Disturbed stress responses in women with polycystic ovary syndrome

Psychoneuroendocrinology. 2009 Jun;34(5):727-35. doi: 10.1016/j.psyneuen.2008.12.001. Epub 2009 Jan 15.


Background: We analyzed the neuroendocrine and immune cell responses to psychosocial stress in PCOS patients compared to BMI-matched healthy controls.

Methods: Responses to public speaking stress were analyzed in 32 PCOS patients and 32 BMI-matched healthy controls. At baseline, during, and 10- and 45-min after stress, state anxiety, cardiovascular responses, cortisol, ACTH, as well as circulating leukocyte subpopulations were analyzed, together with hsCRP and serum IL-6 concentrations.

Results: In response to public speaking stress, both groups showed significant but comparable increases in state anxiety, and blood pressure (all p<0.001; time effects). The ACTH and cortisol stress responses were significantly enhanced in PCOS (both p<0.05; interaction effect). In addition, heart rate was significantly higher in PCOS (p<0.05; group effect). PCOS patients displayed a reduced upregulation of IL-6 levels in response to stress (p<0.05; interaction effect). Baseline levels of circulating leukocyte subpopulations, IL-6 and hsCRP concentrations did not differ between BMI-matched controls and PCOS patients. PCOS patients were characterized by markedly increased psychological distress.

Conclusions: PCOS patients showed enhanced HPA-axis and heart rate reactivity as well as a reduced upregulation of IL-6 in response to stress. The altered stress reactivity in PCOS patients may constitute a link between depression, overweight, and the cardiovascular and diabetes risks associated with the diagnosis.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / complications
  • Anxiety / physiopathology
  • Blood Pressure / drug effects
  • Female
  • Heart Rate / drug effects
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Hypothalamo-Hypophyseal System / drug effects
  • Hypothalamo-Hypophyseal System / metabolism
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Metformin / pharmacology
  • Metformin / therapeutic use
  • Pituitary-Adrenal System / drug effects
  • Pituitary-Adrenal System / metabolism
  • Pituitary-Adrenal System / physiopathology*
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / drug therapy
  • Polycystic Ovary Syndrome / physiopathology*
  • Speech / physiology
  • Stress, Psychological / complications
  • Stress, Psychological / physiopathology*


  • Hypoglycemic Agents
  • Metformin