Stress-related changes in the menstrual cycle and their significance for health: A literature review

Abstract

Relevance: Linked to the hypothalamic-pituitary-adrenal axis, changes in reproductive hormones interact to control the menstrual cycle via regulating cortisol. Ongoing research has not fully clarified the dynamic interaction between menstrual phases and cortisol release in healthy women. The study aimed to evaluate and combine the present information on phase-specific cortisol changes during the menstrual cycle and their influence on emotional and reproductive health. Materials and Methods: Papers published between 2014 and 2024 were thoroughly searched using PubMed, Scopus, and Web of Science. Published in Q1-Q2 journals, qualifying studies described cortisol levels in healthy women during menstrual cycles. A narrative synthesis approach was inspired by methodological variety. Results: The cortisol levels were higher in the follicular and ovulatory stages and lower in the luteal phase. Premenstrual syndrome was linked to changes in the cortisol awakening response and increased symptomatology. Hormonal birth controls reduced stress reactivity and balanced cortisol cycles. Researchers linked failed ovulation and poor fertility to increased cortisol. Changes in the neuroendocrine system could also bring about emotional symptoms throughout the cycle. Conclusion: Cortisol secretion varies with the menstrual period and may influence mood, stress reactions, and reproductive function. These findings influence how to manage disorders connected to menstruation and optimize women’s health. More studies employing standardized methods are needed to confirm clinical relevance.