The Menstrual Cycle: Psychological, Behavioral, Physiological, and Nutritional Factors



The human female menstrual cycle is marked by the regular occurrence of menses appearing on average once every 28 days starting at puberty and ending at menopause. It is controlled by the endocrine system and requires adequate hormonal and nutritional status to function. Since the menstrual cycle is dependent on the synchronized operation between systems inputs and outputs, disturbances or system failures can occur at any point. Menstrual cycle discomfort or distress ranges from clinically defined and physiologically measurable symptoms of, for example, amenorrhea to the more difficult to measure premenstrual dysphoria. Symptoms of premenstrual discomfort or dysphoria, commonly referred to as premenstrual distress, premenstrual syndrome, or premenstrual dysphoric disorder, are physiological, behavioral, and psychological in nature, commonly experienced and can range in severity from mild to debilitating. Although premenstrual disturbances have been studied extensively by researchers from many disciplines, no consensus on its etiology exists. Nevertheless, psychological, behavioral, physiological, endocrine, and nutritional factors have all been identified as relevant in either their contribution causally or as effective in the treatment of these premenstrual dysphoric disorders. The evidence of links between biochemical, nutritional, and psychological variables and the premenstrual phase of the menstrual cycle are explored in this chapter. Nutritional interventions for premenstrual disorders are catching up with the previously extolled pharmacological therapies, but their efficacy is also yet to be confirmed.


Menstrual Cycle Premenstrual Syndrome Late Luteal Phase Premenstrual Dysphoric Disorder Dysphoric Mood 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



