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Park JY, Seok JH, Cho KS, Kang DH, Kim JS, Do SH, Na HS, Jang SA, Ahn RS. Association of salivary testosterone levels during the post-awakening period with age and symptoms suggestive of late-onset hypogonadism in men. Ann Med 2024; 56:2356667. [PMID: 38776237 PMCID: PMC11123501 DOI: 10.1080/07853890.2024.2356667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/23/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The lack of association between serum testosterone levels and symptoms suggestive of hypogonadism is a significant barrier in the determination of late-onset hypogonadism (LOH) in men. This study explored whether testosterone levels increase after morning awakening, likewise the cortisol awakening response (CAR) in the hypothalamic-pituitary-adrenal (HPA) axis, and whether testosterone levels during the post-awakening period are associated with age and symptoms suggestive of late-onset hypogonadism (LOH) in men. METHODS Testosterone and cortisol levels were determined in saliva samples collected immediately upon awakening and 30 and 60 min after awakening, and scores of the Aging Males' Symptoms (AMS) questionnaire were obtained from 225 healthy adult men. RESULTS A typical CAR (an increase in cortisol level ≥ 2.5 nmol/L above individual baseline) was observed in 155 participants (the subgroup exhibiting typical CAR). In the subgroup exhibiting CAR, testosterone levels sharply increased during the post-awakening period, showing a significant negative correlation with age, total AMS score, and the scores of 11 items on the somatic, psychological, and sexual AMS subscales. Of these items, three sexual items (AMS items #15-17) were correlated with age. Meanwhile, there was no notable increase in testosterone levels and no significant correlation of testosterone levels with age and AMS score in the subgroup exhibiting no typical CAR (n = 70). CONCLUSIONS The results indicate that the hypothalamus-pituitary-gonad (HPG) axis responds to morning awakening, and determining testosterone levels during the post-awakening period in men with typical CAR may be useful for assessing HPG axis function and LOH.
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Affiliation(s)
- Jai-Young Park
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangwon, Republic of Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Kang-Su Cho
- Department of Urology, Prostate Cancer Center, Yonsei University Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Dong-Hyun Kang
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangwon, Republic of Korea
| | - Jin-Sun Kim
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangwon, Republic of Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Hyo-Seok Na
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Soo-Ah Jang
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Ryun S. Ahn
- Institute of Behavioral Sciences in Medicine, Yonsei University Gangnam Severance Hospital, College Of Medicine, Yonsei University, Seoul, Republic of Korea
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Haase L, Vehlen A, Strojny J, Domes G. Effects of menstrual cycle phase and ovulation on the salivary cortisol awakening response. Psychoneuroendocrinology 2024; 160:106669. [PMID: 37988874 DOI: 10.1016/j.psyneuen.2023.106669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
The cortisol awakening response (CAR) is influenced by several state and trait variables, one of which might be the menstrual cycle in women. Previous results suggested that the CAR is enhanced around ovulation, which is why it has been recommended to avoid sampling during the ovulatory phase. In two separate studies, we aimed to replicate previous findings that reported the CAR's modulation across the menstrual cycle, especially during ovulation. In Study 1, a group of 27 healthy naturally cycling women collected saliva at 0, 30, 45, and 60 min post-awakening on two days during their follicular, ovulatory, and luteal phases in a repeated measures design. In Study 2, CAR samples were collected from 30 healthy naturally cycling women on seven consecutive days around the expected ovulation. To increase reliability of CAR measurements, participants' compliance of saliva sampling times was monitored, ovarian steroids (estradiol and progesterone) were collected, and ovulation was confirmed with specific test kits. Contrary to our expectations, we detected no differences in the CAR over the menstrual cycle, and no significant association with variations in estradiol and progesterone. In addition, we excluded confounding effects such as compliance and validated the cycle phase. These results suggest that the CAR is largely robust against hormonal variations across the menstrual cycle, including the mid-cycle phase around ovulation. However, further research is needed to understand the potential ovarian steroid-induced modulation of HPA axis functioning and the menstrual cycle's effects on salivary cortisol levels in psychobiological studies.
