Department: Medical Laboratory
Affiliation: Nnamdi Azikiwe University Awka

Undergraduate Students are susceptible to academic stress which peaks around the examination period. This study sets out to observe the effects of examination stress on menstrual cycle characteristics, ovulation and ovarian reserve function. Thirty-two female students between ages of 18 and 26 years were recruited from Faculty of Health Sciences and Technology. They were further sub-grouped into pre and 2 cycles post examination, pre and 3 cycles post examination, pre and 6 cycles post examination and pre and 7 cycles post examination based on the number of menstrual cycles between time of collection of blood samples at pre- and post-examination. Blood samples obtained from the students during days 3 or 4 and 21of the menstrual cycle pre- and post-examination were used to determine serum levels of luteinizing hormone (LH), Follicle Stimulating Hormone (FSH), Estradiol (E2), Progesterone, Cortisol and Glucose. Hormones were estimated using ELISA method while blood glucose was estimated using glucometer. Questionnaires were also administered to the students for assessment of menstrual cycle characteristics such as menstrual cycle length, menstrual blood flow-rate and number of days of blood flow. The result of the present study showed significant elevation in pre-examination mean serum concentrations of cortisol (15.3 ± 5.9μg/dl), and estradiol (85.9 ± 15.7pg/ml) but significant reduction in mean serum LH (7.9±2.7mIU/ml) and Progesterone (3.5± 1.5ng/ml) when compared with post-examination mean serum concentrations of cortisol (10.5 ± 5.1μg/dl), estradiol (77.2 ± 12.4pg/ml), LH (9.6 ± 3.8mIU/ml) and Progesterone (4.2 ± 2.6ng/ml) (p=<0.000, p=0.004, p=0.05). There were significant variations in serum concentrations of estradiol (F=3.304, p=0.005) and cortisol (F=2.447, p=0.029) between the four groups. The pre-examination menstrual cycle length was reduced in 3(9.4%) of the subjects, the menstrual blood flow rate was reduced in 7(21.9%) of the subjects and number of days of blood flow was increased in 1(3.1%) and reduced in 4(12.5%) of the subjects respectively (χ2=21.125, p=<0.000; χ2=10.125, p=0.001; χ2=37.938, p=0.001). These findings demonstrated that academic examination triggered stress, which altered ovulation in some of the subjects but had no effect on ovarian reserve function. Findings also demonstrated that academic examination stress alters menstrual cycle characteristics of some of the subjects. Generally, there was hormonal imbalance, which was as a result of stress and this imbalance normalized few menstrual cycles after examination.

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