American College Obstetricians and Gynecology


Diagnostic and Statistical Manual III


Gonadotropin-releasing hormone


Follicle-stimulating hormone


Luteinizing hormone


National Institute of Mental Health


Premenstrual dysphoric disorder


Premenstrual syndrome


  1. ACOG. American College of Obstetrics and Gynecology: ACOG Practice Bull: Premenstrual syndrome. Washington: ACOG; 2000. April, 15.Google Scholar
  2. Abraham G, Hargrove J Infertility. 1980;3:155–65.Google Scholar
  3. van den Akker O, Steptoe A Br J Psychiatry. 1985;147:164–69.PubMedCrossRefGoogle Scholar
  4. van den Akker O, Steptoe A J Psychophysiol. 1987;1:149–58.Google Scholar
  5. van den Akker O, Steptoe A. Psychosom Med. 1989;51:319–28.PubMedGoogle Scholar
  6. van den Akker O, Steptoe A. Br J Midwifery. 1994;2 Suppl. 5:223–115.Google Scholar
  7. van den Akker O, Neale M, Stein G, Murray R Acta Genet Med Gemellol. 1987;36:541–48.PubMedGoogle Scholar
  8. van den Akker O, Eves F, Service S, Lennon B Soc Sci Med. 1995a;40 Suppl. 10:1417–23.PubMedCrossRefGoogle Scholar
  9. van den Akker O, Eves F, Stein G, Murray RM J Psychosom Res. 1995b;39 Suppl. 4:477–87.PubMedCrossRefGoogle Scholar
  10. van den Akker O, Packer A, Eves F Health Care Women Int. 1995c;16 Suppl. 3:263–72.PubMedCrossRefGoogle Scholar
  11. Atmaca M, Kumru S, Tezcan E Hum Psychopharmacol. 2003;18:191–5.PubMedCrossRefGoogle Scholar
  12. Bancroft J. Psychol Med. 1993;241:1–47.Google Scholar
  13. Barr W. Practitioner. 1984;228:425–7.PubMedGoogle Scholar
  14. Bose Usman S, Indusekhar R, O’Brien S. ) Best Pract Res Clin Obstet Gynaecol. 2008;2:251–60.CrossRefGoogle Scholar
  15. Bramwell R, Dye L Guest editorial. J Reprod Infant Psychol. 2006;24:287–8.CrossRefGoogle Scholar
  16. Braverman P. J Pediatr Adolesc Gynecol. 2007;20:3–12.PubMedCrossRefGoogle Scholar
  17. Bryant M, Truesdae K, Dye L Br J Nutr. 2006;96:888–94.PubMedCrossRefGoogle Scholar
  18. Brzezinski A, Wurtman J, Wurtman R, Gleason R, Greenfield J, Nader T Obstet Gynecol. 1990;76:296–301.Google Scholar
  19. Buchpiguel C, Alavi A, Crawford D, Freeman E, Newberg A J Psychosom Obstet Gynaecol. 2000;21 Suppl. 3:157–65.PubMedCrossRefGoogle Scholar
  20. Canning S, Waterman M, Dye L J Reprod Infant Psychol. 2006;24 Suppl. 4:363–78.CrossRefGoogle Scholar
  21. Coll A, Farooqi I, O’Rahilly S Cell. 2007;129 Suppl. 2:251–62.PubMedCrossRefGoogle Scholar
  22. Collins A, Cerin A, Coleman G, Landgren B Obstet Gynecol. 1993;81:93–7.PubMedGoogle Scholar
  23. Corsica J, Spring B Eat Behav. 2008;9:447–54.PubMedCrossRefGoogle Scholar
  24. De Souza M, Walker A, Robinson P, Bolland K J Womens Health Gend Based Med. 2000;9:131–9.PubMedCrossRefGoogle Scholar
  25. DSM III-R. Diagnostic and statistical manual. 3rd ed. revised. Arlington: American Psychiatric Association; 1987.Google Scholar
  26. DSM IV. Diagnostic and statistical manual. 4th ed. Arlington: American Psychiatric Association; 2000.Google Scholar
  27. Diegoli M, Da Fonseca A, Diegoli C, Pinotti J Int J Gynaecol Obstet. 1998;62:63–7.PubMedCrossRefGoogle Scholar
  28. Doll H, Brown S Thurston A, Vessey M J R Coll Gen Pract. 1989;39:364–8.PubMedGoogle Scholar
  29. Estes J. Diss Abstr. 1993;54 Suppl. 2A: 424.Google Scholar
  30. Facchinetti F, Borella P, Sances G, Fioroni LP, Nappi RE, Genazzani AR Obstet Gynecol. 1991;78:177–81.PubMedGoogle Scholar
  31. Freeman E, Stout A, Endicott J, Spiers P Int J Gynaecol Obstet. 2002;77, 253–4.PubMedCrossRefGoogle Scholar
  32. Gold J., editor. Premenstrual dysphoria: Myths and realities. London: American Psychiatric Press; 1994.Google Scholar
  33. Hagen I, Nesheim B, Tuntland T Acta Obstet Gynecol Scand. 1985;64:667–70.PubMedCrossRefGoogle Scholar
  34. Halaska M, Raus K, Beles P, Martan A Paithner KG Ceska Gynekol. 1998;63:88–92.Google Scholar
  35. Halbreigh U, Borenstein-Perlstein T, Kahn L Psychoneuroendocrinology. 2003;28:1–23.Google Scholar
  36. Haney M, Comer S, Fischman M, Foltin R Psychopharmacology. 1997;132:311–4.PubMedCrossRefGoogle Scholar