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Affiliation(s)
- Lisa Haase
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany; Institute for Cognitive and Affective Neuroscience, University of Trier, Trier, Germany.
| | - Antonia Vehlen
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany
| | - Julia Strojny
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany
| | - Gregor Domes
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany; Institute for Cognitive and Affective Neuroscience, University of Trier, Trier, Germany.
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Cohn AY, Grant LK, Nathan MD, Wiley A, Abramson M, Harder JA, Crawford S, Klerman EB, Scheer FAJL, Kaiser UB, Rahman SA, Joffe H. Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause. J Clin Endocrinol Metab 2023; 108:e1347-e1357. [PMID: 37207451 PMCID: PMC10584010 DOI: 10.1210/clinem/dgad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023]
Abstract
CONTEXT Perturbations to the hypothalamic-pituitary-adrenal (HPA) axis have been hypothesized to increase postmenopausal cardiometabolic risk. Although sleep disturbance, a known risk factor for cardiometabolic disease, is prevalent during the menopause transition, it is unknown whether menopause-related sleep disturbance and estradiol decline disturb the HPA axis. OBJECTIVE We examined the effect of experimental fragmentation of sleep and suppression of estradiol as a model of menopause on cortisol levels in healthy young women. METHODS Twenty-two women completed a 5-night inpatient study during the mid-to-late follicular phase (estrogenized). A subset (n = 14) repeated the protocol after gonadotropin-releasing hormone agonist-induced estradiol suppression. Each inpatient study included 2 unfragmented sleep nights followed by 3 experimental sleep fragmentation nights. This study took place with premenopausal women at an academic medical center. Interventions included sleep fragmentation and pharmacological hypoestrogenism, and main outcome measures were serum bedtime cortisol levels and cortisol awakening response (CAR). RESULTS Bedtime cortisol increased 27% (P = .03) and CAR decreased 57% (P = .01) following sleep fragmentation compared to unfragmented sleep. Polysomnographic-derived wake after sleep-onset (WASO) was positively associated with bedtime cortisol levels (P = .047) and negatively associated with CAR (P < .01). Bedtime cortisol levels were 22% lower in the hypoestrogenized state compared to the estrogenized state (P = .02), while CAR was similar in both estradiol conditions (P = .38). CONCLUSION Estradiol suppression and modifiable menopause-related sleep fragmentation both independently perturb HPA axis activity. Sleep fragmentation, commonly seen in menopausal women, may disrupt the HPA axis, which in turn may lead to adverse health effects as women age.
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Affiliation(s)
- Aviva Y Cohn
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital (BWH), Harvard Medical School (HMS), Boston, MA 02115, USA
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
| | - Leilah K Grant
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, BWH, Boston, MA 02115, USA
- Division of Sleep Medicine, HMS, Boston, MA 02115, USA
| | - Margo D Nathan
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
| | - Aleta Wiley
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
| | - Mathena Abramson
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
| | - Jessica A Harder
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing at UMass Chan Medical School, Worcester, MA 01605, USA
| | - Elizabeth B Klerman
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, BWH, Boston, MA 02115, USA
- Division of Sleep Medicine, HMS, Boston, MA 02115, USA
- Department of Neurology, Massachusetts General Hospital, HMS, Boston, MA 02114, USA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, BWH, Boston, MA 02115, USA
- Division of Sleep Medicine, HMS, Boston, MA 02115, USA
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital (BWH), Harvard Medical School (HMS), Boston, MA 02115, USA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, BWH, Boston, MA 02115, USA
- Division of Sleep Medicine, HMS, Boston, MA 02115, USA
| | - Hadine Joffe
- Women's Hormones and Aging Research Program, Department of Psychiatry, BWH, HMS, Boston, MA 02115, USA
- Connors Center for Women's Health and Gender Biology, BWH, HMS, Boston, MA 02115, USA
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Biopsychosocial predictors of depressive symptoms in the perimenopause—findings from the Swiss Perimenopause Study. ACTA ACUST UNITED AC 2021; 28:247-254. [DOI: 10.1097/gme.0000000000001704] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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5
