Cardiac Autonomic Neuropathy in Women During Menopausal Transition Period and its Association with Psychological Stress Levels: An Observational Study Nagalakshmi Vijaykumar 1 , Sanjivani S Jadhav 2 , S L Karne 3 1 Associate Professor, 2 Tutor, 3 Professor & HOD, Department of Physiology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India ABSTRACT Context: Perimenopause is a transitional stage which occurs before menopause in which women experience myriad symptoms like hot fushes, anxiety & depression with increasing, psychological stress levels leading to autonomic dysfunction. Purpose: Evaluate cardiac autonomic neuropathy (CAN) in women during menopausal transition period and its association with psychological stress levels. Methodology: Study includes three groups of women, group I: premenopausal in the age group of 25- 40 years, group II: perimenopausal women without symptoms and group III: perimenopausal women with symptoms in the age group of 40-50 years of 30 in each (total n=90). CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia (DBD) and heart rate response to Valsalva maneuver (VR) by electrocardiogram (ECG). If any two of them found positive, then presence of CAN was confrmed. Psychological stress levels were evaluated using standard women’s health questionnaire. Correlation between Psychological stress levels with incidence of CAN was assessed. Results: There exists a statistically signifcant positive correlation between DBD and VR with anxiety depressed mood, well being, vasomotor symptoms, somatic symptoms, and memory. (p=0.000**) Conclusion: This study indicates that CAN have a strong association with psychological stress levels in perimenopausal women. Keywords: Perimenopausal, Autonomic functions, Valsalva ratio, Sinus arrhythmia Corresponding author: Dr Sanjivani S. Jadhav, Tutor, Department of Physiology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India- 580009, Contact No.: 7406796222 E-mail address: sanjuj03@gmail.com INTRODUCTION The reproductive period of women, gradually transcends into stage of perimenopause, followed by menopause after couple of years. 1 Perimenopause is a transitional stage which is before menopause which can range from 2 to 10 years. In this stage, menstrual periods are irregular, with 30% decrease in estrogen and progesterone. 1 Vasomotor symptoms (VMS) such as hot fushes and night sweats are main physical signs that occur in 50-70% of women during menopausal transition period. 2 In addition, women also experience symptoms like anxiety, mood changes, cognitive defcits and somatic symptoms (SOM). 3 The changes in hormonal status during this period, mainly estrogen has potent infuence on vital organ systems. 2 Along with cardiovascular risk, reduction in estrogen level also causes climacteric symptoms like vasomotor, psychological or musculoskeletal disturbances that may contribute to stress among DOI Number: 10.5958/2320-608X.2018.00099.9