The Effect of Menstrual Cycle Phases on Approach–Avoidance Behaviors in Women: Evidence from Conscious and Unconscious Processes

Round 1

Reviewer 1 Report

Thank you for the opportunity to review the article “The Effect of Menstrual Cycle Phases on Approach-Avoidance Behaviors in Women: Evidence from Conscious and Unconscious Processes.” This study assessed the approach and avoidance in response to emotional stimuli among 27 women at 3 points in the menstrual cycle. They found differences in approach and avoidance based on menstrual cycle phase. Please see detailed comments below. 

 

-p3: The authors mention that females “generally” experience positive emotions around ovulation and negative emotions premenstrually. Please provide citations. 

P3: The Van Wingen et al 2008 study did not examine friendship and confidence. Please revise for accuracy. 

-p3: Similarly, the authors state that progesterone in the luteal phase increases response to negative emotions, but they cite a review article focusing on sex differences in memory tasks. Please check for accuracy and revise citations as needed. 

-p3: Authors state that women’s responses to positive / negative stimuli are “closely related to their personal growth and security.” No citation is provided. This seems speculative; consider revising. 

-p4: Reverse calculation method was used to determine late follicular and mid-luteal. The statement that the day before the next menstrual period is the “first day” is confusing, as convention for counting days of the menstrual cycle refers to day 1 as the day that menses begins. The authors may consider referring to days as -1, -14, etc to indicate days before menses. 

-The authors state that the participants completed the experiment across three menstrual cycles. Why were the experiments administered across 3 menstrual cycles, instead of within the same menstrual cycle? 

-If an ovulation test was negative, what happened? 

-p4: States that participants had no psychiatric history. How was this assessed? 

-p7: The authors state that the refrigerator was -20 degrees C. Do they mean freezer? 

-p12: The authors again cite the Van Wingen paper regarding friendliness and confidence – are they referring to their own results? The Van Wingen paper did not find this. The authors then refer to results on friendliness in their own study, but this was not assessed by any of the rating scales they administered. Please clarify. 

-p12: The paragraph suggesting that women focus on self-improvement and relaxation is out of context and should be removed. 

-p12: The authors state that women may feel more attractive around ovulation, but this was not measured in the present study and no citations were provided. Please either provide a citation or remove. 

-p13: The section describing women avoiding infection during the luteal phase is speculative. The authors cite a 2001 paper by Fessler, “Luteal phase immunosuppression and meat eating,” which is not a data-driven paper. The “Fessler and Daniel” 2002 paper only has one author, Fessler, which should be corrected. This is also not a data-driven paper. 

-p13: The authors suggest that women should avoid “negative events and risks” during the luteal phase. This seems speculative at best, and could be misinterpreted. Would recommend removing.  

Author Response

Please see the attachment. Thank you very much!

Author Response File: Author Response.doc

Reviewer 2 Report

I agree to publish that paper

Author Response

Thank you very much for your comment and appreciation! Best wishes to you!

Reviewer 3 Report

This is a very interesting paper investigating the influence of sexual hormones on approach-avoidance behaviors in women, in the context of menstrual cycle. The paper is well-written and of interest for the journal. However, several minor changes should be made.

Abstract.

1- The main aim of the study should be clarified in the abstract. 

2- A brief mention of the methods should be stated in the abstract section.How were patients recruited. Did all patients accepted to participate? Drop outs?

3-Which hormones were investigated in the study?

Introduction

1- Please, carefully revise the references' style of the journal.

2- At the beginning of the introduction, the authors are focusing on the "approach advantages and avoid disavantages". The section reviewing aspects of the menstrual cycle is really short. I recommend to add some more references on the effect of different phases of the menstrual cycle on affective symptoms, and cognitive symptoms.

3- The main aims of the present study are described in lines 138-150. I recommend to describe it in a separate subsection, namely 1.1. Aims

Methods

1- At the beginning of the methods, the authors are describing that they recruited 27 female heterosexual students. Why is important to describe that they were heterosexual? Please remove it.

2- Subsection 2.2. should be renamed. It is not correct to call it "Subjective measures". I prefer "assessment scales" or "psychometric instruments".

3- Why is the DASS scale used? Is it superior to other scales? PLease, clarify this point.

4- Estradiol and progesterone were obtained from saliva samples. Why from saliva and not from blood? Is there any correlation between levels from saliva and blood samples?

Discussion

1- I recommend to include a limitations and strentghs subsection at the end of the discussion.

2- Please, revise the journal's style of references.

 

 

Author Response

Please see the attachment. Thank you very much!

Author Response File: Author Response.doc

Round 2

Reviewer 1 Report

Thank you for the edits to the manuscript. It is much clearer. One error that I noticed, "mid-follicle" should be mid-follicular.