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Differential trait and state frontal alpha asymmetry in women with premenstrual syndrome. MOTIVATION AND EMOTION 2019. [DOI: 10.1007/s11031-019-09797-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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6
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Effects of the menstrual cycle and neuroticism on women's sadness emotion and physiological responses based on an emotion-inducing experiment. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2019. [DOI: 10.1016/j.jtcms.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Altered Hypothalamus-Pituitary-Adrenal Axis Function: A Potential Underlying Biological Pathway for Multiple Concurrent Symptoms in Patients With Advanced Lung Cancer. Psychosom Med 2019; 81:41-50. [PMID: 30371632 DOI: 10.1097/psy.0000000000000648] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients with advanced cancer commonly experience multiple symptoms that present as groups or clusters. The present study aimed to examine whether hypothalamus-pituitary-adrenal (HPA) axis dysfunction underlies the concurrent multiple symptoms in patients with advanced cancer. METHODS Patients' cortisol levels were determined in saliva samples collected after awakening (0, 30, and 60 minutes after awakening) and at nighttime (21:00-22:00 PM) from 46 patients with lung cancer (15.2% women), with a mean (standard deviation) age of 64.3 (9.2) years and 47 healthy participants (53.2% women; age = 62.0 [4.6] years). Cancer-related symptoms were measured using the M.D. Anderson Symptom Inventory (MDASI). RESULTS Compared with healthy participants, patients showed a significantly reduced cortisol awakening response (F(1,364) = 46.2, p < .001) and had flatter diurnal slope of cortisol (larger β values) (mean [standard error of the mean] = -0.64 [0.06] versus -0.18 [0.05], p < .001). Altered HPA axis function was significantly and adversely associated with performance status and burden of symptoms (all p values < .01). However, each MDASI item varied widely in the degree of association with the HPA axis function. Hierarchical clustering analysis based on Spearman's rank correlation with complete linkage identified that nausea was clustered with vomiting, numbness, and dry mouth, whereas the other nine MDASI core symptoms associated with altered HPA axis function were clustered together. CONCLUSIONS Altered HPA axis function may be a possible biological pathway that can explain the concurrence of core symptoms in patients with advanced lung cancer.
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Schiffer L, Adaway JE, Baranowski ES, Arlt W, Keevil BG. A novel high-throughput assay for the measurement of salivary progesterone by liquid chromatography tandem mass spectrometry. Ann Clin Biochem 2018; 56:64-71. [DOI: 10.1177/0004563218780904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Liquid chromatography tandem mass spectrometry (LC-MS/MS) enables specific and sensitive quantification of steroids with a high throughput. Saliva sampling is advantageous for multisample profiling over longer periods of time, as it is non-invasive, cheap, can be carried out at home and does not require the attendance of clinical personnel. We developed a rapid LC-MS/MS for the measurement of salivary progesterone, frequently assessed as ovulation marker in patients desiring fertility. Methods Samples (300 μL) were prepared by supported liquid extraction using dichloromethane and were reconstituted in 40% methanol. Chromatography was performed using a C8 column with a water/methanol gradient containing 0.1% formic acid and 2 mmol/L ammonium acetate. Quantification was performed with a Waters TQ-S mass spectrometer. Results Total run time was 5.5 min. The lower limit of quantification was 20 pmol/L (1.2 fmol on column). Inter- and intra-assay comparison showed coefficients of variation and bias between measured and nominal concentrations of less than 11%. Mean recovery was 91%. Interference with a large set of natural and synthetic steroids was excluded. The assay was successfully applied to measure progesterone variation during the menstrual cycle ( n = 9) and diurnal variations during luteal phase ( n = 7) in regularly cycling women. Discussion We present a novel LC-MS/MS assay for the determination of salivary progesterone with high-throughput potential. The applicability of the assay for progesterone profiling during the menstrual cycle is demonstrated.
