Looking for online mental health care? Find licensed psychiatrists or therapists and schedule a session today.

Post Traumatic Stress Disorder: The Link Between Low Estrogen and PTSD in Women

Trauma is a complicated subject to navigate on any level. It’s difficult to work through in therapy, agonizing to share about with loved ones, and, if you suffer from Post-Traumatic Stress Disorder (PTSD), it can be terrifying to re-experience when the symptoms are triggered.  PTSD can have a profound impact upon your day-to-day life and your enjoyment of everyday activities. It can seriously damage your relationships, your career and even your physical health.

As with most mental health problems, PTSD is an often misunderstood condition. For each person who suffers from the disorder, the triggers are specific and unique to their own circumstances, and their experiences are very real and painfully frightening.

PTSD symptoms can vary in intensity over time. One individual may be triggered with symptoms such as flashbacks, nightmares, and severe anxiety when they encounter painful reminders of what they’ve experienced or witnessed. Uncontrollable thoughts about the event are common, especially in a state of hypervigilance. However, symptoms aren’t limited strictly to intrusive thoughts: negative thinking and mood, avoidance, and uncontrolled emotional reactions are also common.

People of all walks of life can have PTSD. It can happen to anyone who may have felt or feels although their personal or physical safety is seriously threatened. This includes events like those involving actual or threatened death, serious injury, or sexually-related violation.

There is not one specific experience or reason PTSD is established. In fact, a myriad of factors come into play. It’s speculated that PTSD is probably caused by a mix of the amount and severity of aggregate trauma you've experienced as well as hereditary mental health factors, like family history of anxiety and depression. Another important factor is the way your brain regulates the chemicals and hormones your body releases in response to stress.


Fear and anxiety roles in our life

Fear and anxiety help defend us against dangerous situations and are primarily controlled via specialized neural circuits passing electrical or chemical signals to each other. However, disturbances in those circuits can cause extensive, disabling emotional reactions that are out of proportion to threatening events. Those disturbances are thought to underlie many anxiety disorders such as phobias and PTSD.

Recently, Emory University School of Medicine and Harvard Medical School cooperatively finished a study which explains how estrogen changes gene activity in the brain to impact the likelihood of PTSD development in women.

Moreover, it indicated that low estrogen levels may make women more susceptible to the development of PTSD at certain points in their menstrual cycles or lifetimes, while high estrogen levels could be preventative.

Researchers examined blood samples from 278 women from the Grady Trauma Project, a study of low-income Atlanta residents with high levels of exposure to violence and abuse. The group included adult women of childbearing age, in which estrogen rises and falls with the menstrual cycle, and women that had gone through menopause and had much lower estrogen levels. This group of women had genetic variabilities indicative of a decreased ability to respond to and recover from fear.

For women experiencing PTSD, the researchers found that the higher the level of estrogen in the blood was with them after the brain attempted to suppress fear, the less likely they were act fearful. Therefore, it was concluded that low estrogen levels are related to higher intrusive thoughts in day-to-day life.

While the connection between low-testosterone and increased PTSD symptoms has been studied fairly extensively, examining estrogen levels is relatively new territory in scientific research. This particular study only examined estrogen’s effects in women. Other researchers have found that in males, testosterone is converted into estrogen in the brain, where it plays a protective role for them. This, perhaps, explains the notable difference in PTSD rates between women and men. Women have a reported rate of PTSD symptoms lasting 4 times longer than men.

The findings of the study, published in Molecular Psychiatry, are significant as they could be instrumental to the future for estrogen being used as a preventive treatment to lower the risk of PTSD after trauma.


Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Accessed 25 Mar 2017. https://www.ncbi.nlm.nih.gov/books/NBK207191/

“Low estrogen levels associated with post-traumatic stress disorder.” Psymethods, 2017.  Accessed 25 Mar 2017. http://www.psymethods.com/news/1237-low_estrogen_levels_associated_with_post-traumatic_stress_disorder.html

McKenzie N, Marks I, Liness S, “Family and Past History of Mental Illness as Predisposing Factors in Post-Traumatic Stress Disorder.” Psychotherapy Psychosomatics. 2001;70:163-165, Accessed 25 Mar 2017. https://doi.org/10.1159/000056243

Miriam Fornells-Ambrojo, Alison Gracie, Chris R. Brewin and Amy Hardy, “Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review.” European Journal of Psychotraumatology 2016, 7: 32095 - Accessed 25 Mar 2017. http://dx.doi.org/10.3402/ejpt.v7.32095

Resnick, Eileen M., Monica Mallampalli, and Christine L. Carter. “Current Challenges in Female Veterans’ Health.” Journal of Women’s Health 21.9 (2012): 895–900. PMC. Web. 28 Mar. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430482/

S A Maddox, V Kilaru, J Shin, T Jovanovic, L M Almli et al.  “Estrogen-dependent association of HDAC4 with fear in female mice and women with PTSD.” Molecular Psychiatry.  Nature Publishing Group, Jan 17, 2017, Accessed 25 Mar 2017.


Behavioral Care News

The telehealth industry is changing rapidly. Stay informed and get the latest news, events and resources delivered straight to your inbox.

[hubspot type=form portal=3282840 id=47bcac38-f48e-4978-bdb4-8af68e0f3a5d]

If you are in crisis, call 988 to talk with the National Suicide Prevention Lifeline, text HOME to 741741 to connect to a free crisis counselor, or go to your nearest emergency room.