Stress-related disturbances of the menstrual cycle

Stress is a common cause of hypothalamic amenorrhoea. In our laboratory, we have studied the effects of an inflammatory-like stress on gonadotropin secretion and on the menstrual cycle in a nonhuman primate model. In this short review, we summarize some of our findings regarding the mechanisms whereby stress induces disturbances of reproductive function. Our data indicate that the hypothalamic-pituitary-adrenal axis, through the release of corticotropin-releasing hormone and vasopressin, plays a mediatory role. One type of action is exerted through a central process resulting in the inhibition of the gonadotropin-releasing hormone pulse generator. The other type is mediated by a peripheral pathway stimulatory to gonadotropin secretion. Activation of one or the other pathway is determined by the ovarian endocrine milieu. Both actions presumably result in deleterious effects on the menstrual cycle.