The Effects of Female Reproductive Hormones in Generalized Social Anxiety Disorder

Abstract

Although generalized social anxiety disorder (gSAD) is more prevalent in women, the role of female reproductive hormones in gSAD has never been investigated. Therefore, our aim was to make a first inventory of the influence of female reproductive hormones on gSAD symptoms. Female patients with gSAD who had previously participated in our research projects in the University Medical Center Utrecht and the Leiden University Medical Center were recruited. A self-report survey with questions on the influence of menarche, the periods of the menstrual cycle, oral contraceptive use, pregnancy, lactation, postpartum period, and menopause on gSAD symptoms was returned by 46% of 140 women suffering form gSAD. Non-parametric statistical tests were used to analyze the data. A subgroup of patients reported an influence of female hormonal cycle on gSAD symptoms. In this subgroup, statistical differences were found for the menstrual cycle and pregnancy. In the premenstrual period, patients reported more severe gSAD symptoms. During pregnancy symptoms decreased, but postpartum symptom severity returned to the same levels as before pregnancy. A subgroup of women with gSAD seemed vulnerable for the influences of gonadal hormones. Prospective research in women with gSAD, in which the gonadal hormones are assessed, is warranted.