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The Impact of the Menstrual Cycle and Underlying Hormones in Anxiety and PTSD: What Do We Know and Where Do We Go From Here?

  • SEX AND GENDER ISSUES IN BEHAVIORAL HEALTH (CN EPPERSON AND L HANTSOO, SECTION EDITORS)
  • Published:
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Abstract

Purpose of Review

This paper reviews the recent literature on menstrual cycle phase effects on outcomes relevant to anxiety and PTSD, discusses potential neurobiological mechanisms underlying these effects, and highlights methodological limitations impeding scientific advancement.

Recent Findings

The menstrual cycle and its underlying hormones impact symptom expression among women with anxiety and PTSD, as well as psychophysiological and biological processes relevant to anxiety and PTSD.

Summary

The most consistent findings are retrospective self-report of premenstrual exacerbation of anxiety symptoms and the protective effect of estradiol on recall of extinction learning among healthy women. Lack of rigorous methodology for assessing menstrual cycle phase and inconsistent menstrual cycle phase definitions likely contribute to other conflicting results. Further investigations that address these limitations and integrate complex interactions between menstrual cycle phase–related hormones, genetics, and psychological vulnerabilities are needed to inform personalized prevention and intervention efforts for women.

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Authors and Affiliations

  1. National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, 150 South Huntington Ave. (116B-3), Boston, MA, 02130, USA

    Yael I. Nillni, Ann M. Rasmusson & Suzanne L. Pineles

  2. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA

    Yael I. Nillni, Ann M. Rasmusson & Suzanne L. Pineles

  3. Department of Psychiatry, Boston Medical Center, Boston, MA, USA

    Emilie L. Paul

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  1. Yael I. Nillni
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  4. Suzanne L. Pineles
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Nillni, Y.I., Rasmusson, A.M., Paul, E.L. et al. The Impact of the Menstrual Cycle and Underlying Hormones in Anxiety and PTSD: What Do We Know and Where Do We Go From Here?. Curr Psychiatry Rep 23, 8 (2021). https://doi.org/10.1007/s11920-020-01221-9

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