Examination stress and its effect on ovulation of female undergraduate students

Nosakhare O. Osakue, Charles Chinedum Onyenekwe, Joseph Eberendu Ahaneku, Onyema Athanasius Onyegbule, Patrick Osaze Okunoghae


Background: Students are susceptible to academic stress which is higher during examination period. Academic stress has been found to activate the Hypothalamic-Pituitary-Adrenal axis resulting in increased cortisol and progesterone levels in circulation. This study sets out to investigate the effects of examination stress on ovulation of 32 apparently healthy female students.

Methods: Serum levels of cortisol (µg/dl), glucose (mmol/L) and progesterone (ng/ml) was determined using blood samples collected on day 21 of the menstrual cycle before and after examination.

Results: The result showed significant elevation in pre-examination serum cortisol (15.3 ± 5.9µg/dl) but significant reduction in Progesterone (3.5± 1.5ng/ml) when compared with post-examination mean serum concentrations of cortisol (10.5 ± 5.1µg/dl) and progesterone (4.2 ± 2.6ng/ml) (P<0.001 and P<0.001) respectively. There was no significance difference in glucose level before examination (5.4 ± 0.8mmol/L) and after examination (5.3 ± 0.7mmol/L) P=0.282.

Conclusions: These findings demonstrated that examination triggers stress, which altered progesterone level in female students.



Cortisol, Progesterone, Glucose, Academic, Menstrual cycle, Ovulatory, Blood flow, Anovulation, Serum

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