The menstrual cycle is characterized by dramatic fluctuations in ovarian steroid levels. Beyond reproductive effects, ovarian steroids actuate changes in well-being and are implicated in stress processes that influence physical and mental health. In this chapter, studies explicating psychophysiological responses to stress provocation in laboratory settings are considered along with those that reveal interrelationships among cyclical hormones, stress processes, and risk factors for disease. We begin by reviewing hormone release patterns across cycle phases and the bi-directional relationships with the autonomic nervous system and hypothalamic-pituitaryadrenal axis. The bi-directional model is supported by research demonstrating cycle phase variations in responses to laboratory stressors. Studies generally reveal greater reactivity and lower cardiac vagal control during the luteal phase of the menstrual cycle compared to the follicular phase. Three explanations are offered for this luteal phase increase including the cardioprotective effects of estrogen, withdrawal effects of plummeting hormones during the late luteal phase, and premenstrual symptomatology. Finally, we consider neuroendocrine processes associated with increased stress reactivity as risk factors for mental health conditions that plague women. We conclude with recommendations for clinicians to consider treatment plans that are sensitive to the effects of cycle phase on stress.
Keywords: stress, hormones, women, cortisol, cardiac vagal control, cardiovascular reactivity
