Impairment of Executive Functions in Premenstrual Syndrome: State or Trait?

The aim of this study was to explore whether cognitive impairments in women with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are phase-dependent or persist across the menstrual cycle. Furthermore, we investigated whether such deficits are limited to working memory (WM) or also extend to inhibitory control (IC).

A total of 105 regularly cycling women between the ages of 19 and 35 years were tested across 3 menstrual cycle phases (mid-follicular, mid-luteal, and late luteal). Premenstrual symptoms were tracked across 2 cycles. Fifty-one women were allocated to the PMS/PMDD group, and 54 women served as control participants. WM and IC were assessed using the n-back and stop signal task, respectively. Hormone levels were determined using saliva samples.

WM deficits in the PMS/PMDD group emerged under high cognitive load and did not vary by cycle phase. The PMS/PMDD group also had significantly longer stop signal reaction times across all cycle phases, with stop signal reaction times positively correlating with premenstrual symptom severity. There was no significant correlation between performance measures and gonadal hormone levels.

Cognitive impairments in PMS/PMDD appear to be trait-like and affect both WM and IC. Additionally, IC was significantly associated with premenstrual symptom severity. Executive deficits may underlie difficulties in emotion regulation and are not solely attributable to gonadal hormone levels.