Hypothalamic-pituitary-adrenal axis, subjective, and thermal stress responses in midlife women with vasomotor symptoms

被引:3
作者
Nathan, Margo D. [1 ]
Wiley, Aleta [1 ,2 ]
Mahon, Pamela B. [1 ]
Camuso, Julie [1 ]
Sullivan, Kathryn [1 ]
McCormick, Kathleen [1 ]
Srivastava, Akanksha [1 ]
Albert, Kim [3 ]
Newhouse, Paul [3 ,4 ]
Joffe, Hadine [1 ,2 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Dept Psychiat, Boston, MA 02115 USA
[2] Connors Ctr Womens Hlth & Gender Biol, HMS, BWH, Boston, MA USA
[3] Vanderbilt Univ, Med Ctr, Ctr Cognit Med, Dept Psychiat & Behav Sci, Nashville, TN USA
[4] Tennessee VA Hlth Syst, Geriatr Res Educ & Clin Ctr GRECC, Nashville, TN USA
来源
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY | 2021年 / 28卷 / 04期
关键词
Cortisol; Hypothalamic-pituitary-adrenal axis; Menopause; Stress; Vasomotor symptoms; Women; ACUTE PSYCHOSOCIAL STRESS; HOT FLASHES; CORTISOL DYSREGULATION; CARDIOVASCULAR-DISEASE; SALIVARY CORTISOL; HEALTH; MENOPAUSE; FLUSH; TRANSITION; REACTIVITY;
D O I
10.1097/GME.0000000000001703
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: Dysregulated responses to experimental stress paradigms may indicate exposure to chronic stress. Vasomotor symptoms (VMS) are linked with diminished quality of life and psychological stress, but induced stress responsivity has received limited investigation. We examined whether women with and without VMS differ in their evoked hypothalamic-pituitary-adrenal axis, subjective, hemodynamic, and thermal stress responses. Methods: A total of 37 midlife women (27 VMS+; 10 VMS-) completed 2 experimental stress paradigms: (1) Montreal Imaging Stress Task (MIST; computerized social-evaluative stressor) and (2) Quantitative Sensory Testing (QST; thermal stress task). Responses on a five-domain (range 0-50) Visual Analog Scale, salivary cortisol (hypothalamic-pituitary-adrenal axis), and hemodynamic indices (blood pressure, heart rate) were measured before and after each task to compare within-person change between groups. Thermal sensitivity was assessed on the QST. Results: On the MIST, the VMS+ group showed a smaller cortisol release (0.01 vs 0.07 mu g/dL; P = 0.046; corresponding to 54% vs 83% increases), and subjective stress response (21.2- vs 31.1-point Visual Analog Scale increase, P = 0.05; corresponding to 2427% vs 2863% increases) but no hemodynamic difference, compared to the VMS- group. The QST did not provoke stress responses via cortisol release or subjective report, but the VMS+ group tended to perceive heat at a higher temperature (38.5 degrees C vs 36.4 degrees C, P = 0.08). Conclusions: Women with VMS exhibited both diminished cortisol and subjective stress responses to the MIST, and reduced thermal sensitivity on QST compared to women without VMS. Dysregulated stress responsivity provides preliminary evidence suggesting that VMS may represent a chronic stress condition.
引用
收藏
页码:439 / 443
页数:5
相关论文
共 35 条
[1]   Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition [J].
Avis, Nancy E. ;
Crawford, Sybil L. ;
Greendale, Gail ;
Bromberger, Joyce T. ;
Everson-Rose, Susan A. ;
Gold, Ellen B. ;
Hess, Rachel ;
Joffe, Hadine ;
Kravitz, Howard M. ;
Tepper, Ping G. ;
Thurston, Rebecca C. .
JAMA INTERNAL MEDICINE, 2015, 175 (04) :531-539
[2]   Cortisol dysregulation in obesity-related metabolic disorders [J].
Baudrand, Rene ;
Vaidya, Anand .
CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY, 2015, 22 (03) :143-149
[3]   Increased Vascular Inflammation in Early Menopausal Women Is Associated with Hot Flush Severity [J].
Bechlioulis, Aris ;
Naka, Katerina K. ;
Kalantaridou, Sophia N. ;
Kaponis, Apostolos ;
Papanikolaou, Odysseas ;
Vezyraki, Patra ;
Kolettis, Theofilos M. ;
Vlahos, Antonis P. ;
Gartzonika, Konstantina ;
Mavridis, Anestis ;
Michalis, Lampros K. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2012, 97 (05) :E760-E764
[4]   Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases? [J].
Biglia, N. ;
Cagnacci, A. ;
Gambacciani, M. ;
Lello, S. ;
Maffei, S. ;
Nappi, R. E. .
CLIMACTERIC, 2017, 20 (04) :306-312
[5]   Increased cortisol level: a possible link between climacteric symptoms and cardiovascular risk factors [J].
Cagnacci, Angelo ;
Cannoletta, Marianna ;
Caretto, Simona ;
Zanin, Renata ;
Xholli, Anjeza ;
Volpe, Annibale .
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2011, 18 (03) :273-278
[6]   Presence of vasomotor symptoms is mineral density: a longitudinal associated with lower bone analysis [J].
Crandall, Carolyn J. ;
Zheng, Yan ;
Crawford, Sybil L. ;
Thurston, Rebecca C. ;
Gold, Ellen B. ;
Johnston, Janet M. ;
Greendale, Gail A. .
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2009, 16 (02) :239-246
[7]  
Dedovic K, 2005, J PSYCHIATR NEUROSCI, V30, P319
[8]   Cardiovascular Implications of the Menopause Transition Endogenous Sex Hormones and Vasomotor Symptoms [J].
El Khoudary, Samar R. ;
Thurston, Rebecca C. .
OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA, 2018, 45 (04) :641-+
[9]   Human hypothalamus-pituitary-adrenal axis responses to acute psychosocial stress in laboratory settings [J].
Foley, Paul ;
Kirschbaum, Clemens .
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS, 2010, 35 (01) :91-96
[10]   Hot flashes and midlife symptoms in relation to levels of salivary cortisol [J].
Gerber, Linda M. ;
Sievert, Lynnette L. ;
Schwartz, Joseph E. .
MATURITAS, 2017, 96 :26-32