  37. Haney M, Hart C, Vosburg S, et al. Psychopharmacology. 2008;197:157–68.PubMedCrossRefGoogle Scholar
  38. Hicks S, Walker A, Gallagher J, Middleton RW, Wright J J Altern Complement Med. 2004;10:925–32.PubMedCrossRefGoogle Scholar
  39. Hope-Riedesel D. The cycle diet. Com. Accessed 06/01/09; 2008.
  40. Hunter M, Ussher J, Cariss M, Browne S, Jelley R, Katz M J Psychosom Res. 2002;53:811–7.PubMedCrossRefGoogle Scholar
  41. Huston J, Fujitsubo L PMDD: A guide to coping with premenstrual dysphoric disorder. Oakland: New Harbinger; 2002.Google Scholar
  42. Kendall K, Schnurr P Obstet Gynecol. 1987;70:145–9.PubMedGoogle Scholar
  43. Khoo S, Munro C, Battistutta D Med J Aust. 1990;153:189–92.PubMedGoogle Scholar
  44. Kalichman L, Malkin I, Kobyliansky E Menopause. 2007;14 Suppl. 1:135–40.PubMedCrossRefGoogle Scholar
  45. Malmgren R. Neuropsychobiology. 1987;18:83–8.PubMedCrossRefGoogle Scholar
  46. Mishell D. Am J Manag Care. 2005; Suppl 11:S473.Google Scholar
  47. Morton J, Addition H, Addition R, Hunr L, Sullivan JJ Am J Obstet Gynecol. 1953;65:1182–91.PubMedGoogle Scholar
  48. Murphy P, Wagner C J Midwifery Womens Health. 2008;53 Suppl 5:440–6.PubMedGoogle Scholar
  49. Myer C, McGrath B, Tweede H J Clin Endocrinol Metab. 2005;90:5711–6.CrossRefGoogle Scholar
  50. Nichols H, Trentham-Dietz A, Hampton JM, Titus-Renstoff L, Egan KM, Willett WC, Newcomb PA Am J Epidemiol. 2006;164 Suppl 10:1003–11.PubMedCrossRefGoogle Scholar
  51. NIMH. National Institute of Mental Health premenstrual syndrome workshop guidelines. Rockville: National Institute of Mental Health; 1983.Google Scholar
  52. Ockerman P, Backrack I, Glans S, Rassner S Recent Adv Clin Nutr. 1986;39:411–4.Google Scholar
  53. Puolakka J, Makarainen L, Vinikka L, Ylikorkala O J Reprod. Med. 1985;30:149–53.PubMedGoogle Scholar
  54. Reed S, Levin F, Evans S Horm Behav. 2008;54:185–93.PubMedCrossRefGoogle Scholar
  55. Rubba F, Mattielo A, Chiodini P, Celentano E, Galasso R, Ciardullo A, Gentile M, Triassi M, Rubba P, Panico S Nutr Metab Cardiovasc Dis. 2008;18:659–63.PubMedCrossRefGoogle Scholar
  56. Schellenberg R. BMJ. 2001;322:134–7.PubMedCrossRefGoogle Scholar
  57. Smallwood J, Ah-Kye D, Taylor I Br J Clin Prac. 1986;40:532–4.Google Scholar
  58. Smith S, Sauder C Psychol Med. 1969;31:281–7.Google Scholar
  59. Steiner M, Pearlstein T, Cohen L Endicott J, Kornstein SG, Broberts C, Roberts DL, Yonkers K J Womens Health. 2006;15:57.CrossRefGoogle Scholar
  60. Stokes J, Mendels J Lancet. 1972;1:1177–8.PubMedCrossRefGoogle Scholar
  61. Tamborini A, Taurelle R Rev Fr Gynecol Obstet. 1993;88:447–57.PubMedGoogle Scholar
  62. Thys-Jacobs S, Ceccarelli S, Bierman A, Weisman H, Cohen M-A, Alvir J J Gen. Intern. Med. 1989;4:183–9.PubMedCrossRefGoogle Scholar
  63. Thys-Jacobs S, Starkey P, Bernstein D, Tan J Calcium carbonate and the premenstrual syndrome: Effects on premenstrual and menstrual symptoms. Am J Obstet Gynecol. 1998;179:444–52.PubMedCrossRefGoogle Scholar
  64. Turner S, Mills S Complement Ther Med. 1993;1:73–2.CrossRefGoogle Scholar
  65. Ussher J. Ann. Rev. Sex Res. 1996;7:218–51.Google Scholar
  66. Ussher J, Perz J J Reprod Infant Psychol. 2006;24 Suppl 4:347–62.CrossRefGoogle Scholar
  67. Walker A, De Souza M, Vickers M, Abeyasekera A, Collins ML, Trinca LA J Womens Health. 1998;7:1157–65.PubMedCrossRefGoogle Scholar
  68. Walker A, De Souza M, Marakis G, Robinson PA, Morris AP, Bolland KM Med Hypotheses. 2002;58:213–20.PubMedCrossRefGoogle Scholar
  69. Williams M, Harris R, Bernard C, Dean C J Int Med Res. 1985;13:174–9.PubMedGoogle Scholar
  70. Wurtman J, Brzezinski A, Wurtman R, Laferrere B Am J Obstet Gynecol. 1989;161:1228–34.PubMedGoogle Scholar
  71. Wyatt K, Dimmock P, Hayes-Gill B, Crowe J, O’Brien S Fertil Steril. 2002;78 Suppl 1:96–101.PubMedCrossRefGoogle Scholar
  72. Yonkers K, O’Brien S, Eriksson E Lancet 2008; 371:1200–10.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of PsychologyMiddlesex UniversityLondonUK

Personalised recommendations