Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

Abstract

Objective To explore the association of hypothalamic-pituitary-adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP). Design and Setting A secondary data analysis was performed using data from female participants in a natural history protocol at the National Institutes of Health. Participants A total of 36 women (19 – 39 years, mean 27.11) were included in the study. Methods This pilot study was conducted using a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included participants with and without CAP who provided a five hour urine sample for determination of cortisol levels and serum samples for determination of circulating levels of cortisol, luteinizing hormone, and follicle stimulating hormone. Chronic abdominal pain was defined as presence or absence of chronic pain for ≥ 6 months and was determined via self-report. Results Anti-Müllerian hormone (AMH) concentrations declined significantly with age as expected. When AMH levels were dichotomized as normal or abnormal (defined as higher or lower than age-specific normative ranges), there were significant associations between abnormal AMH levels and CAP and urine cortisol levels. Subjects with CAP or low urine cortisol levels were significantly more likely to have abnormal AMH levels. Conclusion Results suggest that chronic abdominal pain and hypothalamic-pituitary-adrenal dysregulation may be associated with abnormal AMH levels.

Abdominal pain during the menopause transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study

“…A study involving reproductive aged women found that pelvic pain was associated with anxiety (as measured by the General Anxiety Disorder-7 questionnaire) and abdominal pain [16]. Another study suggested that abdominal wall pain is associated with central sensitization, which would predispose one to abdominal pain, and yet another study found that chronic abdominal pain was associated with lower urine cortisol levels [17, 18]. These potential relationships are currently unexplored in an MT population.…”

Exploring the Ovarian Reserve Within Health Parameters: A Latent Class Analysis

“…Dysregulation of the HPA axis impairs reproductive function by suppressing steroidogenesis and inhibiting gonadotropin release (Schliep et al, 2015). The effect of HPA activity on ovarian reserve is less well understood, however, preliminary studies suggest associations between cortisol and abnormal AMH levels (Hardy, McCarthy, Fourie, & Henderson, 2016).…”

Hair glucocorticoids are not a historical marker of stress – exploring the time-scale of corticosterone incorporation into hairs in a rat model

“…GC levels in the bloodstream will fluctuate wildly and increase for brief periods in response to momentary exertions 12 , both physical and mental -running to catch a train; searching for misplaced car keys; speaking in front of a large audience. It is often of interest to separate these momentary stressors from the chronic stress of, for example, working night shifts 13 or suffering from a chronic pain condition 14 . For these situations, GC levels in urine samples are useful as they approximate the total circulating GCs integrated between voidings 15 , as opposed to the easily-confounded spot-checks offered by blood sampling.…”