CLEVELAND, Ohio (Sept 27, 2023) – Stress, a pervasive and potent force, exerts a profound influence on both the body and mind by prompting the endocrine system to elevate cortisol levels. These elevated cortisol levels manifest throughout the body, and a recent study postulates that heightened cortisol levels in hair and saliva may be predictive of cognitive and mental health challenges in late perimenopausal and early postmenopausal women. The study’s findings are slated for presentation at The Menopause Society’s 2023 Annual Meeting in Philadelphia, running from September 27 to 30.
Stress: A Stealthy Adversary
The repercussions of stress on health are no secret, with a wealth of research illuminating its long-term consequences. However, this new study, although modest in scale, with 43 participants in late perimenopause or early postmenopause, offers a fresh perspective on stress’s impact. It seeks to gauge the connection between hair and salivary cortisol levels and the severity of depression symptoms and cognitive performance—specifically, verbal memory, verbal learning, attention, and working memory—in otherwise healthy women navigating late perimenopause and early postmenopause.
Cortisol’s Unveiling Role
The research outcomes underscore the significance of hair cortisol levels, revealing a substantial association with diminished attention and working memory performance. However, hair cortisol did not exhibit significant correlations with verbal learning or verbal memory assessments. On the other hand, salivary cortisol levels did not significantly correlate with verbal memory recall trials, attention, or working memory performance. Nevertheless, elevated salivary cortisol was markedly linked with more severe depressive symptomatology.
Implications and Future Directions
These findings suggest that indices of hypothalamic-pituitary-axis (HPA) activation, encapsulating the aggregate cortisol secretion over extended periods—such as hair cortisol—display robust correlations with cognitive performance on tasks involving attention and working memory. Conversely, measures of acute cortisol levels, as seen in salivary cortisol, appear to exhibit a stronger association with the severity of depressive symptoms.
Dr. Christina Metcalf, Assistant Professor and lead author from the Department of Psychiatry at the University of Colorado Anschutz Medical Campus in Aurora, CO, comments, “This work provides initial evidence linking longer-term HPA activation with worse attention and memory during perimenopause. Other research has demonstrated that interventions can decrease HPA activation; my next steps will be to study whether longer-term HPA is a modifiable marker and if by decreasing HPA activation with interventions we can improve executive functioning during the perimenopause.”
Dr. Stephanie Faubion, Medical Director of The Menopause Society, emphasizes the study’s significance, noting, “This study, although small in size, provides insight into considering HPA activity when evaluating a patient’s cognitive and mental health. This may be helpful in the future to identify patients who may be at higher risk for depression and cognitive decline.”
The study’s revelations underscore the intricate relationship between stress, hormone regulation, and mental well-being, offering potential insights for future research and patient care in the realm of menopausal health.
