Biological sex and menstrual cycle phase modulation of cortisol levels and psychiatric symptoms in a non-clinical sample of young adults
Abstract
Prior research examined the complex, bidirectional interplay of the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal axes and their roles in (clinical) cognitive/behavioral functions. Less well understood are contemporaneous relationships in non-clinical samples. This pilot study explored cortisol in relation to psychiatric symptoms/personality as a function of self-reported menstrual cycle phase and sex differences in a non-clinical, young adult sample. Consistent with literature and hypotheses, cortisol levels were lowest during early-follicular, intermediary during late-follicular, and highest during mid-luteal phases (not significant), and greater among males than early-follicular females. An acute stressor uniformly affected cortisol across phases and sex, though magnitude and time course differed. Psychiatric symptoms were greater among early-follicular/late-follicular females versus males, and early-follicular and/or late-follicular versus mid-luteal. Contrary to hypotheses, positive psychotic-like symptoms were greater among males than (mid-luteal) females. Cortisol inversely related to early-follicular symptoms, and directly related to late-follicular/mid-luteal symptoms. Results suggest menstrual cycle phase modulates non-clinical psychiatric symptomatology and HPA activity. Findings tentatively bolster a dimensional/continuum model of psychopathology with implications for understanding neurobiological underpinnings and risk/protective factors for mental/physical health conditions, particularly those marked by sex differences and neuroendocrine dysfunction (depression/schizophrenia/Alzheimer's/multiple sclerosis). We speculate a dose-response cortisol effect on symptoms, modulated by endogenous gonadal hormones via gene expression.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In general, differences between menstrual cycle phases in cortisol do not reach statistical significance in prior studies.
“Overall, although changes are apparent, in general the differences between phases do not reach statistical significance in these studies.”
From The relationship between the menstrual cycle and cortisol secretion: Daily and stress-invoked cortisol patterns (2018) · cites this paper as Walder et al., 2012
The present finding that women in the luteal phase had higher cortisol levels immediately following laboratory stressors is similar to Walder et al. (2012).
“These results are similar to those found by Walder et al. (2012), where women in the luteal phase had higher cortisol levels in the stressful task than did women in the follicular phase.”
From The relationship between the menstrual cycle and cortisol secretion: Daily and stress-invoked cortisol patterns (2018) · cites this paper as Walder et al. (2012)
Cites
(1970) · Cited by 24,983 · see citing works
The relation of strength of stimulus to rapidity of habit formation
Yerkes, R. M., & Dodson, J. D. (1908) · Journal of Comparative Neurology and Psychology · doi:10.1002/cne.920180503 · Cited by 6,911 · see citing works
Effects of stress throughout the lifespan on the brain, behaviour and cognition
Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2639 · Cited by 6,256 · see citing works
Psychological Assessment Resources
Abidin, R. R. (1995) · Medical Entomology and Zoology · Cited by 3,140 · see citing works
The SPQ: A Scale for the Assessment of Schizotypal Personality Based on DSM-III-R Criteria
Raine, A. (1991) · Schizophrenia Bulletin · doi:10.1093/schbul/17.4.555 · Cited by 2,164 · see citing works
Schizotaxia, schizotypy, schizophrenia.
Meehl, P. E. (1962) · American Psychologist · doi:10.1037/h0041029 · Cited by 2,036 · see citing works
Sex differences in unipolar depression: Evidence and theory.
Nolen–Hoeksema, S. (1987) · Psychological Bulletin · doi:10.1037/0033-2909.101.2.259 · Cited by 2,001 · see citing works
Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00006 · Cited by 1,890 · cited 3× · see citing works
“The pattern of cortisol levels across self-reported menstrual cycle phase was consistent with study hypotheses and with prior evidence of generally greater stress response in males than females (Kajantie and Phillips, 2006), greater evoked cortisol levels during the luteal than follicular phase (Kirschbaum et al., 199…”
BackgroundResultRevised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI)
Costa, P. T., & McCrea, R. B. (1992) · Medical Entomology and Zoology · Cited by 1,758 · see citing works
Sex differences in HPA axis responses to stress: a review
Kudielka, B. M., & Kirschbaum, C. (2005) · Biological Psychology · doi:10.1016/j.biopsycho.2004.11.009 · Cited by 1,624 · see citing works
Estrogen Actions in the Central Nervous System
McEwen, B. S., & Alves, S. E. (1999) · Endocrine Reviews · doi:10.1210/edrv.20.3.0365 · Cited by 1,483 · see citing works
The effects of sex and hormonal status on the physiological response to acute psychosocial stress
Kajantie, E., & Phillips, D. I. W. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.07.002 · Cited by 1,035 · see citing works
Woolley, C. S., & McEwen, B. (1992) · Journal of Neuroscience · doi:10.1523/jneurosci.12-07-02549.1992 · Cited by 987 · see citing works
Schizophrenia: A neural diathesis-stress model.
