Elsevier

Biological Psychology

Volume 69, Issue 1, April 2005, Pages 113-132
Biological Psychology

Review
Sex differences in HPA axis responses to stress: a review

https://doi.org/10.1016/j.biopsycho.2004.11.009Get rights and content

Section snippets

Overview

In this review article, we set out to update findings on sex differences in hypothalamus–pituitary–adrenal (HPA) axis responses to stress with a main focus on human responses to acute psychological stress. First, we briefly describe normal HPA axis regulation under stress exposure as well as HPA axis dysfunction, which manifests in hyper- or hypo-reactivity, and discuss some important methodological issues in the study of acute HPA axis stress responses. We then outline observations of

The hypothalamus–pituitary–adrenal axis

The hypothalamus–pituitary–adrenal axis is a central control and regulatory system of the organism that connects the central nervous system (CNS) with the hormonal system. This stress-responsive neuroendocrine system helps the organism adapt to increased demands and maintain homeostasis after challenge but is also vital for supporting normal physiological functioning. The end product, cortisol, has a wide range of physiological effects in the body; virtually all of the body's single nucleated

Methodological issues

Since available empirical evidence differs significantly in numerous relevant methodological aspects, it is important to bear in mind a number of study design issues that should influence the evaluation of reviewed data and conclusions that can be reasonably drawn from different studies. Design issues may be classified into the following categories: (1) sample selection/composition and sample size, (2) characteristics of the applied stressor/challenge, (3) the outcome studied, and (4) the

Sex-disease dimorphisms

In humans, sex-disease dimorphisms can be observed. Men and women are at differential risks for a number of illnesses. This observation is reflected by sex-specific prevalence rates for several diseases with women suffering more often from autoimmune illnesses, whereas men are more prone to develop coronary heart diseases or infectious diseases (McCarty et al., 1995; see also Kudielka et al., 2000a, Kudielka et al., 2000b). Concerning psychiatric disorders, women more often develop anxiety,

Sex differences in HPA axis stress responses

At first glance, the overall resulting picture might appear inconsistent or even contradictory. However, it has to be considered that studies providing the available empirical evidence have differed significantly in numerous important methodological aspects (as outlined above). In the following, we review empirical evidence with a main focus on sex differences in stress-related HPA axis responses to psychological stressors in humans.

Over the years, a relatively consistent picture has emerged

Sexual dimorphisms in brain functioning, circulating sex steroids, and corticosteroid binding globulin

Observed sex differences in HPA axis stress responses may be due to sexual dimorphisms in brain function and circulating sex steroid and corticosteroid binding globulin levels. Brain limbic regions, including the prefrontal cortex, the hippocampus, and amygdala, are presumed to be involved in the processing of psychological stress (Herman and Cullinan, 1997, Herman et al., 1996). There is evidence indicating that neurobiological mechanisms and hippocampal structures underlying higher-order

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