Correlation of the salivary cortisol levels in women with functional hypothalamic amenorrhea and healthy women: A pilot study.

Abstract Purpose: The aim of this study was to investigate the aberrations of cortisol secretion, measured by salivary cortisol in women with FHA. Methods The study, an observational study, was performed in a gynecological outpatient clinic of a university hospital in Greece, between July 2019 and March 2021. The study included 12 (twelve) patients with diagnosed FHA and 12 (twelve) women of comparative demographics, with a normal menstrual cycle who were used as controls. Results: 24 women were included in the study. Women with FHA had significantly higher levels of morning salivary cortisol (21.81 ± 5.63 nmol/l vs 12.76 ± 3.64 nmol/l; P <0.0001) when compared to normal controls. Measurements in the afternoon and midnight were not significantly different. There was a negative correlation between morning salivary cortisol levels and ΒΜΙ (rho: -0.53, p = 0.009), while there was a positive correlation between morning salivary cortisol levels and disordered eating habits (rho: 0.53, p = 0.00) and a positive correlation between morning salivary cortisol levels and reported stress levels (rho: 0.47, p = 0.02). Conclusion: Cortisol levels were raised in women with FHA, suggesting increased stress levels. This was particularly obvious the measurement of salivary cortisol levels could be a promising research tool and be used as a potential biomarker of recovery of menses. In addition, it could be used as a tool for the management of the disease and follow-up of patients suffering from functional hypothalamic amenorrhea. Further studies should be conducted to indicate and clarify the specific salivary cortisol levels associated with the occurrence of the disease or recovery of menses.