Walker, E. F., & Diforio, D. (1997) · Psychological Review · doi:10.1037//0033-295x.104.4.667 · Cited by 930 · see citing works
Toward an Integrated Theory of Schizotaxia, Schizotypy, and Schizophrenia
Meehl, P. (1990) · Journal of Personality Disorders · doi:10.1521/pedi.1990.4.1.1 · Cited by 792 · see citing works
Functional Cross‐Talk Between the Hypothalamic‐Pituitary‐Gonadal and ‐Adrenal Axes
Viau, V. (2002) · Journal of Neuroendocrinology · doi:10.1046/j.1365-2826.2002.00798.x · Cited by 744 · see citing works
Stress and the hypothalamic pituitary adrenal axis in the developmental course of schizophrenia
Walker, E., Mittal, V., & Tessner, K. (2008) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.4.022007.141248 · Cited by 615 · see citing works
The SPQ-B: A brief screening instrument for schizotypal personality disorder.
Raine, A., & Benishay, D. (1995) · Journal of Personality Disorders · doi:10.1521/pedi.1995.9.4.346 · Cited by 582 · see citing works
Hormones and mood: from menarche to menopause and beyond
Steiner, M. S. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00432-9 · Cited by 556 · see citing works
Burgess, L. H., & Handa, R. J. (1992) · Endocrinology · doi:10.1210/endo.131.3.1324155 · Cited by 445 · see citing works
Estrogen actions in the central nervous system
McMillan, P. J., & Dorsa, D. M. (1999) · Current Opinion in Endocrinology & Diabetes · doi:10.1097/00060793-199902000-00006 · Cited by 391 · see citing works
Sex Differences in Stress Response Circuitry Activation Dependent on Female Hormonal Cycle
Goldstein, J. M., Jerram, M. W., Abbs, B., Whitfield, S., & Makris, N. (2010) · Journal of Neuroscience · doi:10.1523/jneurosci.3021-09.2010 · Cited by 362 · see citing works
The relationship between stress induced cortisol levels and memory differs between men and women
Wolf, O. T., Schommer, N. C., Hellhammer, D. H., McEwen, B. S., & Kirschbaum, C. (2001) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(01)00025-7 · Cited by 362 · see citing works
Agoraphobia With Panic Attacks
Breier, A. F. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800110015003 · Cited by 306 · see citing works
Relationship between Cortisol Responses to Stress and Personality
Oswald, L. M., Zandi, P. P., Nestadt, G., Potash, J. B., Kalaydjian, A., & Wand, G. S. (2006) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301012 · Cited by 273 · see citing works
Progesterone selectively increases amygdala reactivity in women
van Wingen, G. A., van Broekhoven, F., Verkes, R. J., Petersson, K. M., Bäckström, T., Buitelaar, J. K., & Fernández, G. (2008) · Molecular Psychiatry · doi:10.1038/sj.mp.4002030 · Cited by 273 · see citing works
Sex differences in psychopathology: of gonads, adrenals and mental illness
Solomon, M. B., & Herman, J. P. (2009) · Physiology & Behavior · doi:10.1016/j.physbeh.2009.02.033 · Cited by 272 · see citing works
Sex Differences in Psychoneuroendocrine Reactions to Examination Stress
Frankenhaeuser, M., von Wright, M. R., Collins, A., von Wright, J., Sedvall, G., & Swahn, C. (1978) · Psychosomatic Medicine · doi:10.1097/00006842-197806000-00006 · Cited by 230 · see citing works
Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women
Cohen, L. S., Soares, C. N., Otto, M. W., Sweeney, B. H., Liberman, R. F., & Harlow, B. L. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00458-x · Cited by 209 · see citing works
Androgen and Glucocorticoid Receptor Heterodimer Formation
Chen, S.-Y., Wang, J., Yu, G.-Q., Liu, W., & Pearce, D. (1997) · Journal of Biological Chemistry · doi:10.1074/jbc.272.22.14087 · Cited by 200 · see citing works
Patchev, V. K., Hayashi, S., Orikasa, C., & Almeida, O. F. X. (1995) · The FASEB Journal · doi:10.1096/fasebj.9.5.7896013 · Cited by 193 · see citing works
Cognitive functioning, cortisol release, and symptom severity in patients with schizophrenia
Walder, D. J., Walker, E. F., & Lewine, R. J. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)01052-0 · Cited by 192 · see citing works
Self-citationMenstrual Cycle Modulation of Medial Temporal Activity Evoked by Negative Emotion
Andreano, J. M., & Cahill, L. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.07.011 · Cited by 184 · see citing works
Developmental changes in cortisol secretion in normal and at-risk youth
WALKER, E. F., WALDER, D. J., & REYNOLDS, F. (2001) · Development and Psychopathology · doi:10.1017/s0954579401003169 · Cited by 183 · see citing works