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Affiliation(s)
- Lina Schiffer
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Joanne E Adaway
- Biochemistry Department, Wythenshawe Hospital, Manchester University NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Elizabeth S Baranowski
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Wiebke Arlt
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Brian G Keevil
- Biochemistry Department, Wythenshawe Hospital, Manchester University NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
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Hjelmervik H, Hausmann M, Craven AR, Hirnstein M, Hugdahl K, Specht K. Sex- and sex hormone-related variations in energy-metabolic frontal brain asymmetries: A magnetic resonance spectroscopy study. Neuroimage 2018; 172:817-825. [DOI: 10.1016/j.neuroimage.2018.01.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/22/2017] [Accepted: 01/17/2018] [Indexed: 12/26/2022] Open
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Biological mechanisms underlying the liver's regulation of emotions in women: A study using the Trier Social Stress Test. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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Mielgo-Ayuso J, Zourdos MC, Clemente-Suárez VJ, Calleja-González J, Shipherd AM. Can psychological well-being scales and hormone levels be used to predict acute performance of anaerobic training tasks in elite female volleyball players? Physiol Behav 2017; 180:31-38. [PMID: 28811191 DOI: 10.1016/j.physbeh.2017.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/08/2017] [Accepted: 08/11/2017] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine relationships between pre-training psychological well-being assessment scales (General Health Questionnaire-28-GHQ-28, Competitive State Anxiety Inventory-2-CSAI-2, Sport Competition Anxiety Test-SCAT, State-Trait Anxiety Inventory-S-STAI-S, Oviedo Sleep Questionnaire-OSQ and Psychological Characteristics Related to Sport Performance-PCSP), and pre-training stress hormone concentrations (cortisol-C, total testosterone-TT, free testosterone-FT, adrenocorticotropic hormone-ACTH and testosterone/cortisol-T/C ratios), on acute neuromuscular performance (ANP) in female volleyballers. Forty elite female volleyballers (27±4yrs.; 178.3±8.5cm; 67.9±7.2kg) participated. Bivariate correlations were performed between psychological assessments and hormone levels with ANP. All psychological scales presented at least one significant (p<0.05) relationship or prediction of ANP. Contrastingly, among hormones, the only significant relationship was between TT/C ratio and Overhead Medicine Ball Throw (r=0.34; p<0.05). Therefore, our data shows that results of general and sport-specific psychological well-being scales prior to training are more consistently related to performance in elite female volleyballers than pre-training stress hormone concentrations.
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Affiliation(s)
- Juan Mielgo-Ayuso
- Elikaesport, Nutrition, Innovation & Sport, Donostia-San Sebastián, Spain.
| | - Michael C Zourdos
- Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Florida Atlantic University, Boca Raton, FL, United States
| | | | - Julio Calleja-González
- Faculty of Physical Activity and Sport Sciences, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Amber M Shipherd
- Department of Health and Kinesiology, Texas A&M University - Kingsville, Kingsville, TX, United States
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Jang YJ, Park JI, Jeong SE, Seo YM, Dam PTM, Seo YW, Choi BC, Song SJ, Chun SY, Cho MK. Regulation of interleukin-11 expression in ovulatory follicles of the rat ovary. Reprod Fertil Dev 2017; 29:2437-2445. [DOI: 10.1071/rd16460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/29/2017] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to examine the regulation of interleukin (IL)-11 expression, as well as the role of IL-11, during ovulation in gonadotropin-primed immature rats. Injection of equine chorionic gonadotropin (eCG), followed by human CG (hCG) to induce superovulation stimulated expression of the Il11 gene in theca cells within 6 h, as revealed by northern blot and in situ hybridisation analyses. Real-time reverse transcription–polymerase chain reaction analysis showed that the IL-11 receptor, α subunit gene was expressed in granulosa and theca cells and that injection of hCG had no effect on its expression. IL-11 protein expression was stimulated in theca cells by hCG. LH-stimulated increases in Il11 mRNA levels in cultured preovulatory follicles were inhibited by protein kinase A and mitogen-activated protein kinase kinase inhibitors. Toll-like receptor (TLR) 2 and TLR4 were detected in preovulatory follicles, and the TLR4 ligand lipopolysaccharide, but not the TLR2 ligand Pam3Cys, increased Il11 mRNA levels in theca cells, but not in granulosa cells. Treatment of preovulatory follicles with IL-11 stimulated progesterone production and steroidogenic acute regulatory protein (Star) gene expression. Together, these results indicate that IL-11 in theca cells is stimulated by mitogen-activated protein kinase signalling and TLR4 activation, and increases progesterone production during ovulation.
