Perceived stress, reproductive hormones, and ovulatory function: a prospective cohort study.

Abstract

BACKGROUND:

Stress has been shown to suppress ovulation in experimental models, but its effect on human reproduction at the population level is unclear.

METHODS:

Healthy women (n = 259), aged 18-44 years from Western New York, were followed for 2 menstrual cycles (2005-2007). Women completed daily perceived stress assessments, a 4-item Perceived Stress Scale (PSS-4) up to 4 times each cycle, and a 14-item PSS at baseline. Mixed model analyses were used to assess effects of stress on log reproductive hormone concentrations and sporadic anovulation.

RESULTS:

High versus low daily stress was associated with lower estradiol (-9.5% [95% confidence interval (CI) = -15.6% to -3.0%]), free estradiol (-10.4% [-16.5% to -3.9%]), and luteinizing hormone (-14.8% [-21.3% to -7.7%]) and higher follicle-stimulating hormone (6.2% [95% CI = 2.0% to 10.5%]) after adjusting for age, race, percent body fat, depression score, and time-varying hormones and vigorous exercise. High versus low daily stress was also associated with lower luteal progesterone (-10.4% [95% CI = -19.7% to -0.10%]) and higher odds of anovulation (adjusted odds ratio = 2.2 [95% CI = 1.0 to 4.7]). For each unit increase in daily stress level, women had a 70% higher odds of an anovulatory episode (odds ratio = 1.7 [1.1 to 2.4]). Similar but attenuated results were found for the association between the PSS-4 and reproductive hormones, while null findings were found for the baseline PSS.

CONCLUSION:

Daily perceived stress does appear to interfere with menstrual cycle function among women with no known reproductive disorders, warranting further research to explore potential population-level impacts and causal biologic mechanisms.

• Authors: Karen C Schliep, Sunni L Mumford, Catherine J Vladutiu, Katherine A Ahrens, Neil J Perkins, Lindsey A Sjaarda, Kerri A Kissell, Ankita Prasad, Jean Wactawski-Wende, Enrique F Schisterman
• Journal: Epidemiology (Cambridge, Mass.) (Epidemiology) Vol. 26 Issue 2 Pg. 177-84 (Mar 2015) ISSN: 1531-5487 [Electronic] United States
• PMID: 25643098 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural)

Chemical References

• Biomarkers
• Gonadotropins, Pituitary
• Progesterone
• Estradiol
• Luteinizing Hormone
• Follicle Stimulating Hormone

Topics

• Adolescent
• Adult
• Anovulation (blood, psychology)
• Biomarkers (blood)
• Estradiol (blood)
• Female
• Follicle Stimulating Hormone (blood)
• Gonadotropins, Pituitary (blood)
• Humans
• Linear Models
• Luteinizing Hormone (blood)
• Progesterone (blood)
• Prospective Studies
• Stress, Psychological (blood, physiopathology)
• Young Adult