This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roca, C. A. Articles by Rubinow, D. R. Search for Related Content PubMed PubMed Citation Articles by Roca, C. A. Articles by Rubinow, D. R. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB HYDROCORTISONE LEUPROLIDE Medline Plus Health Information Premenstrual Syndrome

Differential Menstrual Cycle Regulation of Hypothalamic-Pituitary-Adrenal Axis in Women with Premenstrual Syndrome and Controls

Behavioral Endocrinology (C.A.R., P.J.S., D.R.R.) and Geriatric Psychiatry Branches (K.P.), National Institute of Mental Health, and Clinical Center Nursing Department (M.A.D.), National Institutes of Health, Bethesda, Maryland 20892; Department of Health and Human Services, Department of Psychiatry (M.A.), Weill Medical College, Cornell University, New York, New York 10021; and Department of Military and Emergency Medicine (P.D.), Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814

Address all correspondence and requests for reprints to: Catherine A. Roca, M.D., Building 10, Room 3N242, 10 Center Drive MSC 1277, Bethesda, Maryland 20892-1277. E-mail: rocac{at}intra.nimh.nih.gov.

Previous studies in animals indicate that reproductive steroids are potent modulators of the hypothalamic-pituitary-adrenal (HPA) axis, a physiologic system that is typically dysregulated in affective disorders, such as major depression. Determination of the role of reproductive steroids in HPA axis regulation in humans is of importance when attempting to understand the pathophysiology of premenstrual syndrome (PMS), a disorder characterized by affective symptoms during the luteal phase of the menstrual cycle. We performed two studies using treadmill exercise stress testing to determine the effect of menstrual cycle phase and diagnosis on the HPA axis in women with PMS and controls and the role of gonadal steroids in HPA axis modulation in control women. The results of these studies indicate that women with PMS fail to show the normal increased HPA axis response to exercise during the luteal phase and that progesterone, not estradiol, produces increased HPA axis response to treadmill stress testing in control women. These data demonstrate that women with PMS, when symptomatic, appear to have an abnormal response to progesterone and, furthermore, do not display the HPA axis abnormalities characteristic of major depression.

Abbreviations: AUC, Area under the curve; AVP, arginine vasopressin; CBG, cortisol-binding globulin; CV, coefficient of variation; HPA, hypothalamic-pituitary-adrenal; m-CPP, m-chlorophenylpiperazine; PMS, premenstrual syndrome; VO_2max, maximal oxygen uptake.

This article has been cited by other articles:

				M. Klose, M. Lange, A. K. Rasmussen, N. E. Skakkebaek, L. Hilsted, E. Haug, M. Andersen, and U. Feldt-Rasmussen Factors Influencing the Adrenocorticotropin Test: Role of Contemporary Cortisol Assays, Body Composition, and Oral Contraceptive Agents J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1326 - 1333. [Abstract] [Full Text] [PDF]

				J. M. Goldstein, M. Jerram, R. Poldrack, T. Ahern, D. N. Kennedy, L. J. Seidman, and N. Makris Hormonal Cycle Modulates Arousal Circuitry in Women Using Functional Magnetic Resonance Imaging J. Neurosci., October 5, 2005; 25(40): 9309 - 9316. [Abstract] [Full Text] [PDF]

				K. Putnam, G. P. Chrousos, L. K. Nieman, and D. R. Rubinow Sex-Related Differences in Stimulated Hypothalamic-Pituitary-Adrenal Axis during Induced Gonadal Suppression J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4224 - 4231. [Abstract] [Full Text] [PDF]

				M. Bloch, D. R. Rubinow, P. J. Schmidt, A. Lotsikas, G. P. Chrousos, and G. Cizza Cortisol Response to Ovine Corticotropin-Releasing Hormone in a Model of Pregnancy and Parturition in Euthymic Women with and without a History of Postpartum Depression J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 695 - 699. [Abstract] [Full Text] [PDF]

				E. A. YOUNG and M. ALTEMUS Puberty, Ovarian Steroids, and Stress Ann. N.Y. Acad. Sci., June 1, 2004; 1021(1): 124 - 133. [Abstract] [Full Text] [PDF]