Identification of a narrow post-ovulatory window of vulnerability to distressing involuntary memories in healthy women

Abstract

Psychological disorders characterised by intrusive memories are more prevalent in women than men. The biological, social and cognitive processes underlying this gender-difference have yet to be fully elucidated. Some evidence suggests that (fluctuations in) ovarian hormone levels are responsible for altered sensitivity to emotional stimuli during certain phases in the menstrual-cycle and this may form the basis of a specific vulnerability to psychological disorders in women. The post-ovulatory (luteal) phase has been identified as a period of particular vulnerability to the development of post-traumatic stress disorder (PTSD). Using an experimental model of PTSD, we examine whether differences are detectable between discrete phases in the menstrual-cycle in the experience of intrusive memories. Women (18-35 years-old) in one of three tightly-defined periods within the menstrual cycle--mid-follicular (n=15), early-luteal (n=15) and late-luteal (n=11)--provided saliva samples for ovarian-hormone assay and watched a distressing film. Subsequent intrusive memories, assessed using a daily online-diary, occurred significantly more frequently in the early-luteal group compared to mid-follicular and late-luteal groups. Intrusion frequency was negatively correlated with the estradiol-to-progesterone ratio, but not estradiol or progesterone alone, suggesting that the interactive effect of low estradiol and high progesterone at encoding contributes to the observed effect. Our results support the need for further research in a clinical context with naturally-cycling women who experience a traumatic event, since assessment of days-since-last-menses and ovarian hormone levels may help to identify those at greatest risk of developing re-experiencing symptoms akin to those seen in psychological disorder such as depression and PTSD.

Menstrual cycle influence on cognitive function and emotion processing—from a reproductive perspective

“…This review has emphasized that the luteal phase is associated with impaired emotion recognition accuracy (Conway et al, 2007; van Wingen et al, 2007; Derntl et al, 2008b, 2013; Gasbarri et al, 2008; Guapo et al, 2009) and enhanced emotional memory. Emotional events that occur during the luteal phase more often result in spontaneous intrusive recollections (Ferree et al, 2011; Soni et al, 2013), and traumatic flashback memories are more common when the trauma takes place in the luteal phase (Bryant et al, 2011). In addition, a number of studies have pin-pointed progesterone as the driving factor for these findings; progesterone levels correlated with emotional memory (Ertman et al, 2011) and positively predicted intrusive memories (Ferree et al, 2011).…”

“…Indeed, also the menstrual cycle may influence such recollections in trauma patients (Bryant et al, 2011) and as well as in healthy women (Ferree et al, 2011; Soni et al, 2013). These flashbacks or spontaneous intrusive recollections appear to be more common if the trauma or experimental exposure to aversive stimuli occurred in the luteal phase (Bryant et al, 2011; Ferree et al, 2011; Soni et al, 2013), and again, progesterone levels were positively correlated with SIR frequency (Ferree et al, 2011). …”

Sex and menstrual cycle phase at encoding influence emotional memory for gist and detail

“…Previous research, as well as our current study, clearly demonstrates that sex and sex hormones at encoding can influence these systems and modulation of emotional memory. Recent work with an experimental model of PTSD also showed that sex hormone levels at the time of trauma may be critical in naturally cycling women (Soni, Curran, and Kamboj, 2013). Results from the study indicated a period of psychological vulnerability immediately following ovulation in women, and intrusion frequency was negatively correlated with the estrogen: progesterone ratio (Soni, Curran and Kamboj, 2013).…”

“…Recent work with an experimental model of PTSD also showed that sex hormone levels at the time of trauma may be critical in naturally cycling women (Soni, Curran, and Kamboj, 2013). Results from the study indicated a period of psychological vulnerability immediately following ovulation in women, and intrusion frequency was negatively correlated with the estrogen: progesterone ratio (Soni, Curran and Kamboj, 2013). Women in the early luteal phase (immediately post-ovulation) also showed higher rates of intrusive images, suggesting that intrusion frequency is modulated by sex hormone levels and menstrual cycle position in naturally cycling women.…”

Sex differences in anxiety and depression clinical perspectives

“…Finally, a few experimental studies have demonstrated increased vulnerability to intrusive negative memories, when traumatic material is presented in the early luteal phase of the menstrual cycle compared to the follicular or late luteal phase (Soni et al, 2013). …”