Systematic review, 2022
Does the stress hormone cortisol change across the menstrual cycle?
Yes, but only slightly. Across many studies, cortisol was a little higher in the first half of the cycle (follicular phase) than the second half (luteal phase), and higher during a period than right before it, but most other phase comparisons showed no clear difference.
What they did
Researchers searched five databases and combined data from 121 earlier studies that tracked cortisol over the menstrual cycle. Together these studies included 2641 healthy, cycling women aged 18 to 45. This was a systematic review and meta-analysis, so no new experiment was run.
What they found
Cortisol was higher in the follicular phase than the luteal phase (difference d = 0.12, p = .004). Cortisol was also higher during the period (menstrual phase) than in the premenstrual phase (d = 0.17, p = .03). Comparisons between other, more precise cycle phases mostly showed no significant difference. Only a small number of the studies looked at detailed daily cortisol patterns: 4 studies looked at diurnal cortisol profiles and 5 looked at the cortisol awakening response.
What it means for you
Basal cortisol levels seem to shift only slightly across the cycle, and we still know very little about how the daily rhythm of cortisol (not just its overall level) changes with hormones. The main limit is that very few of the 121 studies measured these more detailed daily cortisol patterns, so firmer conclusions about stress-hormone rhythms and the cycle are not yet possible.
121
studies included
2641
women included
d=0.12
follicular vs luteal cortisol difference
About the study
- Original title
- HPA axis activity across the menstrual cycle - a systematic review and meta-analysis of longitudinal studies
- Authors
- Klusmann H, Schulze L, Engel S et al.
- Journal
- Frontiers in neuroendocrinology
- Year
- 2022
- Study design
- Systematic review
- What was tested
- None tested; this was an observational analysis of existing cortisol measurements
- Open access
- Yes
- Read the paper
- doi.org/10.1016/j.yfrne.2022.100998
Original abstract
Differential HPA axis function has been proposed to underlie sex-differences in mental disorders; however, the impact of fluctuating sex hormones across the menstrual cycle on HPA axis activity is still unclear. This meta-analysis investigated basal cortisol concentrations as a marker for HPA axis activity across the menstrual cycle. Through a systematic literature search of five databases, 121 longitudinal studies were included, summarizing data of 2641 healthy, cycling participants between the ages of 18 and 45. The meta-analysis showed higher cortisol concentrations in the follicular vs. luteal phase (d SMC = 0.12, p =.004, [0.04 - 0.20]). Comparisons between more precise cycle phases were mostly insignificant, aside from higher concentrations in the menstrual vs. premenstrual phase (d SMC = 0.17, [0.02 - 0.33], p =.03). In all included studies, nine samples used established cortisol parameters to indicate HPA axis function, specifically diurnal profiles (k = 4) and the cortisol awakening response (CAR) (k = 5). Therefore, the meta-analysis highlights the need for more rigorous investigation of HPA axis activity and menstrual cycle phase.
Reproduced under CC-BY.
Topics
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