a Behavioral Sciences Laboratories , Veterans Affairs Medical Center , Oklahoma City , OK , USA.
b Department of Psychiatry and Behavioral Sciences , University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA.
Stress. 2019 Jul;22(4):421-427. doi: 10.1080/10253890.2019.1581760. Epub 2019 Mar 21.
Women have smaller cortisol responses to psychological stress than men do, and women taking hormonal contraceptives (HC+) have smaller responses than HC- women. Cortisol secretion undergoes substantial diurnal variation, with elevated levels in the morning and lower levels in the afternoon, and these variations are accompanied by differences in response to acute stress. However, the impact of HC use on these diurnal relationships has not been examined. We tested saliva cortisol values in 744 healthy young adults, 351 men and 393 women, 254 HC- and 139 HC+, who were assigned to morning (9:00 am) or afternoon (1:00 pm) test sessions that were held both on a rest day and on a stress day that included public speaking and mental arithmetic challenges. Saliva cortisol responses to stress were largest in men and progressively smaller in HC- and in HC+ women (F = 23.26, p < .0001). In the morning test sessions, HC+ women had significantly elevated rest day cortisol levels (t = 5.99, p ≪ .0001, Cohen's d = 0.95) along with a complete absence of response on the stress day. In the afternoon sessions, both HC+ and HC- women had normal rest-day cortisol levels and normal responses to the stressors. Heart rates at rest and during stress did not vary by time of day or HC status. Cortisol stress responses in HC+ women are absent in the morning and normal in size by early afternoon. Studies of stress reactivity should account for time of day in evaluating cortisol responses in women using hormonal contraceptives.
女性对心理压力的皮质醇反应小于男性,而服用激素避孕药(HC+)的女性比未服用的女性反应更小。皮质醇分泌存在明显的昼夜变化,早晨水平升高,下午水平降低,这些变化伴随着对急性应激的反应差异。然而,HC 使用对这些昼夜关系的影响尚未得到检验。我们测试了 744 名健康年轻成年人的唾液皮质醇值,其中 351 名男性和 393 名女性,254 名未服用 HC 和 139 名服用 HC,他们被分配到上午(9:00 am)或下午(1:00 pm)的测试时段,这些测试时段都在休息日和包括公开演讲和心算挑战的应激日进行。应激时的唾液皮质醇反应在男性中最大,在未服用 HC 和服用 HC 的女性中逐渐减小(F=23.26,p<.0001)。在上午的测试时段,服用 HC 的女性在休息日的皮质醇水平显著升高(t=5.99,p≪.0001,Cohen's d=0.95),而在应激日则完全没有反应。在下午的测试时段,HC+和 HC-女性在休息日的皮质醇水平正常,对应激源的反应正常。休息时和应激时的心率不因时间或 HC 状态而变化。HC+女性的皮质醇应激反应在上午缺失,而在下午早些时候正常。在评估使用激素避孕药的女性的皮质醇反应时,应激反应研究应考虑时间因素。