Persistent Impairment of Executive Functions in Premenstrual Syndrome: Cause or Effect?

Aim: The aim of this paper 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 or also extend to inhibitory control.Methods: 105 regularly cycling women between the ages of 19 to 35 were tested in three menstrual cycle phases (mid-follicular, mid-luteal, late luteal). Premenstrual symptoms were tracked across two cycles. 54 women were allocated to the PMS/PMDD group, 51 women served as controls. Working memory and inhibitory control were assessed using the n-back and stop signal task, respectively. Hormone levels were determined using saliva samples.Results: Working memory 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 (SSRTs) across all cycle phases, with SSRTs positively correlating with premenstrual symptom severity. There was no significant correlation between performance measures and gonadal hormone levels.Conclusions: Cognitive impairments in PMS/PMDD appear to be trait-like and affect both working memory and inhibitory control. These deficits may underlie difficulties in emotion regulation and are not solely attributable to gonadal hormone levels.