Journal
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY
Volume 28, Issue 4, Pages 439-443Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GME.0000000000001703
Keywords
Cortisol; Hypothalamic-pituitary-adrenal axis; Menopause; Stress; Vasomotor symptoms; Women
Categories
Funding
- Brigham and Women's Hospital
- NIH
- National Center for Research Resources [1UL1TR001102]
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This study found that women with vasomotor symptoms (VMS) exhibited differences in physiological and subjective stress responses following experimental stress paradigms compared to women without VMS, suggesting that VMS may represent a chronic stress condition.
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.
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