Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

To explore the association of hypothalamic–pituitary–adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP). A secondary data analysis was performed with data from female participants in a natural history protocol at the National Institutes of Health. A total of 36 women (age range = 19–39 years, mean = 27.11 years) were included in the study. This pilot study was conducted with a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included participants with and without CAP who provided a 5-hour urine sample for determination of cortisol levels and serum samples for determination of circulating levels of cortisol, luteinizing hormone, and follicle-stimulating hormone. CAP was defined as presence or absence of chronic pain for at least 6 months and was determined via self-report. Anti-Müllerian hormone (AMH) concentrations declined significantly with age as expected. When AMH levels were dichotomized as normal or abnormal (defined as higher or lower than age-specific normative ranges, respectively), there were significant associations between abnormal AMH levels and CAP and urine cortisol levels. Participants with CAP or low urine cortisol levels were significantly more likely to have abnormal AMH levels. Results suggest that chronic abdominal pain and hypothalamic–pituitary–adrenal dysregulation may be associated with abnormal AMH levels.