Physiology & Behavior, Vol. 20, pp. 239-243. Pergamon Press and Brain

Research Publ., 1978. Printed in the U.S.A.

Visual Perception in Women During the Menstrual Cycle MARCIA M. WARD

Department of Psychology, The Ohio State University SERGIO C. STONE

Department of Obstetrics and Gynecology, Section of Reproductive Physiology, Louisiana State University School o f Medicine CURT A. SANDMAN:

Department o[ Psychology, The Ohio State University, Columbus, OH 43210 (Received 26 March 1977) WARD, M. M., S. C. STONE AND C. A. SANDMAN. Visualperception in women during the menstrual cycle. PHYSIOL. BEHAV. 20(3) 239-243, 1978. - Twelve females were tested at four times during the menstrual cycle with a visual detection task and a visual pattern discrimination task. Mood levels and confidence ratings were evaluated for each session. In addition to the behavioral testing, plasma samples were collected and radioimmunoassayed for estradiol, progesterone, luteinizing hormone, and follicle stimulating hormone levels. Visual detection fluctuated significantly during the menstrual cycle with impaired performance occurring at the premenstrual session. In contrast to previous reports, the impaired performance was not related to lowered confidence ratings or to mood levels. Visual perception

Menstrual cycle

Progesterone

Water retention

IN addition to the reviews of numerous physiological and psychological changes associated with the menstrual cycle [1,15], it has been reported that sensory sensitivity fluctuates during the course of the menstrual cycle with varying levels of estrogen and progesterone. Among the most provocative evidence of menstrual related sensory changes are the data from studies of visual perception. When compared with males and females using oral contraceptives, it was found that normally cycling women showed significant changes in visual threshold over a six week test period [3]. For the normally cycling women, visual sensitivity was lowest during menstruation, progressively increased until ovulation, and remained elevated for the duration of the cycle. In another study, women who were tested over two successive menstrual cyles showed a tendency toward higher values for time estimation and two-flash threshold tasks premenstrually [8]. It was suggested that a "diminution of perceptual ability" occurs premenstrually that may "reflect a general state of slowing of the internal clock or lower arousal at that time" (p. 186). A related study employing the two-flash threshold task also yielded impaired performance during the premen-

strual session [2]. However, the results of a signal detection analysis suggested that the impaired threshold premenstrually probably resulted from the subject's adoption of a stricter criterion and not from visual sensitivity changes. In yet another study with the two-flash threshold task, visual sensitivity and criterion were found to be lowest at menstruation and highest at ovulation for normally cycling women [19]. Since sensitivity and criterion scores were not found to fluctuate in a group of subjects taking oral contraceptives, it was suggested that visual sensitivity may be related to cyclic hormonal changes. Three of the four previous studies [2, 8, 19] found increased visual threshold premenstrually. However, there has been no agreement as to the cause of the observed visual impairment. The present study was undertaken to provide data on two additional visual tests and to examine the possible effect of several important mediating factors. While all four of the previous studies have examined visual threshold, the study presented here employed visual detection and visual pattern discrimination tasks to further test the hypothesis that visual perception varies over the menstrual cycle. Surprisingly, data concerning mood levels,

1Dr. Jack M. George and the Ohio State University Hospital Clinical Endocrinology nursing staff are gratefully acknowledged for their assistance in gathering the plasma samples. Specific antibody against progesterone was kindly supplied by Dr. Dan Tulchinsky, Harvard Medical School and antibodies against estradiol-17-beta were obtained from Dr. Ian H. Thorneycroft of the University of Southern California School of Medicine. Material for the RIA of gonadotropins was supplied by the Hormone Distribution Office, National Institute of Arthritis and Metabolic Disease, National Institute of Health, Bethesda, MD. The authors also wish to thank Drs. Harvey Shulman, Jaques Kaswan and Mari.Jones for their valuable editing of earlier drafts of this paper. 2Address reprint requests to Dr. Curt A. Sandman, Department of Psychology, The Ohio State University, 164 W. 19th Avenue, Columbus, Ohio 43210. 239

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WAR[). S T O N [ AND SANt)MA\~

confidence ratings, and hormonal levels have been absent from previous studies of the effects of the menstrual cycle on sensory sensitivity. In the present study, the subjects rated directly their mood and perceptual confidence at each of four test sessions. In addition, the levels of estradiol, progesterone, luteinizing hormone, and follicle stimulating hormone were ascertained by radioimmunoassay for each testing session to provide a direct test of the influence of sex-related hormones on visual perception. METHOD

Subjects Twenty-three female students, aged 2 0 - 3 5 years, from advanced undergraduate psychology classes completed the experiment. Data from eleven of the volunteers had to be discarded because the timing of their test sessions did not coincide with the days designated in the experimental design. The remaining twelve women served as subjects. With a single exception (one subject was taking a maintenance dose of synthetic thyroid hormone - Synthroid 0.3 mg daily), the subjects were not presently taking any prescription medication. Also, none of the subjects had used any oral contraceptives in the previous six months. All subjects reported having regular menstrual cycles and good vision. Because of reports that the fit and comfort of contact lenses varies over the menstrual cycle [4], the subjects were permitted to wear corrective lenses but not contact lenses during testing.

