrine levels. Cortisol, epinephrine, and norepineph rine levels led symptoms for all groups with one exception: there was no cr oss-correlation between epinephrine and turmoil for the PMS group. Perceive d stress led both types of symptoms, regardless of group, and symptoms also led stress. The results provide evidence for a unique relationship between epinephrine, perceived stress, and symptoms for women with PMS, and for a reciprocal relationship between stress and symptoms for each of the groups. (C) 1998 John Wiley & Sons, Inc.