Hemostatic Responses to Mental Stress during the Menstrual Cycle

Summary

To study the effect of sex hormones on the hemostatic responses to stress, blood samples were collected before, during, and after 20 min of mental stress from 9 healthy, non-smoking female volunteers, examined in the follicular and luteal phase. Mental stress caused significant increases in heart rate, blood pressure, and plasma catecholamines. In addition, analysis of variance indicated significant changes of leukocyte count, hematocrit, fibrinogen, von Willebrand factor antigen, t-PA activity and antigen in response to the stress test. However, in contrast to a male group previously investigated, there were no significant changes in factor VII coagulant activity in either menstrual phase. Overall the responses were more pronounced in the luteal as compared to the follicular phase. The findings support the concept that both gender and physiological variations in female sex hormones may modulate hemostatic responses to psychosocial stress.

• References

• 1 Jern C, Wadenvik H, Mark H, Hallgren J, Jern S. Haematological changes during acute mental stress. Br J Haematol 1989; 17: 153-6
• 2 Jern C, Eriksson E, Tengbom L, Risberg B, Wadenvik H, Jern S. Changes of plasma coagulation and fibrinolysis in response to mental stress. Thromb Haemostas 1989; 62: 767-71
• 3 Kannel WB, Doyle JT, Ostfeld AM. et al. Optimal resources for primary prevention of atherosclerotic diseases. Atherosclerosis Study Group. Circulation 1984; 70: 155A-205A
• 4 Meade TW, North WRS. Population-based distributions of haemostatic variables. Br Med Bull 1977; 33: 283-8
• 5 Balleisen L, Bailey J, Epping P-H, Schulte H, van de Loo J. Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population: I. Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill-using, and menopause. Thromb Haemostas 1985; 54: 475-9
• 6 Jespersen J, Kluft C. Increased euglobulin fibrinolytic potential in women on oral contraceptives low in oestrogen-levels of extrinsic and intrinsic plasminogen activators, prekallikrein, factor XII, and C1-inactivator. Thromb Haemostas 1985; 54: 454-9
• 7 Manhem K, Jern C, Pilhall M, Shanks G, Jern S. Altered haemodynamic responses to psychosocial stress during the menstrual cycle. Clin Sci 1991; 81: 17-22
• 8 Vermylen C, de Vreker RA, Verstraete M. A rapid enzymatic method for assay of fibrinogen fibrin polymerization time (FPT test). Clin Chim Acta 1963; 8: 418-24
• 9 Eriksson E, Risberg B. Measurement of tissue plasminogen activator in plasma. A comparison of 3 methods and description of a new improved technique. Thromb Res 1987; 46: 213-23
• 10 Eriksson E, Rånby M, Gyzander E, Risberg B. Determination of tissue plasminogen activator inhibitor in plasma using t-PA and a chromogenic single-point poly-D-lysine stimulated assay. Thromb Res 1988; 50: 91-101
• 11 Weicker H, Feraudi M, Hôgele H, Pluto R. Electrochemical detection of catecholamines in urine and plasma after separation with HPLC. Clin Chim Acta 1984; 141: 17-25
• 12 Siegbahn A, Ruusuvaara L. Age dependence of blood fibrinolytic components and the effects of low-dose oral contraceptives on coagulation and fibrinolysis in teenagers. Thromb Haemostas 1988; 60: 361-4
• 13 Cash JD. Effect of moderate exercise on the fibrinolytic system in normal young men and women. Br Med J 1966; 2: 502-6
• 14 Pepper H, Lindsay S. Levels of platelets, eosinophils, total leukocytes, and polymorphonuclear leukocytes during the normal menstrual cycle. Obstet Gynecol 1959; 14: 657-64
• 15 Mathur S, Mathur RS, Goust JM, Williamson HO, Fudenberg HH. Cyclic variations in white cell subpopulations in the human menstrual cycle: correlations with progesterone and estradiol. Clin Immunol Immunopathol 1979; 13: 246-53
• 16 Benhamou E, Noughy A. Les plaquettes sanguines au cours de la menstruation, de la grossesse et des suites de couches. Gynecol Obstet 1932; 55: 97-110
• 17 Pepper H, Lindsay S. Elevation of platelets in mid-cycle; an indication of ovulation. Science 1956; 124: 180-1
• 18 Beller FK, Goebelsmann U, Douglas GW, Johnson A. The fibrinolytic system during the menstrual cycle. Obstet Gynecol 1964; 23: 12-6
• 19 Jespersen J, Kluft C. Inhibition of tissue-type plasminogen activator in plasma of women using oral contraceptives and in normal women during a menstrual cycle. Thromb Haemostas 1986; 55: 388-9
• 20 Meade TW, Mellows S, Brozovic M. et al. Haemostatic function and ischaemic heart disease: Principal results of the Northwick Park Heart Study. Lancet 1986; ii: 533-7