Exploring Patterns of Stress and Premenstrual Symptoms in Daily Life: The ISSAC Study

Background: Female individuals are at heightened risk for stressrelated disorders, particularly during hormonal transition periods.
Symptoms of premenstrual dysphoric disorder (PMDD) are closely
tied to hormonal fluctuations during the luteal phase of the menstrual
cycle. Despite evidence implicating stress as a key pathophysiological factor contributing to PMDD symptoms, the underlying psychobiological mechanisms remain poorly understood. Specifically,
potential bidirectional relationships between stress and PMDD
symptoms across the menstrual cycle have yet to be explored.
Purpose: The ISSAC study seeks to elucidate psychobiological patterns between stress and premenstrual symptomatology in daily life
by investigating stress and PMDD symptom patterns across two menstrual cycles, employing both biological and self-reported measures.
We hypothesize that momentary and daily stress is positively associated
with PMDD symptom severity.
Method: Eighty regularly menstruating individuals with varying
severities of PMDD symptoms will complete two menstrual cycles of
daily Ecological Momentary Assessments (EMA) on a smartphone.
EMA will capture perceived stress and PMDD symptoms, while saliva
will be sampled to assess cortisol and alpha-amylase as biomarkers of
stress. Traumatic experiences and chronic stress will be assessed at
baseline. To analyze within- and between-subject associations, multilevel modeling will be applied.
Results: At the forthcoming conference, the ISSAC study protocol
will be presented along with preliminary findings from ongoing data
collection.
Conclusion(s): This is the first study to prospectively examine both
psychological and biological stress factors in PMDD throughout the
entire menstrual cycle. Findings will offer novel insights into stress
mechanisms and potential bidirectional relationships, informing targeted interventions for PMDD.