Self-citationRoca, C. A., Schmidt, P. J., Altemus, M., Deuster, P., Danaceau, M. A., Putnam, K., & Rubinow, D. R. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021570 · Cited by 180 · see citing works
Tandon, R., Mazzara, C., DeQuardo, J., Craig, K. A., Meador-Woodruff, J. H., Goldman, R., & Greden, J. F. (1991) · Biological Psychiatry · doi:10.1016/0006-3223(91)90353-n · Cited by 168 · see citing works
Mottaghy, F. M., Keller, C. E., Gangitano, M., Ly, J. D., Thall, M., Parker, J. A., & Pascual‐Leone, Á. (2002) · Psychiatry Research Neuroimaging · doi:10.1016/s0925-4927(02)00032-x · Cited by 163 · see citing works
The three-factor model of schizotypal personality: invariance across age and gender
Fossati, A., Raine, A., Carretta, I., Leonardi, B., & Maffei, C. (2003) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00314-8 · Cited by 163 · see citing works
Sex Steroids and Cognitive Function
Luine, V. N. (2008) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2008.01710.x · Cited by 159 · see citing works
Menstrual cycle modulation of the relationship between cortisol and long-term memory
Andreano, J. M., Arjomandi, H., & Cahill, L. F. (2008) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.03.009 · Cited by 156 · see citing works
Stereological Approaches to Identifying Neuropathology in Psychosis
Dorph‐Petersen, K., & Lewis, D. A. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.04.030 · Cited by 151 · see citing works
Pruessner, M., Pruessner, J. C., Hellhammer, D. H., Bruce Pike, G., & Lupien, S. J. (2007) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2006.12.007 · Cited by 150 · see citing works
Arafat, E. S., Hargrove, J. T., Maxson, W. S., Desiderio, D. M., Wentz, A. C., & Andersen, R. N. (1988) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(88)90448-6 · Cited by 134 · see citing works
Chakrabarti, S., Liu, N., & Gintzler, A. R. (2010) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1009923107 · Cited by 129 · see citing works
Longitudinal changes in cortisol secretion and conversion to psychosis in at-risk youth.
Walker, E. F., Brennan, P. A., Esterberg, M., Brasfield, J., Pearce, B., & Compton, M. T. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0018399 · Cited by 127 · see citing works
Weinstein, D. D., Diforio, D., Schiffman, J. E., Walker, E. F., & Bonsall, R. W. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.4.617 · Cited by 120 · see citing works
Menstrual cycle related mood changes in women with bipolar disorder
Rasgon, N., Bauer, M., Glenn, T., Elman, S., & Whybrow, P. C. (2003) · Bipolar Disorders · doi:10.1034/j.1399-5618.2003.00010.x · Cited by 119 · see citing works
The structure of schizotypy, its relation to subdiagnoses of schizophrenia and to sex and age
Venables, P. H., & Bailes, K. (1994) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1994.tb01124.x · Cited by 117 · see citing works
Członkowska, A., Ciesielska, A., Gromadzka, G., & Kurkowska‐Jastrzębska, I. (2005) · Current Pharmaceutical Design · doi:10.2174/1381612053381693 · Cited by 116 · see citing works
The Two Faces of Estradiol: Effects on the Developing Brain
McCarthy, M. (2009) · The Neuroscientist · doi:10.1177/1073858409340924 · Cited by 116 · see citing works
Schommer, N., Kudielka, B. M., Hellhammer, D. H., & Kirschbaum, C. (1999) · Psychological Reports · doi:10.2466/pr0.1999.84.3.840 · Cited by 115 · see citing works
Sex Differences in Neuroticism: A Quantitative Synthesis of Published Research
Jorm, A. F. (1987) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048678709158917 · Cited by 104 · see citing works
Gonda, X., Telek, T., Juhász, G., Lazáry, J., Vargha, A., & Bagdy, G. (2008) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2008.07.016 · Cited by 101 · see citing works
Franz, C. E., O’Brien, R. C., Hauger, R. L., Mendoza, S. P., Panizzon, M. S., Prom‐Wormley, E. C., Eaves, L. J., Jacobson, K. C., Lyons, M. J., LUPIEN, S. J., et al. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.01.002 · Cited by 94 · see citing works
Schizophrenia: Reproductive Hormones and the Brain
Stevens, J. R. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.5.713 · Cited by 90 · see citing works
Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle
