Self-reported crying during the menstrual cycle: sign of discomfort and emotional turmoil or erroneous beliefs?

Crying is generally associated with distress and discomfort, and is also part of the premenstrual syndrome in women. The present studies focussed on crying fluctuations during the menstrual cycle. First, a retrospective cross-cultural study of women from 33 different countries (n = 2447) was conducted. Crying proneness reportedly increased before menstruation, with remarkable cross-cultural differences. Women who were using oral contraceptives (OC) reported largely the same pattern of results as women who were not using OC. In a second study, 82 Dutch students kept a crying and mood diary for two consecutive menstrual cycles. During no phase of the menstrual cycle did actual crying episodes or crying proneness increase, although significant changes in mood were reported. Given the large cross-cultural differences on the one hand, and the remarkable correspondence between the self-reports of those using OC and those who did not use them on the other, it is concluded that the role of female sex hormone fluctuations in crying has to be questioned. Rather, it seems more likely that fluctuations in self-reported crying are based on implicit theories about the relationship between the menstrual cycle, mood and crying.

Measuring depression in women around menopausal age: towards a validation of the Edinburgh Depression Scale.

BACKGROUND: The relationship between menopause and depression is still rather unclear. Studies using different methodology - especially those lacking a clear definition of depression - are hardly comparable. Since the Edinburgh Depression Scale (EDS) is not influenced by (menopause-related) somatic symptoms, the validity of the Dutch version of this instrument was investigated in a large community sample of menopausal women. METHODS: In 951 women, aged between 47 and 56 years, depressive symptomatology was measured using the EDS, together with a syndromal diagnosis of depression using Research Diagnostic Criteria. RESULTS: Twenty-two percent of the subjects had scores of 12 or higher on the EDS. With this cut-off point, depression (major or minor) was detected with a sensitivity of 66%, a specificity of 89%, and a positive predictive value (PPV) of 62%. A cut-off score of 15 or higher detected half of the women with major depression (sensitivity 73%, specificity 93%, PPV 53%). LIMITATIONS: Screening of depressive symptomatology at menopausal age in women of the community can only partly detect women with clinical depression. The relation between menopausal status and depression should preferentially be investigated using a longitudinal rather than a cross-sectional design. CONCLUSIONS: The EDS, which is easy to implement in both community and clinical settings (e.g., General Practice), might be used as an effective screening tool for detecting women at menopausal age who are at risk for depression, followed by clinical evaluation in those with high scores.