Mu Eveline, Thomas Elizabeth H X, Kulkarni Jayashri
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC, Australia.
Front Glob Womens Health. 2022 May 30;3:910220. doi: 10.3389/fgwh.2022.910220. eCollection 2022.
Fluctuations of sex hormones across the menstrual cycle have been linked to exacerbation of symptoms of psychiatric disorders. Women diagnosed with trauma-related disorders such as post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD) have reported worsening of mood symptoms at various phases of their menstrual cycle. There is also considerable overlap between PTSD, BPD, and complex-PTSD (cPTSD) symptoms, suggesting similar biological underpinnings. This mini-review examines the influence of sex hormones and the menstrual cycle on PTSD, BPD, and cPTSD symptoms, and discusses the involvement of the hypothalamic-pituitary-adrenal (HPA) axis. We review literature showing that PTSD and BPD symptoms fluctuate with the menstrual cycle, though the effect of the menstrual cycle phase appears to be inconsistent, warranting future research. Based on the reported phasic vulnerability in individuals with PTSD and BPD, it is plausible to assume that women diagnosed with the newly introduced cPTSD may experience similar difficulties. However, no study to date has addressed this. This review highlights the importance of considering an individual's trauma history as it may influence symptom severity and diagnosis, and the phase of the menstrual cycle at the time of diagnosis. This review also highlights that additional work is needed to clarify the influence of estradiol and progesterone fluctuations on trauma-related symptoms, especially in cPTSD. Continued research on menstrual cycle vulnerability and trauma will lead to better informed management and treatment of PTSD, BPD, and cPTSD.
月经周期中性激素的波动与精神疾病症状的加重有关。被诊断患有创伤相关疾病（如创伤后应激障碍（PTSD）和边缘型人格障碍（BPD））的女性报告称，在月经周期的不同阶段情绪症状会恶化。PTSD、BPD和复杂性创伤后应激障碍（cPTSD）的症状也有相当大的重叠，这表明它们有相似的生物学基础。这篇小型综述探讨了性激素和月经周期对PTSD、BPD和cPTSD症状的影响，并讨论了下丘脑-垂体-肾上腺（HPA）轴的参与情况。我们回顾的文献表明，PTSD和BPD症状会随月经周期波动，尽管月经周期阶段的影响似乎并不一致，这值得未来进一步研究。基于PTSD和BPD患者报告的阶段性易感性，可以合理推测，被诊断患有新引入的cPTSD的女性可能也会经历类似的困难。然而，迄今为止尚无研究涉及这一点。这篇综述强调了考虑个人创伤史的重要性，因为它可能会影响症状严重程度和诊断，以及诊断时的月经周期阶段。这篇综述还强调，需要更多工作来阐明雌二醇和孕酮波动对创伤相关症状的影响，尤其是在cPTSD中。对月经周期易感性和创伤的持续研究将有助于更明智地管理和治疗PTSD、BPD和cPTSD。
