Emory University Graduate Program in Neuroscience, Atlanta, GA, United States.
Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, United States.
Front Neuroendocrinol. 2019 Oct;55:100790. doi: 10.1016/j.yfrne.2019.100790. Epub 2019 Sep 19.
Women are twice as likely than men to suffer from posttraumatic stress disorder (PTSD). While women have increased exposure to traumatic events of many types and have greater prevalence of comorbid psychiatric disorders compared to men, these differences do not account for the overall sex difference in the prevalence of PTSD. The current review summarizes significant findings that implicate the role of estradiol, progesterone, and allopregnanolone in female risk for PTSD symptoms and dysregulation of fear psychophysiology that is cardinal to PTSD. We also discuss how these steroid hormones influence the stress axis and neural substrates critical for the regulation of fear responses. Understanding the role of ovarian steroid hormones in risk and resilience for trauma-related adverse mental health outcomes across the lifespan in women has important translational, clinical, and intergenerational implications for mitigating the consequences of trauma exposure.
女性患创伤后应激障碍(PTSD)的可能性是男性的两倍。尽管女性比男性更容易接触到多种类型的创伤性事件,并且与男性相比,合并精神疾病的患病率更高,但这些差异并不能解释 PTSD 总体性别差异的原因。本综述总结了一些重要的发现,这些发现表明雌二醇、孕酮和别孕烯醇酮在女性 PTSD 症状风险和恐惧心理生理学失调方面发挥了作用,而恐惧心理生理学失调是 PTSD 的主要特征。我们还讨论了这些甾体激素如何影响压力轴和神经基质,这些对于调节恐惧反应至关重要。了解卵巢甾体激素在女性一生中与创伤相关的不良心理健康结局的风险和恢复力中的作用,对于减轻创伤暴露的后果具有重要的转化、临床和代际意义。