Effects of menstrual cycle phase and ovulation on the salivary cortisol awakening response

Psychoneuroendocrinology. 2024 Feb:160:106669. doi: 10.1016/j.psyneuen.2023.106669. Epub 2023 Nov 4.

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.

Keywords: Cortisol awakening response (CAR); Female menstrual cycle; Hypothalamus-pituitary-adrenal (HPA) axis; Hypothalamus-pituitary-gonadal (HPG) axis; Ovulation; Salivary cortisol.

MeSH terms

  • Estradiol / pharmacology
  • Female
  • Humans
  • Hydrocortisone* / pharmacology
  • Hypothalamo-Hypophyseal System / physiology
  • Menstrual Cycle / physiology
  • Ovulation / physiology
  • Pituitary-Adrenal System / physiology
  • Progesterone* / pharmacology
  • Reproducibility of Results
  • Saliva
  • Steroids / pharmacology

Substances

  • Progesterone
  • Hydrocortisone
  • Estradiol
  • Steroids