Effect of Ramadan Fasting on Activity of Hypothalamus-Pituitary-Adrenal Axis in Polycystic Ovary Syndrome Patients

Document Type : Original Article


1 Assistant Professor of Research, Vali-e-Asr, Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.

2 Lecturer of Community Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.

3 Assistant Professor, Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Tehran, Iran.

4 M.Sc. of Psychology, Maternal, Fetal-Neonatal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

5 Assistant Professor, Department of Obstetrics and Gynecology, Royan Institute for Reproductive Biomedicine, Tehran, Iran.


Introduction: Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder affecting 4-18% of reproductive-aged women that is associated with reproductive, metabolic and psychological dysfunction. The hypothalamic pituitary gonadal axis has a critical part in the development and regulation of the reproductive system in men and women. The over activity of this axis has been reported in PCOS.  The purpose of this study was biochemical comparison of stress neurohormones in two groups of fasting and non-fasting women with PCO.
Methods: This cross sectional study was conducted on 40 patients with PCO who referred to Royan Institute of Tehran in July 2011 (during the month of Ramadan). Patients were divided into two groups of case (fasting women) and control (non-fasting women). Data were collected using a research made questionnaire. For evaluating the effect of Ramadan fasting, stress neurohormones were evaluated in the next menstrual cycle of PCO women after Ramadan. Data were analyzed using SPSS software version 18, chi-square test, Pearson correlation coefficient, independent t-test and Mann Whitney tests. P value less than 0.05 was considered significant.
Results: In PCO patient mean of Cortisol in fasting group (8.2±4.4µg/dl) was lower than patient without fasting (11.2±4.7 µg/dl) (p=0.049). Also the median of noradrenaline in fasting group (1273.5 pg/ml) was lower than non-fasting group (1503.5 pg/ml) (p=0.047). Adrenalin (p=0.151), beta-endorphin (p=0.543) and Insulin (p=0.818) had no significant differences between PCO women in both fasting and non-fasting groups.
Conclusion: Ramadan fasting decreases neurohormonal stress (cortisol and noradrenaline) in PCO patients. The lifestyle intervention is effective in improving the health of body.