Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain

Abstract

The objective of this study was to evaluate the perceived stress index, quality of life, and hypothalamus-pituitary-adrenal axis activity in women with endometriosis and chronic pelvic pain. For the study, 93 women with endometriosis and 82 healthy women volunteered. The visual analogue scale (VAS) (0=no pain; 10=severe pain) was used to determine pain intensity; the perceived stress questionnaire (PSQ) defined stress index, and the health-related quality-of-life (HRQOL)-SF-36 questionnaire was used to evaluate quality of life. Salivary cortisol was measured at 0800, 1600, and 2000 h and the awakening cortisol response was assessed to evaluate the hypothalamus-pituitary-adrenal axis activity. The results show that women with endometriosis and chronic pelvic pain of moderate intensity (4.1+/-0.58, mean+/-SEM) have higher levels of perceived stress (0.55+/-0.01 versus 0.42+/-0.01, p<0.05), a poorer quality of life expressed as lower scores for all items of the inventory and hypocortisolism. Lower levels of salivary cortisol were observed in all three samples collected, as well as in the awakening cortisol response, for women with endometriosis (0.19+/-0.09 microg/dl) when compared with controls (0.78+/-0.08 microg/dl, p<0.05 l), and it was independent of pain intensity and Mental health (MH) scores in SF-36. We concluded that women with endometriosis and chronic pelvic pain show low concentrations of salivary cortisol and a high level of perceived stress, associated with a poor quality of life. Whether the hypocortisolism was an adaptive response to the aversive symptoms of the disorder or a feature related to the etiology of endometriosis remains to be elucidated.

Epigallocatechin-3-Gallate Reduces Myometrial Infiltration, Uterine Hyperactivity, and Stress Levels and Alleviates Generalized Hyperalgesia in Mice Induced With Adenomyosis

“…32 Consistent with this observation, higher serum cortisol levels are reported in infertile women with stage III to IV endometriosis than in healthy women, 33 although another study reported lower salivary cortisol levels in women with endometriosis when compared to controls, even though those women with endometriosis reported a high level of perceived stress. 34 The CORT is a glucocorticoid secreted by the cortex of the adrenal gland in response to the stimulation by adrenocorticotropic hormone. In rodents, CORT is a major indicator of stress.…”

Qualidade de vida em pacientes com endometriose: um estudo de revisão

“…A presente revisão incluiu 12 publicações sobre qualidade de vida (QV) em pacientes com endometriose (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) , sendo um terço delas conduzido no Brasil (8,10,12,15) . A avaliação da QV envolve aspectos multidimensionais, uma vez que ela não é caracterizada pela ausência de doença, e sim pelo bem-estar biopsicossocial, pelo como as pessoas vivem, sentem e compreendem seu cotidiano.…”

Depressão e Ansiedade em Mulheres com Endometriose: Uma Revisão Crítica da Literatura

“…A infertilidade pode até mesmo comprometer o relacionamento do casal, ocasionando uma desestabilização no contexto familiar e social do indivíduo, com presença de sentimento de fracasso e inferioridade, isolamento e redução da autoestima, com consequentes alterações psicológicas, como ansiedade, depressão e estresse (Monga, Alexandrescu, Katz, Stein, & Ganiats, 2004;Barbosa & Rocha-Coutinho, 2007). Esse último foi alvo de investigação em dois estudos que mostraram ní-veis elevados de estresse em pacientes com endometriose (Petrelluzzi, Garcia, Petta, Grassi-Kassisse, & Spadari-Bratfisch, 2008;Siedentopf et al, 2008). Ainda, em relação à ansiedade e à depressão na infertilidade, Golombok (1992) aponta que a primeira pode ser decorrente dos longos processos de tratamento e do temor de que eles fracassem, e a segunda está relacionada com a inabilidade para conceber.…”