The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

8947424 JA

Stress disrupts ovarian function by altering central neural processes involving hypothalamic function, and women with menstrual irregularities have been noted to have elevated cortisol levels. Some evaluated stress variables include war, prison, psychosocial stressors, travel, performance pressure, depression, anxiety, drug use, exercise, eating disorders, weight loss or low weight, and various personality characteristics.

1996 Am J Sports Med 24;6 Suppl:S36-7

Berga, S. L.

10870779 JA

In women with acute orthopedic trauma, 6% developed polymenorrhea and 25% oligo or amenorrhea in the six months following surgery. Menstrual dysfunction was significantly associated with having a general anesthetic or having a longer surgical operation.

2000 Aust N Z J Obstet Gynaecol 40;1:48-53

To, W. W. and Wong, M. W.

2928463 JA

Women with subclinical eating disorders, who did not have weight loss or diagnosable eating pathology but did have abnormal eating attitudes, had a highly significant incidence of menstrual abnormalities (93.4% vs. 11.7% control group).

1989 Psychosom Med 51;1:81-6

Kreipe, R. E., Strauss, J., Hodgman, C. H., and Ryan, R. M.

9065977 JA

Psychosocial problems can affect the central GnRH-LH/FSH drive, and cause ovarian compromise on a continuum of amenorrhea, oligomenorrhea, polymenorrhea, or luteal-phase deficiency. Although drug treatment can restore reproductive function, it is also masking the problem. “Attitudes, moods, and behaviors can have endocrine consequences and cause definable reproductive disorders...Misattributions, negative images of self and others, unrealistic expectations, and emotional disharmony can cause neuroendocrine havoc.”

1997 Semin Reprod Endocrinol 15;1:47-53

Berga, S. L.

10852450 RCT

In estrogen treated postmenopausal women, acute stress led to a significant increase in LH. Hypothesis is that acute stress during the follicular phase of the menstrual cycle in non-menopausal women might lead to a premature LH surge, interfering with follicular maturation and ovulation.

2000 J Clin Endocrinol Metab 85;6:2184-8

Puder, J. J., Freda, P. U., Goland, R. S., Ferin, M., and Wardlaw, S. L.

9326832 JA

Significant changes in LH pulsation amplitude and rhythmicity were found in depressed women compared to controls. Findings were similar to those found in women with functional hypothalamic amenorrhea.

1997 Am J Psychiatry 154;10:1454-5

Meller, W. H., Zander, K. M., Crosby, R. D., and Tagatz, G. E.

2894827 R

LH pulse frequency and amplitude decrease in both female and male runners. Article reviews this and other neuroendocrine effects of exercise.

1987 Baillieres Clin Endocrinol Metab 1;2:299-317

Prior, J. C.

3402086 JA

Authors feel that since sexual behavior affects cycle length and ovulation, women with menstrual disorders of long cycle lengths who are not in a regular sexual relationship, should not be treated medically if they are going to be establishing a relationship soon.

1988 Clin Exp Obstet Gynecol 15;3:71-3

Blum, M. and Kitai, E.

[Top]

Polycystic Ovary Syndrome

11811299 JA

PCOS is the leading cause of anovulatory infertility, and affects up to one fifth of the female population. Medical symptoms as well as psychosocial stress problems are reviewed.

2001 Coll Antropol 25;2:673-85

Eggers, S. and Kirchengast, S.

11293003 R,T

Extensive discussion of the many factors involved in PCOS, including increased GnRH pulse frequency. The GnRH pulse generator is a collection of neurons that develop during fetal life in the olfactory (smell) area and migrate to the median eminence of the hypothalamus. Since the median eminence is well supplied with blood vessels, it is not protected by the blood-brain barrier, making it potentially susceptible to any number of hormonal, metabolic, or immunologic processes.

2001 Obstet Gynecol Clin North Am 28;1:35-62

Kalro, B. N., Loucks, T. L., and Berga, S. L.

