Abstract
Post-traumatic stress disorder (PTSD) is characterized by re-experiencing a traumatic event, avoidance, negative alterations in cognitions and mood, hyperarousal, and severe functional impairment. Women have a two times higher risk of developing PTSD than men. The neurobiological basis for the sex-specific predisposition to PTSD might be related to differences in the functions of stress-responsive systems due to the interaction between gonadal hormones and stress peptides such as corticotropin-releasing factor (CRF), orexin, oxytocin, and neuropeptide Y. Additionally, in phases where estrogens levels are low, the risk of developing or exacerbating PTSD is higher. Most studies have revealed several essential sex differences in CRF function. They include genetic factors, e.g., the CRF promoter contains estrogen response elements. Importantly, sex-related differences are responsible for different predispositions to PTSD and diverse treatment responses. Fear extinction (the process responsible for the effectiveness of behavioral therapy for PTSD) in women during periods of high endogenous estradiol levels (the primary form of estrogens) is reportedly more effective than in periods of low endogenous estradiol. In this review, we present the roles of selected neuropeptides in the sex-related predisposition to PTSD development.
Highlights
Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a traumatic event [1,2]
Epidemiological studies suggest that women may have a higher risk of developing or exacerbating PTSD during the phases of their lives when estrogen levels are low, such as puberty, menses, postpartum, and menopause [10]
The neurobiological basis of sex-related susceptibility to PTSD is associated with differences in the functioning of the HPA axis and hypothalamic neuropeptides that are partially dependent on estrogens
Summary
Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a traumatic event [1,2]. The pathophysiology of PTSD is associated with enhanced feedback sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis, hypersecretion of corticotropin-releasing factor (CRF), subnormal cortisol levels (hypocortisolemia), and noradrenergic hyperactivity [1,4]. Epidemiological studies suggest that women may have a higher risk for developing PTSD or exacerbating their present symptoms during phases of their lives, when estrogen levels are low: puberty, menses, postpartum, and menopause [10]. Res. Public Health 2022, 19, 314 consequence of estrogen-related differences in neuroendocrine and stress response systems [12]. Considering that the stress response is variable and depends on the changes in hormones concentration, in this review, we focus on the role of selected hypothalamic hormones in the estrogen dependent predisposition, course, and treatment of PTSD in females. We decided to introduce this poorly explored problem
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