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Ryun S Ahn
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Jee H Choi Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Bum C Choi Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Jung H Kim Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Sung H Lee Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Simon S Sung Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Cortisol concentration in both serum and saliva sharply increases and reaches a peak within the first hour after waking in the morning. This phenomenon is known as the cortisol awakening response (CAR) and is used as an index of hypothalamus–pituitary–adrenal (HPA) axis function. We examined whether ovarian steroid concentrations increased after awakening as with the CAR in the HPA axis. To do this, cortisol, estradiol-17β (E2), and progesterone (P4) concentrations were determined in saliva samples collected immediately upon awakening and 30 and 60 min after awakening in women with regular menstrual cycles and postmenopausal women. We found that both E2 and P4 concentrations increased during the post-awakening period in women with regular menstrual cycles, but these phenomena were not seen in any postmenopausal women. The area under the E2 and P4 curve from the time interval immediately after awakening to 60 min after awakening (i.e. E2auc and P4auc) in women with regular menstrual cycles were greater than those in the postmenopausal women. E2 and P4 secretory activity during the post-awakening period was influenced by the phase of the menstrual cycle. E2auc in the peri-ovulatory phase and P4auc in the early to mid-luteal phase were greater than in the menstrual phase. Meanwhile, cortisol secretory activity during the post-awakening period was not influenced by menstrual status or the phase of menstrual cycle. These findings indicate that, as with the CAR in the HPA axis function, ovarian steroidogenic activity increased after awakening and is closely associated with menstrual status and phase of menstrual cycle.

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