• Mohammad Khaksari
  • Mehdi Mahmoodi
  • Mohammad E. Rezvani
  • Mohammad A. Sajjadi
  • Gholamreza Asadi Karam
  • Sohrab Hajizadeh


Background: It is known that stress alters biological processes.  The aim of the present study was to examine the effect of examination stress in young adult male and female students. Methods: Examination stress was studied in 28 young female and 21 young male volunteer students of Rafsanjan university of medical Sciences, 0.5 hour before Physiology examination (stress condition) at 10-12 a.m. and 45 days after examination (control condition) at the same time in the year 2003. Results: There were no differences in BMI of male and female groups at control and stress conditions.  Subsequent analysis between two sexes showed that males had significantly higher systolic [SBP (124.7±4.01 mmHg)] and diastolic blood pressure [DBP (76.56±2.48 mmHg)], heart rate [HR (84.6±2.63)] increases in stress condition, in both sexes, but in males the increasing of HR is more than females, whereas females had higher repsiratory frequency increase in stress condition, compare to males.  Moreover, there were no differences in SBP, DBP and HR responses to stress condition in different phases of the menstrual cycle.  The increased amonut of the plasma cortisol in stress condition was significantly higher in males (485.3±37.9 in stress vs. 335.7±27.9 pg/ml in control) than females, stress also reduced females’ ACTH in both phases of the menstrual cycle (13.3±0.8 in stress vs. 27.47±7.25 pg/ml in control), but in males stress increased ACTH (43.72±4.45 in stress vs. 49.29±3.25 pg/ml in control).  In males, stress induced a significant decrease in plasma testosterone.  Plasma progesterone in response to stress showed a significant decrease in the luteal phase. Conclusion: These data suggest that, the responses to physiology examination stress are different between two sexes.Key words: Cardiovascular; Endocrine; Physiology Examination; Sex differences; Stress.


Brann DW, Mahesh, VB. Role of corticostroids in female reproduction. FASEB J 1991; 5: 2691-8.

Berne, RM, Levy, MN. Physiology. 4th Ed. London: Mosby Year Book;1988..

Miller NE. Learning, stress and Psychosomatic symptoms. Acta Neuobiol Exp 1978; 36: 141-56.

Redei E, Lifang L, Halasz I, McGivern RF, Aird F. Fast glucocorticoid feedback inhibition of ACTH secretion in ovariectomized rat: Effect of chronic estrogen and progesterone. Neuroendocrinology 1994;60:113-23.

Stoney CM, Davis MC, Matthews KA. Sex differences in lipid, lipoprotein, cardiovascular, and neuroendocrine responses to the acute stress. Psychophysiology 1988;25: 624-51.

Matthews KA, Stoney CM. Influences of sex and age on cardiovascular responses during stress. Psychosom Med 1988; 50: 46-56.

Saab PG, Matthews KA, Stoney CM, McDonald RH. Premenopausal and postmenopausal women differ in their cardiovascular and neuroendocrine responses to behavioral stressors. Psychophysiology 1989;26:270-80.

Parker G, Cai Y, Tan S, Dear K, Henderson AS, Poh GT, Kwee GC. Examination stress in Singapore primary schoolchildren: how compliance by subjects can impact on study results. Acta Psychiatr Scand 2003;108(3):239-43.

Chiu A, Chon, SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol 2003;139(7):897-900.

Droogleever Fortuyn HA, Van Broekhoven F, Span PN, Backstrom T, Zitman FG, Verkes RJ. Effects of PhD examination stress on allopregnanolone and cortisol plasma levels and peripheral benzodiazepine receptor density. Psychoneuroendocrinology 2004;29(10):1341-4.

Tersman Z, Collins A, Eneroth P. Cardiovascular responses to psychological and physiological stress during the menstrual cycle. Psychosom Med 1991;53: 185-97.

Zeller A, Handschin D, Gyr N, Martina B, Battergay E. Blood pressure and heart rate of students undergoing a medical licensing examination. Blood Press 2004; 13(1): 20-4.

Bijlani RL, Sud S, Gandhi BM, Tandon BM. Relationship of examination stress to serum lipid profile. Indian J Physiology Pharmacology 1986;30:22-30.

Collins A, Frankenhaeuser M. Stress responses in male and female engineering students. J Human Stress 1978; 4:43-8.

Maes M, Van Gastel A, Delmeire L, Kenis G, Bosmans E, Song C. Platelet alpha2-adrenoceptor density in humans: relationships to stress-induced anxiety, psychathenic constitution, gender,and stress-induced changes in the inflammatory response system. Psychol Med 2002;32(5):919-28.

Makarenko MV, Lyzohub VS, Iukhymenko LI. Heart rhythm in students with different individual and typological characteristics of the higher nervous activity during examination stress. Fiziol Zh 2003; 49(1): 28-33.

Faustov AS, Shcherbatykh IuV. Changes in the functional state of the nervous system of students during studies. Gig sanit 2000; 6: 33-35.

Martinek L, Oberascher-Holzinger K, Weishuhn S, Klimesch W, Kerschbaum HH. Anticipated academic examinations induce distinct cortisol responses in adolescent pupils. Neuro Endocrinol 2003;24(6):449-53.

Armario A, Marti O, Molina T, de Pablo J, Valdes M. Acute stress markers in humans: response of plasma glucose, cortisol and prolactin to two examinations differing in the anxiety they provoke. Psychoneuroendocrinology 1996; 21(1): 17-24.

Johansson GG, Laakso M, Peder M, Karonen SL. Endocrine patterns before and after examination stress in males and females. Act Nerv Super (Praha) 1989;31(20): 81-8.

Komesaroff PA, Esler M, Clark IJ, Fullerton MJ, Funder JW. Effect of estrogen and estrus cycle on glucocorticoid and catecholamine response to stress in sheep. Am J Physiology (End Met) 1998; 275: E671-8.

Most read articles by the same author(s)