4.4 Review

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

Journal

CURRENT PSYCHIATRY REPORTS
Volume 23, Issue 2, Pages -

Publisher

SPRINGER
DOI: 10.1007/s11920-020-01221-9

Keywords

Anxiety disorder; Post-traumatic stress disorder; Menstrual cycle; Extinction recall; CO2 challenge; Premenstrual exacerbation

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Recent literature suggests that the menstrual cycle and its hormones impact symptoms and processes relevant to anxiety and PTSD. However, methodological limitations and inconsistent definitions of menstrual cycle phases contribute to conflicting results, highlighting the need for further research to inform personalized prevention and intervention efforts for women.
Purpose of ReviewThis 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 FindingsThe 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.SummaryThe 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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