Mokhtari et al indicated that chronic stress had been found to activate the hypothalamic–pituitary–adrenal axis, causing the dysregulation of corticotropin-releasing factor, leading to elevated glucocorticoid receptors in immune cells, which can bind to systemic cortisol and become activated.[7] The immune imbalance may exacerbate the progression of EMs. This evidence concerns the gene CRH and Postural instability.