ReviewSex differences in HPA axis responses to stress: a review
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
References (155)
- et al.
Sex-related difference in amygdala activity during emotionally influenced memory storage
Neurobiol. Learn. Mem.
(2001) - et al.
HPA axis response to a psychological stressor in generalised social phobia
Psychoneuroendocrinology
(2002) - et al.
An in vivo study of the action of antiglucocorticoids on thymus weight ratio, antibody titre and the adrenal-pituitary-hypothalamus axis
J. Steroid Biochem.
(1979) - et al.
Differential effects of harassment on cardiovascular and salivary cortisol stress reactivity and recovery in women and men
J. Psychosom. Res.
(1999) - et al.
Consistency in catecholamine and cortisol excretion in males and females
Pharmacol. Biochem. Behav.
(1982) - et al.
Dissociation between sympathetic-adrenal and pituitary-adrenal responses to an achievement situation characterized by high controllability: comparison between type A and type B males and females
Biol. Psychol.
(1980) - et al.
Abnormal salivary cortisol levels in social phobic patients in response to acute psychological but not physical stress
Biol. Psychiatry
(2001) - et al.
Adaptation of female rats to stress: shift to male pattern by inhibition of corticosterone synthesis
Brain Res.
(1988) - et al.
Androgen regulation of adrenocorticotropin and corticosterone secretion in the male rat following novelty and foot shock stressors
Physiol. Behav.
(1994) - et al.
The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders
Psychoneuroendocrinology
(2000)