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14
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Emotion Dysregulation of Women with Premenstrual Syndrome. Sci Rep 2016; 6:38501. [PMID: 27922107 PMCID: PMC5138621 DOI: 10.1038/srep38501] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/10/2016] [Indexed: 11/08/2022] Open
Abstract
The aim of the current study was to test whether women with premenstrual syndrome (PMS) had difficulties in emotion regulation. In Study 1, we investigated the relationship between the habitual use of emotion-regulation strategies and the severity of PMS (n = 230). The results showed that the severity of PMS was negatively associated with the habitual use of reappraisal, but positively associated with the habitual use of suppression. In Study 2, we first investigated the difference in the spontaneous use of suppression versus reappraisal between women with (n = 42) and without PMS (n = 42) when watching sad film clips. Then we instructed some participants (PMS group = 20, healthy group = 21) to use reappraisal to regulate their emotions induced by a second sad film clip, and the other participants were asked to watch the second film clip freely (PMS group = 22, healthy group = 21). The results showed that there was no significant difference between participants with and without PMS in the self-reported spontaneous use of emotion-regulation strategies. For participants with PMS, increases in spontaneous suppression use were associated with increases in skin conductance level (SCL), while this association was not found among participants without PMS.
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Wang YE, Kakigi C, Barbosa D, Porco T, Chen R, Wang S, Li Y, Singh K, Pasquale LR, Lin SC. Oral Contraceptive Use and Prevalence of Self-Reported Glaucoma or Ocular Hypertension in the United States. Ophthalmology 2016; 123:729-36. [PMID: 26948305 PMCID: PMC4857187 DOI: 10.1016/j.ophtha.2015.11.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/25/2015] [Accepted: 11/29/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the association between oral contraceptive (OC) use and glaucoma prevalence in the United States. DESIGN Cross-sectional study. PARTICIPANTS A total of 3406 female participants, aged 40 years or older, from the 2005 to 2008 National Health and Nutrition Examination Survey, who reported a presence or absence of glaucoma or ocular hypertension completed both the vision and the reproductive health questionnaires and underwent eye examinations. METHODS Multivariate regression analysis was used to assess the correlation between OC use and self-reported glaucoma or ocular hypertension (n = 231 cases), controlling for potential confounders, including age, ethnicity, systemic comorbidities such as hypertension and stroke, ocular diseases such as cataract and diabetic retinopathy, and reproductive health factors, including age at menopause, age at menarche, history of hormone replacement therapy, and gynecological surgical history. MAIN OUTCOME MEASURES The outcome variable was self-reported glaucoma or ocular hypertension. RESULTS After adjusting for confounders, those with ≥3 years of OC use had greater odds (odds ratio, 1.94; 95% confidence interval, 1.22-3.07) of self-reported glaucoma or ocular hypertension. Other factors associated with higher glaucoma or ocular hypertension prevalence included older age, African American race, and later age at menarche. CONCLUSIONS Oral contraceptive use may be associated with increased risk of self-reported glaucoma or ocular hypertension.
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Affiliation(s)
- Ye Elaine Wang
- Department of Ophthalmology, University of California, San Francisco, California; Department of Ophthalmology, Harbor-UCLA Medical Center, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, California
| | - Caitlin Kakigi
- Department of Ophthalmology, University of California, San Francisco, California
| | - Diego Barbosa
- Department of Ophthalmology, University of California, San Francisco, California
| | - Travis Porco
- Department of Ophthalmology, University of California, San Francisco, California
| | - Rebecca Chen
- Department of Ophthalmology, University of California, San Francisco, California; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Sophia Wang
- Department of Ophthalmology, University of California, San Francisco, California; Kellogg Eye Institute, University of Michigan, Ann Arbor, Michigan
| | - Yingjie Li
- Department of Ophthalmology, University of California, San Francisco, California; Third Hospital of Nanchang University Medical School, Nanchang, Jiangxi Province, People's Republic of China P.R
| | - Kuldev Singh
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California
| | - Louis R Pasquale
- Massachusetts Eye and Ear Infirmary, Glaucoma Service, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shan C Lin
- Department of Ophthalmology, University of California, San Francisco, California.
