The monthly rhythm of the brain-heart connection

Fig. 1.. Role of endogenous ovarian hormone fluctuations on the heart-brain axis during the menstrual cycle. (Top) Expression of estrogen and progesterone receptors in brain regions important for cardiac autonomic control, as well as the interplay between sympathetic and parasympathetic innervation in the uterus and heart. Hormonally mediated adaptability along the heart-brain(-uterine) axis is a highly complex phenomenon, driven by multiple neurobiological, neurochemical, and neurophysiological mechanisms. Multiple critical knowledge gaps persist in this area. (Bottom) Fluctuations in the female resting heart rate across the menstrual cycle. On average, resting heart rate increased by 2.33 beats per minute during the midluteal phase when progesterone levels are high. The underlying neuromolecular mechanism as well as the (patho)psychological implications of these hormonal fluctuations on the heart-brain connection and associated cognitive functions remains to be fully understood. Illustration credit: A. Mastin/Science Advances