Abnormal Menstrual Cycle in Second Year Medical Students at Siriraj Hospital

Objective To determine the effect of psychological stress on the menstrual cycie insecond year medical students.Design Before and after study.Setting Departrnent of Physiology, Faculty of Medicine Siriraj Hospital.Subiects Forty-nine volunteers (18 - 21 years old) from second year medical studentswere studied. Two blood samples were collected from each student, one during theassumed non-stressed (ANS) period and the other during the assumed stressed(AS)period.Main outcome measures Characteristic of menstrual cycle was recorded. Serum cortisol, prolactin, gonadotropins and progesterone were measured usingradioimmunoassay.Results Abnormal cycles were found in 2 characteristics : (1) irregular cyclecomprised 22/" ol all subjects ; (2) low serum progesterone in the assumed lutealphase, implying anovulation or luteal defect, comprised 62/" and 70/" of subjectsduring the ANS and the AS periods respectively. There was no significantdifference in the incidence of abnormal cycle between the two periods. Nocorrelation between serum levels of progesterone and cortisol, prolactin or LH : FSHratio could be demonstrated.Conclusion Over 60% of second year medical students at Siriraj Hospital had abnormalmenstrual cycles. We could not demonstrate the correlation between this highincidence and th.e level of stress hormone, i.e. cortisol.