Plasma Melatonin Circadian Rhythms during the Menstrual Cycle and after Light Therapy in Premenstrual Dysphoric Disorder and Normal Control Subjects
Abstract
The aim of this study was to replicate and extend previous work in which the authors observed lower, shorter, and advanced nocturnal melatonin secretion patterns in premenstrually depressed patients compared to those in healthy control women. The authors also sought to test the hypothesis that the therapeutic effect of bright light in patients was associated with corrective effects on the phase, duration, and amplitude of melatonin rhythms. In 21 subjects with premenstrual dysphoric disorder (PMDD) and 11 normal control (NC) subjects, the authors measured the circadian profile of melatonin during follicular and luteal menstrual cycle phases and after 1 week of light therapy administered daily, in a randomized crossover design. During three separate luteal phases, the treatments were either (1) bright (> 2500 lux) white morning (AM; 06:30 to 08:30 h), (2) bright white evening (PM;19:00 to 21:00 h), or (3) dim (< 10 lux) red evening light (RED). In PMDD subjects, during the luteal phase compared to the follicular menstrual cycle phase, melatonin onset time was delayed, duration was com pressed, and area under the curve, amplitude, and mean levels were decreased. In NC subjects, melatonin rhythms did not change significantly during the menstrual cycle. After AM light in PMDD subjects, onset and offset times were advanced and both duration and midpoint concentration were decreased as compared to RED light. After PM light in PMDD subjects, onset and offset times were delayed, midpoint concentration was increased, and duration was de creased as compared to RED light. By contrast, after light therapy in NC subjects, duration did not change; onset, offset, and midpoint concentration changed as they did in PMDD subjects. When the magnitude of advance and delay phase shifts in onset versus offset time with AM, PM, or RED light were compared, the authors found that in PMDD subjects light shifted offset time more than onset time and that AM light had a greater effect on shifting melatonin offset time (measured the following night in RED light), whereas PM light had a greater effect in shifting melatonin onset time. These findings replicate the authors' previous observation that nocturnal melatonin concentrations are decreased in women with PMDD and suggest specific effects of light therapy on melatonin
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Most other studies have found no change in the patterns of melatonin secretion across the menstrual cycle in healthy women.
“Most other studies have found no change in the patterns of melatonin secretion (including onset, offset, duration, midpoint, and AUC) across the menstrual cycle in healthy women [47, 60–62, 65, 67].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
PMDD patients experience alterations in the timing and amount of nocturnal melatonin secretion.
“Interestingly, PMDD patients experience alterations in the timing and amount of nocturnal melatonin secretion (see Section 8.2 below [62, 65]), though it is unclear whether this is a cause or a characteristic of the disorder.”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
In PMDD patients compared to controls, melatonin secretion shows decreased amplitude.
“Some evidence supporting this notion, such as decreases in amplitude, AUC, and mean levels, a phase-advance, and a shorter duration of melatonin secretion in PMDD patients compared to controls were reported [62, 65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
In PMDD patients compared to controls, melatonin secretion shows decreased AUC.
“Some evidence supporting this notion, such as decreases in amplitude, AUC, and mean levels, a phase-advance, and a shorter duration of melatonin secretion in PMDD patients compared to controls were reported [62, 65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
In PMDD patients compared to controls, melatonin secretion shows a phase-advance.
“Some evidence supporting this notion, such as decreases in amplitude, AUC, and mean levels, a phase-advance, and a shorter duration of melatonin secretion in PMDD patients compared to controls were reported [62, 65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Within PMDD patients, melatonin off-set time is advanced in the luteal phase compared to the follicular phase.
“Additionally, when comparing across the menstrual cycle within PMDD patients, onset time was delayed, off-set time was advanced, and duration of secretion was decreased in the LP compared to the FP [65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
In PMDD patients compared to controls, melatonin secretion shows a shorter duration.
“Some evidence supporting this notion, such as decreases in amplitude, AUC, and mean levels, a phase-advance, and a shorter duration of melatonin secretion in PMDD patients compared to controls were reported [62, 65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
In PMDD patients compared to controls, melatonin secretion shows decreased mean levels.
“Some evidence supporting this notion, such as decreases in amplitude, AUC, and mean levels, a phase-advance, and a shorter duration of melatonin secretion in PMDD patients compared to controls were reported [62, 65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Within PMDD patients, melatonin duration of secretion is decreased in the luteal phase compared to the follicular phase.
“Additionally, when comparing across the menstrual cycle within PMDD patients, onset time was delayed, off-set time was advanced, and duration of secretion was decreased in the LP compared to the FP [65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Within PMDD patients, melatonin onset time is delayed in the luteal phase compared to the follicular phase.
“Additionally, when comparing across the menstrual cycle within PMDD patients, onset time was delayed, off-set time was advanced, and duration of secretion was decreased in the LP compared to the FP [65].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Bright evening light therapy increases the midpoint concentration of melatonin in PMDD patients during the luteal phase.
“This improvement may be achieved via a resynchronization or phase-shift of biological rhythms, since, compared to neutral-dim red light, bright evening light therapy was shown to delay the onset and offset of melatonin [65], increase the midpoint concentration of melatonin [65], delay cortisol acrophase [63], and increase TSH nadir [63] in PMDD patients during the LP.”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Compared to neutral-dim red light, bright evening light therapy delays the onset and offset of melatonin in PMDD patients during the luteal phase.
“This improvement may be achieved via a resynchronization or phase-shift of biological rhythms, since, compared to neutral-dim red light, bright evening light therapy was shown to delay the onset and offset of melatonin [65], increase the midpoint concentration of melatonin [65], delay cortisol acrophase [63], and increase TSH nadir [63] in PMDD patients during the LP.”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
Nonpharmacological therapies for PMDD symptoms which target the sleep-wake cycle and circadian rhythms, such as phototherapy and sleep deprivation, are often effective in improving mood and sleep quality in these patients.
“Finally, nonpharmacological therapies for PMDD symptoms which target the sleep-wake cycle and circadian rhythms, such as phototherapy [110–112] and sleep deprivation [52, 65, 113, 114], are often effective in improving mood and sleep quality in these patients.”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [65]
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- Authors
- Parry, B. L., Berga, S. L., Mostofi, N., Klauber, M. R., & Resnick, A.
- Affiliations
- University of California San Diego (US)
- University of Pittsburgh (US)
- ORCID
- Berga, Sarah L.
- Venue
- Journal of Biological Rhythms
- Publisher
- SAGE Publications
- Published
- 1997-02
- Volume
- 12
- Issue
- 1
- Pages
- 47-64
- ISSN
- 0748-7304 (ISSN-L)
- 1552-4531
- OpenAlex
- W2112391298
- Semantic Scholar
- c1728904e0b95e052feb6e11c011381c1acc57e8
- Cited by
- 129
- References
- 39
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 1 · 2013: 3 · 2012: 6
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Biological Rhythms (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29mh042831-05)
- National Institute of Mental Health (R29MH42831)
- National Center for Research Resources (M-01RR00827, M01RR000827)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- premenstrual dysphoric disorder, melatonin, circadian rhythm, phototherapy, bright light, red light, menstrual cycle, luteal phase, follicular phase, melatonin onset, phase shift, mood, depression, women's health
- MeSH terms
- Adult, Affect, Circadian Rhythm, Estrogens, Female, Humans, Melatonin, Menstrual Cycle, Phototherapy, Premenstrual Syndrome, Progesterone, Radioimmunoassay, Cross-Over Studies
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