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Journal of the Society for Gynecologic Investigation
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Reversal of Diurnal Cortisol Rhythm and Suppression of Plasma Testosterone in Obstetric Residents on Call

Robert T. Chatterton, Jr., PhD

Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois; chat{at}nwu.edu

Sharon L. Dooley, MD, MPH

Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois

Objective: The study was undertaken to quantify the psychologic and physiologic responses to the stresses of an obstetrics/gynecology residency program.

Methods: Six male residents were studied on four occasions: one day during the first 2 weeks of their residency, one day immediately following a vacation period, one day after a night on call in obstetrics, and one day while in the gynecology clinic. Stress was evaluated by validated psychologic instruments and by levels of plasma testosterone, luteinizing hormone (LH), cortisol, and prolactin in morning and afternoon blood samples.

Results: Self-reported stress was significantly elevated during the first 2 weeks of the residency after a night on call. Anxiety scores were significantly elevated after a night on call as were depression subscores for some residents. Plasma testosterone was highly significantly suppressed after the obstetrics night on call and during the first 2 weeks of the residency in comparison with the vacation period. Luteinizing hormone levels were also significantly lower after the obstetrics on-call experience. Plasma cortisol levels after a night on call were suppressed in the morning and normal or elevated in the afternoon. In comparison, the gynecology rotation was associated with normal levels of testosterone and lower levels of cortisol.

Conclusion: In this small sample of residents, we observed an inverse relationship between self-reported stress levels and the concentrations of plasma testosterone and LH. The high levels of stress and anxiety expressed after a night on call also disrupted the normal pattern of plasma cortisol levels.

Key Words: Plasma testosterone • plasma cortisol • on-call rotation • stress

Journal of the Society for Gynecologic Investigation, Vol. 6, No. 1, 50-54 (1999)
DOI: 10.1177/107155769900600110
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