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Abstract
OBJECTIVE Sex differences in pain are well established, with women reporting greater incidence of clinical pain and heightened responsivity to experimental pain stimuli relative to men. Sex hormones (ie, estrogens, progestins, androgens) could contribute to extant differences in pain sensitivity between men and women. Despite this, there has been limited experimental research assessing the relationship between pain and sex hormones. The purpose of this study was to extend previous research and examine the association between sex hormones and nociceptive processing in healthy women. MATERIALS AND METHODS A total of 40 healthy women were tested during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle (testing order counterbalanced). Salivary estradiol, progesterone, and testosterone were collected at each testing session and pain was examined from electrocutaneous threshold/tolerance, ischemia threshold/tolerance, and McGill Pain Questionnaire-Short Form ratings of noxious stimuli. Nociceptive flexion reflex threshold was assessed as a measure of spinal nociception. RESULTS Overall, there were no significant menstrual phase-related differences in pain outcomes. Nonetheless, variability in testosterone (and to a lesser degree estradiol) was associated with pain; testosterone was antinociceptive, whereas estradiol was pronociceptive. No hormone was associated with nociceptive flexion reflex threshold. DISCUSSION Although future research is needed to replicate and extend these findings to clinical populations (ie, chronic pain, premenstrual dysphoric disorder), results from the present study indicate that menstrual phase-related changes in sex hormones have minimal influence on experimental pain. However, individual differences in testosterone may play a protective role against pain in healthy women.
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Marcos J, Pol M, Fabregat A, Ventura R, Renau N, Hanzu FA, Casals G, Marfà S, Barceló B, Barceló A, Robles J, Segura J, Pozo OJ. Urinary cysteinyl progestogens: Occurrence and origin. J Steroid Biochem Mol Biol 2015; 152:53-61. [PMID: 25913395 DOI: 10.1016/j.jsbmb.2015.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/15/2015] [Accepted: 04/21/2015] [Indexed: 02/09/2023]
Abstract
The presence of two cysteinyl progestogens, 16-cysteinyl-progesterone (16-Cys-Prog) and 16-cysteinyl-pregnenolone (16-Cys-Preg), in human urine is described for the first time. Their occurrence was unequivocally confirmed by comparison with synthesized material by using mass spectrometric detectors. Several experiments were performed in order to clarify their origin. The adrenal origin of both 16-Cys-Prog and 16-Cys-Preg can be inferred from the increase in their concentrations after ACTH stimulatory test, together with their circadian variation similar to the one observed for cortisol. Moreover, the notable increase in excretions of 16-Cys-Prog during the luteal phase of the menstrual cycle points towards an ovarian production for this progestogen. However, the analysis of samples during the course of two pregnancies revealed that, in spite of the large amounts of progesterone produced during gestation, the human placenta lacks the capacity to make 16-Cys-Prog. The adrenal and ovarian origin has been further indicated by the absence of both metabolites in samples collected from a subject with bilateral adrenalectomy and hypogonadotrophyic hypogonadism. Regarding liver action, in vitro studies with hepatocytes and progesterone indicate that, although the liver is able to metabolize progesterone to 6-dehydroprogesterone, it has not the enzymatic machinery for the generation of 16-dehydroprogesterone. Taken together, these results open the possibility for a noninvasive test for the simultaneous evaluation of progesterone biosynthesis in different organs.
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Affiliation(s)
- Josep Marcos
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marta Pol
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Andreu Fabregat
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Rosa Ventura
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Nuria Renau
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Felicia A Hanzu
- Department of Endocrinology and Nutrition, Hospital Clinic, Laboratory of Endocrine Disorders, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Gregori Casals
- Biochemistry and Molecular Genetics Department, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Santi Marfà
- Biochemistry and Molecular Genetics Department, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Bernardí Barceló
- Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Antonia Barceló
- Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Juan Robles
- Servei d'Anàlisis Cliniques Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Jordi Segura
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Oscar J Pozo
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain.
