Do menstrual symptoms affect motor imagery skills in young women?

Archives of Gynecology and Obstetrics https://doi.org/10.1007/s00404-025-07936-5 GENERAL GYNECOLOGY Do menstrual symptoms affect motor imagery skills in young women? Özgü İnal Özün1 · Merve Öztürk2 · Esra Üzelpasacı3 Received: 29 August 2024 / Accepted: 2 January 2025 © The Author(s) 2025 Abstract Purpose To examine the relationship between menstrual symptoms and motor imagery skills in young women. Methods A total of 117 women between the ages of 18–40 were included in the study. Visual Analog Scale (VAS) for the menstrual pain intensity, the Menstrual Symptom Questionnaire (MSQ) for the menstrual-related symptoms, and the Kinesthetic and Visual Imagery Questionnaire-20 (KVIQ-20) for the motor imagery were used. All measurements were conducted on the first or second day of the menstruation, depending on when the subject declared subjectively experiencing most symptoms. Results The relationship between menstruation symptoms and visual imagery (VI) and kinesthetic imagery (KI) skills was examined. A weak negative correlation was found between MSQ_negative effects/somatic complaints and KVIQ-20_KI (p = .040, r = −.199). The relationship between menstrual pain intensity and KVIQ-20 items was examined. The strongest relationship was found between VAS and KVIQ-20_knee_VI and KVIQ-20_hip_VI (p = 003, r = −.288; p = 005, r = −.270; p = 004, respectively). A weak negative correlation was also found between VAS and KVIQ-20_VI_total and KVIQ-20_KI_ total (p = 0.004, r = −.275; p = 0.19, r = −.227, respectively). Discussion This is the first study to examine menstrual symptoms in women in detail and reveal their relationship with motor imagery skills. Menstrual symptoms, especially negative effects/somatic complaints seen during menstruation, negatively affect kinesthetic imagery ability. In addition; chronic menstrual pain has a negative effect on both kinesthetic and visual imagery abilities. Considering the impairments in motor imagery skills due to negative effects/somatic complaints during menstruation and chronic menstrual pain, adding motor imagery training to treatment programs aimed at improving women’s health may have positive effects. Keywords Menstrual symptoms · Motor imagery · Pain · Somatic complaints What does this study add to the clinical work * Özgü İnal Özün ; Merve Öztürk Esra Üzelpasacı 1 Faculty of Gülhane Physiotherapy and Rehabilitation, Department of Neurological Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey 2 Ankara Etlik City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara, Turkey 3 Faculty of Gülhane Physiotherapy and Rehabilitation, Department of Cardiopulmonary Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey This is the first study to examine the relationship between menstrual symptoms and motor imagery skills in women. The study findings provide evidence that increased negative affect/somatic complaints from menstrual symptoms reduce kinesthetic imagery ability. Furthermore, chronic menstrual pain has a negative effect on both kinesthetic and visual imagery abilities. Adding motor imagery training to treatment programs designed to improve women's health may have positive effects. Vol.:(0123456789) Archives of Gynecology and Obstetrics Introduction Menstrual cycle is a physiological process that occurs approximately every 28 days in women of reproductive age due to hormonal fluctuations. Studies have shown that women may experience physical and mental symptoms due to hormone fluctuations that occur during the menstrual cycle [1]. The most common of these symptoms are perimenstrual mood disorders (frequently irritability, tension, anger, etc.) and somatic symptoms (e.g., breast tenderness, heavy menstrual bleeding, dysmenorrhea, abdominal bloating, headache and limb edema) [2]. All these menstrual symptoms negatively affect women’s daily lives, academic and sports performance. In addition, hormonal changes seen during menstruation may affect cognitive and psychomotor performance changes and may also alter executive functions [3, 4]. Motor imagery (MI) is one of the practices that have an effect on motor performance. MI is the act of imagining the movement without actually performing it. MI is a movement representation technique that causes brain regions involved in the planning, generation, adjustment, and automation of voluntary movement to be activated in much the same way as when the action is actually performed [5]. For a variety of tasks (such as motor sequencing, motor timing, strenght, flexibility of the motor system) the benefits of motor imagery practice have been demonstrated [6]. Researches on the use of MI in women’s health have begun to increase in the last few years [7, 8]. There are two main types of MI; kinesthetic motor imagery (KMI) and visual motor imagery (VMI). KMI is defined as the ability to imagine performing a movement using an impression of the muscle contraction and sensation during an actual movement. VMI is the ability to imagine seeing oneself performing the movement [9]. MI is an important tool used in rehabilitation to improve motor performance skills [10], and therefore, it is important to understand the mechanisms associated with MI. Studies in the literature mostly focus on changes in motor skills across the menstrual cycle and menstrual pain symptom and their negative effects on cognitive abilities. Ronca et al. [11] have suggested that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase. It has also been emphasized that this cognitive changes specific to menstrual phase may increase the risk of injury in women, in addition to biomechanical factors. A recent study [12] indicated that fine motor skills vary across the phases of the menstrual cycle and that this may be modulated by sensorimotor integration and menstruation-related symptoms. However, there is no study that examines menstrual symptoms in detail and reveals their relationship with both motor and visual cognitive abilities. Measuring motor imagery ability and determining the factors affecting motor imagery ability before starting training in the rehabilitation process of women is a very important factor in terms of the trainings to be given [13]. This study was planned to understand the relationship between menstrual symptoms and motor imagery skills in young women. It is thought that the findings of the study will be guiding in terms of women’s health rehabilitation studies. Materials and methods The study was approved by the Ethics Committee of the Çankırı Karatekin University Health Sciences (decision date: 03–04-2024; meeting number: 12). This study was a cross-sectional study and participants were reached by snowball sampling method [14]. Literate women between the ages of 18–40, with a menst (...truncated)