Shibui, K., Uchiyama, M., Okawa, M., Kudo, Y., Kim, K., Liu, X., Kamei, Y., Hayakawa, T., Akamatsu, T., Ohta, K., et al. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00912-4 · Cited by 85 · see citing works
Altemus, M. M., Redwine, L. S., Leong, Y.-M., MD, D. L. M., Ph.D, T. Y., Detera-Wadleigh, S. D., & Ph.D, R. Y. (1997) · Neuropsychopharmacology · doi:10.1016/s0893-133x(97)00039-0 · Cited by 84 · see citing works
Altemus, M. (1997) · Neuropsychopharmacology · doi:10.1016/s0893-133x(97)00121-8 · Cited by 74 · see citing works
Premenstrual symptoms and premenstrual exacerbation in patients with psychiatric disorders
Hsiao, M.-C., Hsiao, C.-C., & Liu, C.-Y. (2004) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2003.01215.x · Cited by 70 · see citing works
Souza‐Talarico, J. N., Chaves, E. C., LUPIEN, S. J., Nitríni, R., & Caramelli, P. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-1282 · Cited by 67 · see citing works
The dynamic genome and mental health : the role of genes and environments in youth development
Kendler, K. S., Jaffee, S. R., & Römer, D. (2011) · Medical Entomology and Zoology · Cited by 65 · see citing works
Relative binding affinity of steroids for the corticosterone receptor system in rat hippocampus
De Kloet, E. R., Veldhuis, H. D., Wagenaars, J. L., & Bergink, E. W. (1984) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(84)90380-7 · Cited by 47 · see citing works
Al’Absi, M., & Lovallo, W. R. (1993) · Psychoneuroendocrinology · doi:10.1016/0306-4530(93)90011-9 · Cited by 46 · see citing works
Walder, D. J., Trotman, H. D., Cubells, J. F., Brasfield, J., Tang, Y.-L., & Walker, E. F. (2010) · Psychiatric Genetics · doi:10.1097/ypg.0b013e32833a1ff3 · Cited by 34 · see citing works
Self-citationThe Effect of Progestins on Behavioral Stress Responses in Postmenopausal Women
Lindheim, S. R., Legro, R. S., Morris, R. S., Wong, I. L., Tran, D. Q., Vijod, M. A., Stanczyk, F. Z., & Løbo, R. A. (1994) · Journal of the Society for Gynecologic Investigation · doi:10.1177/107155769400100116 · Cited by 31 · see citing works
DST and schizophrenic symptomatology
Keshavan, M. S., Brar, J. S., Ganguli, R., & Jarrett, D. (1989) · Biological Psychiatry · doi:10.1016/0006-3223(89)90132-7 · Cited by 18 · see citing works
Babalonis, S. L., Lile, J. A., Martin, C. A., & Kelly, T. H. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2206-7 · Cited by 12 · see citing works
Cocaine-induced delirium versus delusional disorder
Pearlson, G. D., Fischman, M. W., Foltin, R. W., et al. (1989) · Biological Psychiatry · doi:10.1016/0006-3223(89)90125-x · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Pruessner, M., Cullen, A. E., Aas, M., & Walker, E. F. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.12.013 · Cited by 315 · see citing works
Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review
Handy, A. B., Greenfield, S. F., Yonkers, K. A., & Payne, L. A. (2022) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000329 · Cited by 153 · see citing works
Montero-López, E., Santos-Ruiz, A., García-Ríos, M. C., Rodríguez-Blázquez, M., Rogers, H. L., & Peralta-Ramírez, M. I. (2018) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2018.03.021 · Cited by 113 · see citing works
Villada, C., Espin, L., Hidalgo, V., Rubagotti, S., Sgoifo, A., & Salvador, A. (2017) · Physiology & Behavior · doi:10.1016/j.physbeh.2016.12.011 · Cited by 38 · see citing works
- Authors
- Walder, D. J., Statucka, M., Daly, M. P., Axen, K., & Haber, M.
- Affiliations
- Queens College, CUNY (US)
- City University of New York (US)
- Corresponding author
- Walder, Deborah J.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 197
- Issue
- 3
- Pages
- 314-321
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2019933919
- Cited by
- 40
- References
- 68
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 9 · 2013: 4 · 2012: 3
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- menstrual cycle phases, cortisol, sex differences, psychiatric symptoms, psychotic-like symptoms, hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-gonadal axis, acute stress, follicular phase, luteal phase, young adults, neuroendocrine dysfunction, gonadal hormones
- MeSH terms
- Behavioral Symptoms, Female, Humans, Hydrocortisone, Male, Menstrual Cycle, Personality Inventory, Psychiatric Status Rating Scales, Saliva, Sex Characteristics, Time Factors, Young Adult, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