Apparatus The subjects were seated in a dimly lighted, sound attenuated chamber with the experimenter and testing equipment in an adjacent room. A Kodak Carousel slide projector equipped with a tachistoscopic lens projected the stimuli on a screen in the subject chamber. The projector was programmed for automatic advance and stimulus presentation with BRS Foringer diglbit logic units.

Design All subjects were tested at each of four sessions: menstrual, preovulation, luteal, and premenstrual. To counteract a possible practice effect, the order of sessions was balanced according to a Latin square design. The menstrual, preovulation, and luteal sessions were scheduled for Days 2 - 4 , Days 1 0 - 1 4 , and Days 1 9 - 2 3 , respectively. Eleven of the twelve subjects had menstrual cycles which ranged from 22 to 32 days in length. The premenstrual sessions for these subjects was scheduled for Days 2 1 - 3 0 and always occurred 1 to 3 days before the onset of menstruation. The remaining subject experienced an unusually lengthy menstrual cycle of 34 days. Her premenstrual session occurred 6 days prior to the onset of menstruation. While the data from this session was analyzed as premenstrual, she was probably tested during the late luteal/early premenstrual phase of her cycle. The scheduling of the four test sessions corresponded with particular patterns of hormone levels. These times were chosen to test the hypothesis that changes of visual perception might be related to absolute patterns of hormone levels. The menstrual session (Days 2 - 4 ) was chosen to occur when estrogen, progesterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels are all low. The preovulation session was designed to occur two

days prior to ovulation when estrogen is elevated b~t ihc other three hormone levels have not yet started to rise. t'h¢~ luteat session occurred during a time when both estrogen and progesterone are maximally elevated. The premenstrual session was scheduled to occur within the last few days of the cycle when both estrogen and progesterone are decreas.. ing rapidly.

Procedure Preexperimental sessions. Subjects recorded their basal body temperature for one month prior to testing and during the m o n t h of testing. This provided an estimate of the day of ovulation which helped in the scheduling of the postovulatory sessions. Also in the month prior to testing, the subjects were given a practice session to familiarize them with the detection and discrimination procedures. Experimental sessions. On each day of testing, the subject reported to the endocrinology clinic of the University Hospital to have a 10 ml sample of venous blood drawn. The samples were allowed to clot, the sera were then separated by centrifugation and stored at --20°C until the end of the experiment when they were radioimmunoassayed for FSH, LH, estradiol, and progesterone. Plasma steroids (progesterone and estradiol-17-beta) were measured by radioimmunoassay technique (RIA) using specific antibodies [17]. Plasma gonadotropins (FSH and LH) were nleasured by RIA with a double antibody technique [121. The procedure for each of the four testing sessions was identical and began with the administration of the Moos Menstrual Distress Questionnaire Form T [11]. For this study the instructions of the Moos Menstrual Distress Questionnaire directed the subject to rate how much she was experiencing each of the 46 symptoms at that moment and in the previous 24 hr. Following 20 min of dark adaptation, the subject completed the detection task. During each session, the subject viewed one of four random orderings of 240 stimuli. One half of the stimuli were blank and half were a dot, Of the stimuli which were dots, half were large and half were small. The stimuli were projected tachistoscopically on a screen opposite the subject with a 20 msec exposure duration and a six sec intertrial interval. Because luminance is the critical variable in detection tasks of this type [7], blocks of ten, fifteen, or twenty stimuli were randomly paired with one of three filters which varied the level of illumination. The subject was instructed to depress one key if she saw a dot and another key if she did not see a dot. Half of the subjects were instructed to press the right key if shown a dot, the other half of the subjects pressed the left key for a dot. After each response, the subject estimated her confidence by choosing a number from one to seven corresponding to a scale presented next to the stimulus screen. The choices ranged from certain that the previous stimulus was blank (one) to certain that the stimulus had been a dot (seven). The subject was instructed to report the middle point (four) only if she did not see the stimulus or if she would not guess. After a five rain rest period, the subject completed the pattern discrimination task. During each session, the subject viewed one of four random orderings of 240 stimuli. The stimuli consisted of a row of dots, half of which were evenly spaced and half of which were spaced to appear in pairs. A complete description of the stimulus parameters is available elsewhere [6]. In addition to the spatial arrangement, exposure duration rather than luminance has been

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FIG. 1. Mean plasma levels of (a)estradiol, (b) progesterone, (c) luteinizing hormone, and (d) follicle stimulating hormone for each session. shown to be a critical variable in predicting response accuracy for this paradigm [6]. Consequently, illumination remained constant but the exposure duration of tachistoscopic presentation of stimulus blocks varied randomly from 20 msec to 10 msec to 6 msec with an intertrial interval of six see. The subject pressed one key for evenly spaced dots and another key for paired dots. The key assigned to blank stimuli in the previous paradigm now was assigned to evenly spaced dots. Again, the subject responded with the appropriate confidence rating; the lower end of the scale corresponded to even dots and the upper end of the scale corresponded to paired dots. RESULTS

Hormones

A series of analyses of variance revealed that all of the hormone levels except FSH varied significantly across the menstrual cycle as shown in Fig. 1. These included estradiol, F(3,33) = 5.88, p < 0 . 0 1 ; progesterone, F(3,33) = 10.63, p

Visual perception in women during the menstrual cycle.

Physiology & Behavior, Vol. 20, pp. 239-243. Pergamon Press and Brain Research Publ., 1978. Printed in the U.S.A. Visual Perception in Women During...
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