The Relationship Between Perceived Premenstrual Symptoms and Salivary Cortisol Levels in Women with Premenstrual Syndrome
TL;DR
The findings suggest that the pattern of cortisol secretion during the hours of the day is higher in the menses than in luteal and premenstrual phases, which can trigger cycle-specific behavioral issues.
Abstract
Aim: It is known that phasic social and behavioral changes occur during the menstrual cycle. As a stress marker, cortisol rises in the morning (cortisol awakening response, CAR) and decreases around midnight. Therefore, the present study aimed to establish a link between perceived symptom severity and diurnal cortisol levels during the menstrual cycles of cyclic women. Materials and Methods: Healthy, cycling women (18–31 years old, n=15) had salivary cortisol tested at 12:00 pm, 05:00 pm, and 10:00 pm (for diurnal rhythm) after waking (0, 15, 30, and 60 min, CAR). The same subjects were tested during menses, luteal, and premenstrual periods of a single menstrual cycle. Participants recorded perceived problem severity during the test. The STAI-T and Karolinska Sleep Scale measured trait anxiety and sleep quality. CAR and diurnal cortisol area under curve (AUC) were calculated. Results: The phases did not differ in cortisol concentration or CAR AUC (p>0.05). CAR was significantly higher than diurnal cortisol throughout all phases (p<0.05). Additionally, Diurnal AUCg of cortisol was higher during menses than luteal and premenstrual phases (p<0.05). The diurnal AUC and the CAR-AUC showed a strong positive correlation across all phases (rho=0.210; p=0.002). Problem scores and diurnal AUCg correlated negatively (rho=- 0.648; p=0.01). STAI-T points were negatively correlated with menses and premenstrual diurnal AUCg (rho=-0.638; p=0.014, -0.744; p=0.002). Conclusion: In conclusion, the findings suggest that the pattern of cortisol secretion during the hours of the day is higher in the menses than in luteal and premenstrual phases. Potential changes in cortisol secretion patterns can trigger cycle-specific behavioral issues. Keywords: Cortisol awakening response, diurnal cortisol, Hypothalamuspituitary- adrenal (HPA) axis, menstrual cycle, premenstrual symptoms, state trait anxiety inventory score.