Science & Technology

Symptoms of PTSD depend on the stage of the menstrual cycle

Symptoms of PTSD change over the course of the menstrual cycle.

Studies suggest that the findings may affect diagnosis and treatment.

In women who have experienced trauma, the symptoms of post-traumatic stress disorder can change during the menstrual cycle, with more symptoms during the first few days of the low hormone estradiol cycle and ovulation with estradiol. Find a study published by the American Psychological Association that has less close symptoms.

Results can affect PTSD Diagnosis and treatment, according to lead author Dr. Jenna Leader, an assistant professor of psychology at Thomas Jefferson University in Philadelphia. “When assessing women in the cycle, it can actually affect whether women meet the diagnostic criteria for PTSD, especially for people at the border,” she said. “And it can actually have a practical impact on those who are veterans and who are eligible for benefits and for health insurance purposes.”

The study was published in the journal Psychological trauma: theory, research, practice and policy..

Estradiol is a type of estrogen that regulates the female reproductive cycle. During the follicular phase of the menstrual cycle, elevated estradiol levels trigger a series of events that lead to ovulation. Studies have linked the low estradiol portion of the cycle to greater activation in the marginal regions of the brain associated with emotions, and lower activation in the prefrontal cortex when displaying emotional content. Low estradiol is also associated with greater stress and anxiety, as well as increased fear response.

To determine if these associations affect the traumatic response, researchers surveyed 40 women aged 18-33 years. All of these women experienced or witnessed traumatic events such as serious injuries and sexual violence. In the first part of the study conducted in the laboratory, researchers were asked to measure the levels of estradiol in the saliva of participants and then explain to them the trauma they experienced and the PTSD symptoms they experienced. bottom. last month. They found that the lower the estradiol, the more severe the participants’ self-reported symptoms.

The researchers also measured two stress biomarkers in the participants’ saliva, the hormone cortisol and the enzyme salivary α-amylase, before and after the participants explained their trauma. Salivary α-amylase is associated with a “fight or flight” stress response, and cortisol is associated with a slower, more persistent stress response in the body.

“A healthy system requires a moderate and coordinated response to both of these biomarkers,” says Leader. In women with low estradiol parts of the menstrual cycle, researchers instead found low cortisol and high salivary α-amylase levels in response to telling a trauma story. This is a pattern associated with maladaptive stress responses in previous studies.

In the second part of the study, researchers answered participants five daily questionnaires (at wake, before bedtime, and three times a day) for 10 days spanning the high and low estradiol parts of the menstrual cycle. I asked you to do it. .. The questionnaire measured how participants felt each time (from “very uncomfortable” to “very comfortable” and from “very unstimulated or activated” to “very stimulating”. Has been or has been activated “). Participants also completed a nightly PTSD symptom checklist.

On average, researchers found that participants had greater fluctuations in their daily mood during the low estradiol days of their cycle, and reported more severe PTSD symptoms on those days. Did.

The findings may affect the diagnosis and treatment of PTSD in women, who have long been underestimated in PTSD studies. “PTSD has long been studied primarily in men, because it was primarily studied in male veterans,” said Leader.

According to leaders, knowing how the menstrual cycle affects PTSD symptoms, in addition to affecting diagnosis, can be useful to both clinicians and patients. “This is something clinicians want to know, so we can convey this knowledge as part of our psychoeducation,” says Leader. “For women who are cycling naturally, it may be useful to understand how the menstrual cycle affects their symptoms. Being able to explain what is happening biologically is less threatening. Often becomes. “

See: “Estradiol, stress responsiveness, and daily emotional experience in traumatized women,” by Dr. Jenna Leader, University of Thomas Jefferson. Dr. Olena Kleshchova and Dr. Marianne R. Weierich of the University of Nevada, Reno, October 28, 2021. Psychological trauma: theory, research, practice and policy..
DOI: 10.1037 / tra0001113

Symptoms of PTSD depend on the stage of the menstrual cycle Symptoms of PTSD depend on the stage of the menstrual cycle

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