11824912 JA

Interviews with 30 women with PCOS revealed themes of feeling “abnormal", “freakish", “different” and “less feminine” than other women. “It was evident from women that the way that their condition had been explained to them by medical practitioners (as secreting too many ‘masculine hormones’) contributed significantly to their feelings of freakishness.”

2002 Soc Sci Med 54;3:349-61

Kitzinger, C. and Willmott, J.

10433180 JA

In this small study of 13 women with PCOS, mean levels of vitamin D and its metabolites were low normal or abnormally low, while calcium levels were normal and some women had elevated parathyroid hormone. Treatment with vitamin D and calcium restored normal menstrual cycles in 7 women, two of whom became pregnant. Calcium regulation may play a role in PCOS because calcium is very important for egg maturation and follicle development in the ovary.

1999 Steroids 64;6:430-5

Thys-Jacobs, S., Donovan, D., Papadopoulos, A., Sarrel, P., and Bilezikian, J. P.

[Top]

Amenorrhea (not having periods)

11591409 JA

Women with functional hypothalamic amenorrhea had elevated cortisol levels. In women who recovered, prior to return of ovulation there was a gradual rise in estrogen level, which was preceded by a normalization of cortisol.

2001 Fertil Steril 76;4:748-52

Kondoh, Y., Uemura, T., Murase, M., Yokoi, N., Ishikawa, M., and Hirahara, F.

11476778 JA

Women with functional hypothalamic amenorrhea had increased depressive symptoms and significantly more symptoms of disordered eating. Specifically, they had more concerns about dieting and weight, fear of weight gain, and tendencies to engage in binge eating.

2001 Fertil Steril 76;2:310-6

Marcus, M. D., Loucks, T. L., and Berga, S. L.

10764453 JA

Although women with hypothalamic amenorrhea have documented increased serum cortisol levels and decreased GnRH drive, this study showed a normal CRH level in the cerebral spinal fluid. Paper contains a roundtable discussion about this result.

2000 Am J Obstet Gynecol 182;4:776-81; discussion 781-4

Berga, S. L., Loucks-Daniels, T. L., Adler, L. J., Chrousos, G. P., Cameron, J. L., Matthews, K. A., and Marcus, M. D.

2058948 R,T

LH is secreted in a pulsatile fashion that differs in amplitude, frequency and duration during different phases of the menstrual cycle. Stress can interfere with this via the opioidergic and dopaminergic systems and CRH. Women with stress-related amenorrhea also have reduced T3 and T4 values in the face of normal TSH, and altered circadian plasma cortisol, growth hormone and melatonin.

1991 Ann N Y Acad Sci 626;125-9

Genazzani, A. R., Petraglia, F., De Ramundo, B. M., Genazzani, A. D., Amato, F., Algeri, I., Galassi, M. C., Botticelli, G., and Bidzinska, B.

9176439 JA

Cortisol secretion was higher in women with functional hypothalamic amenorrhea than women with other causes of anovulation or normally ovulating women. Increased HPA (hypothalamic-pituitary-adrenal) activity reduces GnRH drive.

1997 Fertil Steril 67;6:1024-30

Berga, S. L., Daniels, T. L., and Giles, D. E.

7883836 CT

Women in the follicular phase, in the luteal phase, and with stress-related anovulation were given an anti-anxiety medication found to inhibit CRH. In the stress related group, there was a significant reduction in cortisol levels, and a restoration of LH pulsatility.

1995 J Clin Endocrinol Metab 80;3:818-23

Judd, S. J., Wong, J., Saloniklis, S., Maiden, M., Yeap, B., Filmer, S., and Michailov, L.

3976546 JA

Reviews use of various hypnotic techniques for amenorrhea, including the direct approach of suggesting what day the period will start, to regressing back to when cycles were regular and inquiring what happened. Then the author discusses two cases of a “metaphorical approach”, in which each woman was told to “ask her unconscious to let happen what is right for her”. Both women had spontaneous imagery relating to their uteruses and subsequently began their cycles.

1985 Am J Clin Hypn 27;3:159-65

van der Hart, O.