Impact of Gender, Menstrual Cycle Phase, and Oral Contraceptives on the Activity of the Hypothalamus-Pituitary-Adrenal Axis -- Kirschbaum et al. 61 (2): 154 -- Psychosomatic Medicine: "Impact of Gender, Menstrual Cycle Phase, and Oral Contraceptives on the Activity of the Hypothalamus-Pituitary-Adrenal Axis
Clemens Kirschbaum, PhD, Brigitte M. Kudielka, MS, Jens Gaab, MS, Nicole C. Schommer, MS and Dirk H. Hellhammer, PhD

From the Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.

Address reprint requests to: Clemens Kirschbaum, PhD, Center for Psychobiological and Psychosomatic Research, University of Trier, Dietrichstr. 10–11, 54290 Trier, Germany. E-mail: Kirschba@uni-trier.de

OBJECTIVE: Results from animal and human studies suggest that disregulations of the hypothalamus-pituitary-adrenal (HPA) axis are involved in several behavioral, circulatory, endocrine, and immune disorders with clear-cut gender differences in disease prevalence. The aim of the present study was to investigate sex-specific HPA response patterns with a focus on the contribution of gonadal steroids as possible mediators.

METHODS: A total of 81 healthy adults were investigated in the present study. Twenty men, 19 women in the follicular phase of the menstrual cycle, 21 women in the luteal phase, and 21 women using oral contraceptives (OC) were exposed to a brief psychosocial stress test (Trier Social Stress Test; TSST) and injected with 0.25 mg ACTH1–24 on consecutive days. Basal HPA activity was investigated by repeatedly measuring cortisol levels immediately after awakening, as well as in 30-minute intervals from 9:00 AM to 9:00 PM. Additionally, questionnaires were used to assess psychological state and trait parameters.

RESULTS: Results show that the TSST induced significant increases in ACTH, salivary-free cortisol, total plasma cortisol, and heart rates, as well as increased wakefulness and reduced calmness in the total gr"