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Hjelmervik H, Westerhausen R, Hirnstein M, Specht K, Hausmann M. The neural correlates of sex differences in left-right confusion. Neuroimage 2015; 113:196-206. [PMID: 25776218 DOI: 10.1016/j.neuroimage.2015.02.066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/15/2015] [Accepted: 02/26/2015] [Indexed: 02/03/2023] Open
Abstract
Difficulties in left-right discrimination (LRD) are commonly experienced in everyday life situations. Here we investigate the neurocognitive mechanisms of LRD and the specific role of left angular gyrus. Given that previous behavioral research reported women to be more susceptible to left-right confusion, the current study focuses particularly on the neural basis of sex differences in LRD while controlling for potential menstrual cycle effects (repeated measures design). 16 women and 15 men were presented pictures of pointing hands in various orientations (rotated versus non-rotated) and were asked to identify them as left or right hands. Results revealed that LRD was particularly associated with activation in inferior parietal regions, extending into the right angular gyrus. Irrespective of menstrual cycle phase, women, relative to men, recruited more prefrontal areas, suggesting higher top-down control in LRD. For the subset of rotated stimuli as compared to the non-rotated, we found leftward asymmetry for both men and women, although women scored significantly lower. We conclude that there are sex differences in the neurocognitive mechanisms underlying LRD. Although the angular gyrus is involved in LRD, several other parietal areas are at least as critical. Moreover, the hypothesis that more left-right confusion is due to more bilateral activation (in women) can be rejected.
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Affiliation(s)
- Helene Hjelmervik
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| | | | - Marco Hirnstein
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
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Park JY, Hwang TK, Park HK, Ahn RS. Differences in cardiovascular and hypothalamic-pituitary-adrenal axis functions between high-altitude visitors and natives during a trek on the Annapurna circuit. Neuroendocrinology 2014; 99:130-8. [PMID: 24821470 DOI: 10.1159/000363367] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 04/29/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Differences in the cardiovascular and hypothalamic-pituitary-adrenal (HPA) axis functions at high altitudes (HAs) between visitors to and natives of HA were examined. METHODS The cardiovascular functions and peripheral oxygen saturation (SPO2) were monitored, and the cortisol awakening response (CAR) and nighttime cortisol concentration (NCC), as indices of the HPA axis function, were determined in 25 trekkers and 21 Sherpas during an Annapurna circuit trek. RESULTS SPO2 decreased less in the Sherpas than in the trekkers at HAs (3,540, 3,800, and 4,800 m). Blood pressure and heart rate in the Sherpas changed concurrently during the trek; however, a tachycardic response occurred without changes in blood pressure in the trekkers at HAs. The CAR and NCC at HAs in the trekkers differed from those observed at 1,100 m and those observed at HAs in the Sherpas. The trekkers exhibited an elevated morning cortisol level at 3,540 and 3,800 m, a heightened CAR at 4,800 m, and an elevated NCC at 3,800 m. Alteration of the CAR resulted in an increase in the integrated volume of cortisol released within the first hour after awakening (CARauc) in the trekkers. The changes in SPO2 occurred concurrently with the changes in the CARauc and the heart rate in the trekkers. CONCLUSIONS The alterations of CAR occurred at HAs where blood pressure levels reached a peak plateau, which is associated with an increase in heart rate at HAs in the trekkers. The CAR was unaltered in the Sherpas during the trek.
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Affiliation(s)
- Jai Y Park
- Department of Anesthesiology and Pain Medicine, The Armed Forces Capital Hospital, Seoul, Republic of Korea
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21
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Gamble KL, Resuehr D, Johnson CH. Shift work and circadian dysregulation of reproduction. Front Endocrinol (Lausanne) 2013; 4:92. [PMID: 23966978 PMCID: PMC3736045 DOI: 10.3389/fendo.2013.00092] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/10/2013] [Indexed: 01/18/2023] Open
Abstract
Health impairments, including reproductive issues, are associated with working nights or rotating shifts. For example, shift work has been associated with an increased risk of irregular menstrual cycles, endometriosis, infertility, miscarriage, low birth weight or pre-term delivery, and reduced incidence of breastfeeding. Based on what is known about circadian regulation of endocrine rhythms in rodents (and much less in humans), the circadian clock is an integral regulatory part of the reproductive system. When this 24-h program is disordered by environmental perturbation (such as shift work) or genetic alterations, the endocrine system can be impaired. The purpose of this review is to explore the hypothesis that misalignment of reproductive hormones with the environmental light-dark cycle and/or sleep-wake rhythms can disrupt menstrual cycles, pregnancy, and parturition. We highlight the role of the circadian clock in regulating human reproductive physiology and shift work-induced pathology within each step of the reproductive axis while exploring potential mechanisms from the animal model literature. In addition to documenting the reproductive hazards of shift work, we also point out important gaps in our knowledge as critical areas for future investigation. For example, future studies should examine whether forced desynchronization disrupts gonadotropin secretion rhythms and whether there are sleep/wake schedules that are better or worse for the adaptation of the reproductive system to shift work. These studies are necessary in order to define not only whether or not shift work-induced circadian misalignment impairs reproductive capacity, but also to identify strategies for the future that can minimize this desynchronization.
