Does the menstrual cycle phase affect hemodynamic and sympathetic nervous system responses to stress in healthy premenopausal women?
Hemodynamic and sympathetic responses to stress are lower during the luteal phase compared to the follicular phase, suggesting blood pressure should be evaluated across different menstrual phases before diagnosing hypertension in premenopausal women.
In this study, the impact of menstrual cycle phase on hemodynamic and sympathetic nervous system responses was examined during exposure to a battery of laboratory stressors. Participants were 40 healthy premenopausal women, aged 26 to 51. Impedance cardiography was used to measure stroke volume, heart rate, and cardiac output. Systemic vascular resistance was derived on the basis of concurrently recorded blood pressure and cardiac output. The menstrual cycle's effect on the sympathetic nervous system response was explored by evaluating plasma catecholamine responses during stress. In luteal compared with follicular subjects, systemic vascular resistance was significantly lower during all stress tasks (P < 0.03). Catecholamine responses were also significantly lower in luteal subjects (P < 0.004). The results suggest that the sympathetic nervous system may respond to stress differently during different phases of the menstrual cycle. This finding has implications for understanding "whitecoat hypertension" in women, and highlights the need to measure blood pressure during several office visits. Perhaps high blood pressure readings recorded during the follicular phase should be reexamined during the luteal phase before considering pharmacologic intervention.
McFetridge et al. (Mon,) studied this question.