Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/S2237-60892012000100003
Trends in Psychiatry and Psychotherapy
Review Article

Neuropsychological performance and menstrual cycle: a literature review

Desempenho neuropsicológico e ciclo menstrual: revisão da literatura

Eliana Gonçalves V. Souza; Melissa G. Ramos; Cláudia Hara; Bárbara Perdigão Stumpf; Fábio L. Rocha

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Abstract

Approximately 80% of all women of reproductive age experience psychological and physical changes associated with the premenstrual phase. Cognitive alterations are among the most common complaints. In this context, studies have assessed cognitive performance across the menstrual cycle in healthy women and also in women with premenstrual syndrome (PMS). The main objective of the present study was to review the literature on cognitive function in different phases of the menstrual cycle in women of reproductive age, both healthy and with PMS, in particular premenstrual dysphoric disorder (PMDD). We searched MEDLINE and LILACS databases. A total of 27 studies were selected. The studies used heterogeneous methodologies. Most studies suggested that healthy women show small fluctuations in cognitive performance across the menstrual cycle, with low performance scores in the luteal phase for visuospatial and motor skills, attention and concentration, verbal memory, visual memory, working memory, and reaction time. Among women with PMS or PMDD, low performance scores for visuospatial and motor skills, attention and concentration, verbal memory, working memory, reaction time and impulsivity were also detected in the luteal phase. Symptoms observed in PMS/PMDD patients showed low intensity, but greater when compared with healthy women. Evidence indicates fluctuations in cognitive performance in the different phases of the menstrual cycle in healthy and PMS women, with worse performance for women with PMS/PMDD in the luteal phase. However, methodological limitations prevent us from drawing solid conclusions. Further studies are needed to investigate the impact of these cognitive fluctuations on patients' daily activities.

Keywords

Premenstrual syndrome, premenstrual dysphoric disorder, cognitive functioning, impulsivity, attention, executive functions

Resumo

Cerca de 80% das mulheres em idade fértil apresentam alterações psicológicas e físicas associadas à fase pré-menstrual. Dentre as queixas mais comuns estão as alterações cognitivas. Nesse contexto, tem-se estudado o desempenho cognitivo ao longo do ciclo menstrual de mulheres com e sem síndrome pré-menstrual (SPM). O objetivo principal deste estudo foi revisar a literatura acerca do desempenho das funções cognitivas nas diferentes fases do ciclo menstrual de mulheres em idade reprodutiva, sadias ou portadoras de SPM, em particular o transtorno disfórico pré-menstrual (TDPM). Foram revisadas as bases de dados MEDLINE e LILACS. Um total de 27 estudos foram selecionados. Os estudos eram heterogêneos em suas metodologias. Em sua maioria, os trabalhos evidenciaram que mulheres sadias apresentam variações leves no desempenho cognitivo ao longo do ciclo menstrual, obtendo menor pontuação, durante a fase lútea, nas habilidades visuoespaciais e motoras, atenção e concentração, memória verbal, memória visual, memória de trabalho e tempo de reação. Entre as mulheres com SPM ou TDPM, foi identificada, na fase lútea, redução no desempenho das habilidades visuoespaciais e motoras, atenção e concentração, memória verbal, memória de trabalho, tempo de reação e impulsividade. Tais sintomas apresentaram intensidade leve, porém superior à observada em mulheres sadias. As evidências indicam a existência de variações no desempenho cognitivo ao longo das diferentes fases do ciclo menstrual de mulheres sadias ou com SPM, com desempenho cognitivo pior em mulheres com SPM/TDPM na fase lútea. Entretanto, limitações metodológicas impedem conclusões sólidas. Novos estudos são necessários para investigar o impacto dessas oscilações cognitivas nas atividades cotidianas dos pacientes.

Palavras-chave

Síndrome pré-menstrual, transtorno disfórico pré-menstrual, funcionamento cognitivo, impulsividade, atenção, funções executivas

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