case_images: PMC8280840_01
case_images: PMC8280840_02
case_images: PMC8280840_03
case_images: PMC8280840_04
case_images: Mental health indicators.
case_images: 10.1177_17455065211031079-fig1.jpg
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case_images: fig1-17455065211031079
case_images: Figure 1 displays the changes in each continuous measure across study time-points.
case_images: Adrenocorticotropic hormone (ACTH) and C-reactive protein.
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case_images: ACTH in the anterior pituitary gland,   characteristic of the HPA axis response. ACTH, reported in Figure 2, remains consistent across all visits except at M0. Alteration of immune functioning from HPA axis dysregulation may be evidenced in inflammation biomarkers.   Figure 2 displays CRP across visits, demonstrating low levels and variability.
case_images: Salivary cortisol, cortisol awakening response (CAR).
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case_images: Impairment of the process that regulates cortisol production is considered to be dysregulation of the HPA axis.   Figure 3 displays the average CAR after each visit, demonstrating a distinctive response only at M0.
case_images: PMC8280840_05
case_images: Female genital tract inflammatory biomarkers.
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case_images: fig4-17455065211031079
case_images: M1 which continued through M2 and M3, followed by a trend in recovery at M4 and M5 (Figure 4). M6 typically showed values less than M0 and may indicate return to baseline.