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Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

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BMC Women's Health
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Open Access 01-12-2024 | Research

Menstrual cycle related depressive symptoms and their diurnal fluctuations – an ambulatory assessment study

Authors: Hannah Klusmann, Annette Brose, Lars Schulze, Sinha Engel, Sebastian Laufer, Elise Bücklein, Christine Knaevelsrud, Sarah Schumacher

Published in: BMC Women's Health | Issue 1/2024

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Abstract

Background

Reproductive mood disorders indicate that within-person variation in depressive symptoms across the menstrual cycle can be related to ovarian hormone changes. Until now, such cycle-related symptom changes have been measured once daily, even though depression research indicates systematic diurnal changes in symptoms. Further, previous research often focused on aggregated depression scores. This study examined whether three daily assessments of depressive symptoms follow similar trajectories across the menstrual cycle and investigated within-person cyclical fluctuation of all individual symptoms and the aggregated score.

Methods

77 naturally-cycling participants (35 with and 42 without depressive disorder) provided three daily ratings of depressive symptoms across one menstrual cycle to evaluate individual and summarized symptoms.

Results

Reliability estimates (w) of the three diurnal measurements ranged from 0.56 to 0.78. Cyclicity showed statistically significant interindividual differences for all symptoms, and individual symptoms differed significantly from each other in their magnitude of cyclicity.

Limitations

Only one menstrual cycle was assessed to reduce participant burden. Further, ovulation testing dates were based on self-reported cycle lengths, and only LH (luteinizing hormone) peaks were tested without subsequent progesterone rises.

Conclusions

The results highlight the need for a symptom-specific approach to assess individual variance in cyclicity of depressive symptoms. Reliability for one daily assessment can be improved by using the afternoon value, a sum score for depressiveness, or multiple items per symptom. Furthermore, this study emphasizes, that depressive symptoms can systematically change across the menstrual cycle, and it is, therefore, important to include it in depression research. Exploring female-specific risk factors of depression will enable the development of person-tailored treatments.

Trial registration

The study was preregistered at ClinicalTrials.gov (NCT04086316) with the first registration on 27/08/2019.
Appendix
Available only for authorised users
Footnotes
1
Item 3 (on sleep quality) was excluded from the sum-score since this item was only asked in the morning survey, after participants had slept.
 
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Metadata
Title
Menstrual cycle related depressive symptoms and their diurnal fluctuations – an ambulatory assessment study
Authors
Hannah Klusmann
Annette Brose
Lars Schulze
Sinha Engel
Sebastian Laufer
Elise Bücklein
Christine Knaevelsrud
Sarah Schumacher
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2024
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-024-03438-9

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Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the broader systemic effects of menopause, so you can help patients in your clinics through the transition.

Launching: Thursday 12th December 2024
 

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Dr. Claudia Barth
Dr. Samar El Khoudary
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