Exploring psychophysiological stress variability across menstrual phases: insights from a tertiary care centre in...

The menstrual cycle is the primary biological rhythm orchestrated by the hypothalamic-pituitary-ovarian axis, subject to complex hormonal fluctuations. These hormonal changes modulate cardiovascular activity, changes in heart rate variability, blood pressure, and psychological states. They often appear as premenstrual syndrome in the luteal phase. Previous studies suggested that stress reactivity is different across menstrual stages but inconsistently. For the present study, we aimed to explore psychophysiological stress reactivity following the follicular and luteal phases of the menstrual cycle in women aged 18 to 30 years.

Several menstrual phases were assessed by luteinizing hormone test. All participants underwent laboratory studies in the follicular and luteal stages as follows: basal blood pressure and heart rate measurements were taken, whereas psychological stress was measured with the State-Trait Anxiety Inventory (STAI). Stress responses were elicited using the cold pressor test, and data were quantified using paired t-test and correlation analyses.

Upon analysing the results, it was found that basal blood pressure and heart rate were not significantly different between the three phases. However, diastolic blood pressure rose considerably during the luteal phase following the cold pressor test. Trait anxiety scores were significantly increased during the luteal phase, and significant differences in state anxiety were detected only after the stressor in this phase.

These findings indicated that the luteal phase could reflect maladaptive psychophysiological stress reactivity. Taken in aggregate, the findings highlight the relevance of menstrual cycle phases in stress assessments and treatment interventions, promoting individualized methods in women's healthcare.