Exp Clin Endocrinol Diabetes 2006; 114
Responses to acute psychological stress in PCOS
Objectives: The psychological implications of polycystic ovary syndrome (PCOS) include emotional distress and reduced quality-of-life, which is particularly pronounced in obese patients. The goal of this study was to assess the effect of obesity on stress-induced neuroendocrine responses in PCOS patients compared to healthy controls.
Conclusion: Hypothalamic-pituitary-adrenal-axis and cardiovascular responses to acute stress are enhanced in overweight PCOS patients. These findings may have implications for the long-term health risks associated with the diagnosis, particularly with cardiovascular conditions such as hypertension and atherosclerosis.
Methods: Acute stress was induced with the public speaking stress model, which involves a 5-min. preparation time followed by a 3-min. videotaped speech delivery phase in front of an audience. At baseline, immediately after preparation, 10-min. following speech, and after a 45-min. recovery period, state anxiety, serum cortisol levels, and cardiovascular responses were analyzed. Responses of PCOS patients with a body mass index (BMI) >25 (overweight PCOS) were compared to PCOS with a BMI
Results: The groups differed significantly in cortisol responses (ANOVA group effect: p<0.01), with reduced cortisol levels at baseline in overweight PCOS. In response to stress, overweight PCOS showed a markedly enhanced increase in serum cortisol (increase over baseline: + 205±36 nmol/l vs. + 89±57 nmol/l in lean PCOS vs. + 96±38 nmol/l in controls). Whereas there were no basal differences in blood pressure between groups, overweight PCOS demonstrated enhanced blood pressure responses to stress (ANOVA group effect: p<0.05) with significantly greater systolic and particularly diastolic blood pressures during public speech (diastolic: 109±8mmHg vs. 87±4mmHg in lean PCOS vs. 91±5mmHg in controls, p<0.05). These effects were not related to group differences in the emotional response to stress.
S Benson1, S Hahn2, S Tan2, N Rifaie1, K Pleger1, R Kimmig3, K Mann2, OE Janssen2, S Elsenbruch1
1 Dept. of Medical Psychology, University Hospital of Essen Medical School, Essen, Germany
2 Div. of Endocrinology, Dept. of Medicine, University Hospital of Essen Medical School, Essen, Germany
3 Dept. of Obstetrics & Gynaecology, University Hospital of Essen Medical School, Essen, Germany