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Affiliation(s)
- Karen L. Gamble
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Resuehr
- Department of Cell and Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carl Hirschie Johnson
- Department of Biological Sciences, Vanderbilt University, Nashville, TN, USA
- *Correspondence: Carl Hirschie Johnson, Department of Biological Sciences, Vanderbilt University, 465 21st Avenue South, Nashville, TN 37235, USA e-mail:
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Cote KA, McCormick CM, Geniole SN, Renn RP, MacAulay SD. Sleep deprivation lowers reactive aggression and testosterone in men. Biol Psychol 2012; 92:249-56. [PMID: 23046906 DOI: 10.1016/j.biopsycho.2012.09.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/10/2012] [Accepted: 09/25/2012] [Indexed: 01/13/2023]
Abstract
The role of sleep deprivation in aggressive behavior has not been systematically investigated, despite a great deal of evidence to suggest a relationship. We investigated the impact of 33 h of sleep loss on endocrine function and reactive aggression using the Point Subtraction Aggression Paradigm (PSAP) task. PSAP performance was assessed in 24 young men and 25 women who were randomly assigned to a sleep deprivation or control condition. Sleep deprivation lowered reactive aggression and testosterone (but not cortisol) in men, and disrupted the positive relationship between a pre-post PSAP increase in testosterone and aggression that was evident in rested control men. While women increased aggression following provocation as expected, no influence of sleep deprivation was found. This is the first experimental study to demonstrate that sleep deprivation lowers reactive aggression in men. Testosterone, but not cortisol, played a role in the relationship between sleep and reactive aggression in men.
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Affiliation(s)
- Kimberly A Cote
- Psychology Department, Brock University, St. Catharines, Ontario, L2S 3A1, Canada.
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Kim KS, Kim YC, Oh IJ, Kim SS, Choi JY, Ahn RS. Association of worse prognosis with an aberrant diurnal cortisol rhythm in patients with advanced lung cancer. Chronobiol Int 2012; 29:1109-20. [PMID: 22889441 DOI: 10.3109/07420528.2012.706767] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A flatter diurnal rhythm of cortisol has been reported to be associated with early mortality in patients with metastatic breast cancer. The clinical stage of disease at the time of diagnosis and the patient's performance status (PS) are known to be important prognostic factors for lung cancer (LC) survival. The authors examined the relationship between diurnal cortisol rhythms and these prognostic factors in patients with advanced LC. Cortisol concentrations were measured in saliva samples collected from 52 patients (37 males/15 females) with advanced LC and from 56 healthy subjects (32 males/24 females) to characterize the diurnal cortisol rhythm, specifically the cortisol awakening response (CAR) and diurnal cortisol decline (DCD). Variations of CAR and DCD in the patients were analyzed according to their clinical disease stage and PS score, and the differences in CAR and DCD between patients and healthy controls were compared. The patient group showed significantly reduced diurnal cortisol secretory activity and rhythmicity, compared with healthy controls. When the patients were subgrouped according to their clinical disease stage, patients with stage 4 disease showed significantly reduced CAR and flatter DCD compared with the healthy controls. However, the CAR and DCD in patients with stage 3a and 3b disease were comparable to those of healthy controls. Neither the CAR nor the DCD showed stepwise changes as the disease stage worsened. When patients were subgrouped according to their Eastern Cooperative Oncology Group (ECOG) PS score, there was stepwise reduction in the CAR and flattening of the DCD as the PS score increased. Both an abolished CAR and a flattened DCD were common in patients with ECOG PS scores of 3 and 4. These results indicate that alteration of the diurnal cortisol rhythm in patients with advanced LC is more closely associated with their PS score than with their clinical disease stage. Gradual alteration of the CAR and DCD, indicative of loss of 24-h cortisol rhythm, in concert with increase in PS score implies that endogenous circadian rhythms may also be disintegrating as the PS score worsens in these patients.
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Affiliation(s)
- Kyu S Kim
- Department of Pulmonology and Critical Care Medicine, Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
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