Menstrual cycle phase and premenstrual symptoms in relation with the stress response: an fMRI study
- 1Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University of Tuebingen, Germany
Abstract
Objective: Women with premenstrual syndrome (PMS) experience affective lability, irritability, depressed mood, and anxiety during the late luteal phase of the menstrual cycle. Stress reactivity may contribute to the development of these symptoms, yet neural correlates remain unexplored. We examined neural, behavioral and endocrine stress responses across menstrual cycle phases in women with and without PMS. Methods: 26 women with PMS and 24 women without PMS participated in two fMRI sessions, during the mid-follicular (days 5 to 11) and late-luteal phases (days -7 to -1). Participants completed the Montreal Imaging Stress Task (MIST). Subjective stress ratings and salivary cortisol were collected at six time points before and after stress induction. Stress-related brain activation was assessed using whole-brain and region-of-interest analyses. Results: Subjective stress ratings increased as expected from before to after the MIST, with no group or phase differences. Salivary cortisol was significantly higher during the mid-follicular phase, with no group effect or significant pre-post MIST difference. While the stress task elicited activation patterns in stress-related regions, whole-brain analysis revealed no significant effects of group (PMS vs. no PMS) or menstrual cycle phase (follicular vs. luteal) on the neural stress response. Considering premenstrual symptom severity as a predictor revealed significant group-by-symptom severity interactions in the right inferior frontal gyrus and the right superior temporal gyrus. Conclusion: Using a within-subject repeated-measures design, we found neural responses to psychosocial stress to be stable across menstrual cycle phases. Individual differences in symptom severity may nevertheless be associated with differences in stress-related brain activation.
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BibTeX
@misc{bueckleinehlers2026menstrual,
title = {{Menstrual cycle phase and premenstrual symptoms in relation with the stress response: an fMRI study}},
author = {E. Buecklein-Ehlers and A.-C. S. Kimmig and T. Dresler and M. Laemmerhofer and T. Janker and L. Kogler and B. Derntl and A. J. Fallgatter and E. Comasco and A.-C. Ehlis},
howpublished = {bioRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.21.753084},
url = {https://www.biorxiv.org/content/10.64898/2026.09.21.753084v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Menstrual cycle phase and premenstrual symptoms in relation with the stress response: an fMRI study
AU - E. Buecklein-Ehlers
AU - A.-C. S. Kimmig
AU - T. Dresler
AU - M. Laemmerhofer
AU - T. Janker
AU - L. Kogler
AU - B. Derntl
AU - A. J. Fallgatter
AU - E. Comasco
AU - A.-C. Ehlis
PY - 2026
DA - 2026/09/21
PB - bioRxiv
DO - 10.64898/2026.09.21.753084
UR - https://www.biorxiv.org/content/10.64898/2026.09.21.753084v1
AB - Objective: Women with premenstrual syndrome (PMS) experience affective lability, irritability, depressed mood, and anxiety during the late luteal phase of the menstrual cycle. Stress reactivity may contribute to the development of these symptoms, yet neural correlates remain unexplored. We examined neural, behavioral and endocrine stress responses across menstrual cycle phases in women with and without PMS. Methods: 26 women with PMS and 24 women without PMS participated in two fMRI sessions, during the mid-follicular (days 5 to 11) and late-luteal phases (days -7 to -1). Participants completed the Montreal Imaging Stress Task (MIST). Subjective stress ratings and salivary cortisol were collected at six time points before and after stress induction. Stress-related brain activation was assessed using whole-brain and region-of-interest analyses. Results: Subjective stress ratings increased as expected from before to after the MIST, with no group or phase differences. Salivary cortisol was significantly higher during the mid-follicular phase, with no group effect or significant pre-post MIST difference. While the stress task elicited activation patterns in stress-related regions, whole-brain analysis revealed no significant effects of group (PMS vs. no PMS) or menstrual cycle phase (follicular vs. luteal) on the neural stress response. Considering premenstrual symptom severity as a predictor revealed significant group-by-symptom severity interactions in the right inferior frontal gyrus and the right superior temporal gyrus. Conclusion: Using a within-subject repeated-measures design, we found neural responses to psychosocial stress to be stable across menstrual cycle phases. Individual differences in symptom severity may nevertheless be associated with differences in stress-related brain activation.
ER -