Circadian rhythms, sleep, and the menstrual cycle

Mar 27, 2007Sleep medicine

How the Menstrual Cycle Relates to Body Clocks and Sleep

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Abstract

Women with ovulatory menstrual cycles experience an elevated body temperature in the post-ovulation luteal phase, but the amplitude of this temperature rhythm is reduced.

Circadian rhythms in body temperature, hormone profiles, and sleep-wake behavior vary throughout the menstrual cycle.
The amplitude of melatonin and cortisol rhythms may also be reduced during the luteal phase.
Subjective sleep quality is reported to be lowest around menstruation, yet sleep timing and composition remain stable across the cycle.
Disruption of circadian rhythms is linked to menstrual irregularity and longer menstrual cycles in shiftworking women.
Circadian disruption may increase the risk of breast cancer in women, potentially due to changes in light exposure and melatonin levels.

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Women with ovulatory menstrual cycles have a circadian rhythm superimposed on the menstrual-associated rhythm; in turn, menstrual events affect the circadian rhythm. In this paper, we review circadian rhythms in temperature, selected hormone profiles, and sleep-wake behavior in healthy women at different phases of the menstrual cycle. The effects on menstrual cycle rhythmicity of disrupted circadian rhythms, for example, with shiftwork and altered circadian rhythms in women with menstrual-related mood disturbances, are discussed. Compared to the follicular phase, in the post-ovulation luteal phase, body temperature is elevated, but the amplitude of the temperature rhythm is reduced. Evidence indicates that the amplitude of other rhythms, such as melatonin and cortisol, may also be blunted in the luteal phase. Subjective sleep quality is lowest around menses, but the timing and composition of sleep remains relatively stable across the menstrual cycle in healthy women, apart from an increase in spindle frequency activity and a minor decrease in rapid eye movement (REM) sleep during the luteal phase. Disruption of circadian rhythms is associated with disturbances in menstrual function. Female shiftworkers compared to non-shiftworkers are more likely to report menstrual irregularity and longer menstrual cycles. There also is accumulating evidence that circadian disruption increases the risk of breast cancer in women, possibly due to altered light exposure and reduced melatonin secretion. Further investigations into the biological consequences of circadian disruption in women will offer insight into some menstrual-associated disorders, including mood changes, as well as reproductive function and possible links with breast cancer.

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Circadian rhythms, sleep, and the menstrual cycle

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