Medically unexplained symptoms in women as related to physiological stress responses

The present, cross-sectional study explored whether self-reported symptoms are related to physiological stress indicators in a group of 43-year-old women representing the general population in Sweden. Analyses were performed both on raw scores of physiological indicators and on a multisystem summary index of allostatic load as a measure of cumulative biological burden. Participants answered a health questionnaire and underwent a medical examination including blood pressure, heart rate measurements, determination of blood lipids and stress hormones. Urinary epinephrine and norepinephrine were measured both on a working day and a work free day at home. In addition, salivary morning cortisol was measured on a non-work day. The physiological profiles based on raw scores from 222 women showed that women with a high symptom load had significantly higher levels of cortisol (p < 0.05), and higher heart rate (p < 0.05) than did those with a low symptom load. In contrast, women with a low symptom load had significantly higher levels of epinephrine on a work free day than did women with a high symptom load (p < 0.05). No significant differences were found in norepinepbrine responses. When analysing the summary measure of allostatic load in relation to symptom prevalence no significant difference between the symptom groups emerged. One possible explanation for this result could be that a majority of the study population was healthy, reporting a low level of symptoms in general. However, the results support the notion that common, medically unexplained symptoms among women are associated with certain biological parameters known to play a role in the development of ill health. Copyright (C) 2004 John Wiley Sons, Ltd.