Cevik, Remzi, Gur, Ali, Acar, Suat et al. · BMC musculoskeletal disorders · 2004 · DOI
This study examined hormone levels in women with ME/CFS, focusing on hormones that control the menstrual cycle and stress response. Researchers found that women with ME/CFS had lower stress hormone (cortisol) levels than healthy women, while menstrual cycle hormones were normal. Depression symptoms did not change these hormone patterns.
This study provides evidence that the hormonal abnormalities in ME/CFS may involve the stress response system (HPA axis) rather than reproductive hormones, suggesting the condition involves distinct biological mechanisms. Understanding these hormonal patterns could help differentiate ME/CFS from primary psychiatric conditions and guide future treatment approaches.
This cross-sectional study cannot establish causation—low cortisol may be a consequence of CFS rather than a cause. The findings apply only to premenopausal women and cannot be generalized to men, postmenopausal women, or all CFS presentations. A single cortisol measurement may not capture full HPA axis dysfunction, which often requires dynamic testing.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Cevik, Remzi, Gur, Ali, Acar, Suat, Nas, Kemal, & Sarac, Aysegül Jale (2004). Hypothalamic-pituitary-gonadal axis hormones and cortisol in both menstrual phases of women with chronic fatigue syndrome and effect of depressive mood on these hormones.. BMC musculoskeletal disorders. https://doi.org/10.1186/1471-2474-5-47
BibTeX
@article{mecfsatlas-cevik-2004-hypothalamic-pituitary,
author = {Cevik, Remzi and Gur, Ali and Acar, Suat and Nas, Kemal and Sarac, Aysegül Jale},
title = {Hypothalamic-pituitary-gonadal axis hormones and cortisol in both menstrual phases of women with chronic fatigue syndrome and effect of depressive mood on these hormones.},
journal = {BMC musculoskeletal disorders},
year = {2004},
doi = {10.1186/1471-2474-5-47},
note = {PubMed: 15588275},
url = {https://www.mecfsatlas.com/evidence/cevik-2004-hypothalamic-pituitary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/cevik-2004-hypothalamic-pituitary
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