Category: Gender

Categories : Gender Mental HealthTags :

Menstrual Cycles May Impact PTSD Symptoms in Women

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New research has found that post-traumatic stress disorder symptoms in women may vary over the course of the menstrual cycle, with more symptoms during the cycle’s first few days when the hormone oestradiol is low and fewer symptoms close to ovulation, when oestradiol is high.

The results could have implications for PTSD diagnosis and treatment, said lead author Jenna Rieder, PhD, an assistant professor of psychology at Thomas Jefferson University in Philadelphia. “When in the cycle you assess women might actually affect whether they meet diagnostic criteria for PTSD, especially for people who are right on the border. And that can have real practical implications, say, for someone who is a veteran and entitled to benefits or for health insurance purposes.”

The research was published in the journal Psychological Trauma: Theory, Research, Practice and Policy.

Oestradiol is a form of oestrogen that regulates the menstrual cycle. During the follicular phase, rising oestradiol levels trigger a cascade of events that result in ovulation. Studies have linked low-oestradiol portions of the cycle to greater activation in the limbic areas of the brain, which are related to emotion, and to lower activation in the prefrontal cortex when viewing emotional content. Low oestradiol has also been linked to greater stress and anxiety as well as increased fear responses.

To find out whether those links were related to traua response, researchers studied 40 women, aged 18 to 33, all of whom had experienced or witnessed a traumatic event, such as a serious injury or sexual violence. In the lab, researchers measured the participants’ level of oestradiol in their saliva, then asked them to describe the trauma that had happened to them and the PTSD symptoms they’d experienced in the past month. They found that lower oestradiol was associated with greater self-reported symptom severity in the participants.

The researchers also measured two stress biomarkers in participants’ saliva, the hormone cortisol and the enzyme salivary alpha-amylase, before and after the participants described their trauma. Salivary alpha-amylase is related to the “fight-or-flight” stress response, and cortisol is related to the body’s slower, more sustained stress response.

“In a healthy system we want a moderate, coordinated response of both of these biomarkers,” Prof Rieder said. In the women in the low-oestradiol portions of their menstrual cycles, the researchers instead found low cortisol and high salivary alpha-amylase levels resulting from recounting their trauma stories – a pattern that’s been linked in previous studies with maladaptive stress responses.

The researchers then asked the participants to answer five daily questionnaires for 10 days spanning the high- and low-oestradiol portions of their menstrual cycles. The questionnaires measured how participants were feeling at each time (from “extremely unpleasant” to “extremely pleasant” and “extremely nonstimulated or activated” to “extremely stimulated or activated”). Participants also completed a PTSD symptom checklist each evening.

Participants were found to have greater variability in their daily moods during the low-oestradiol days of their cycle and reported more severe PTSD symptoms on those days.

This could have implications for diagnosis and treatment of PTSD in women, who have long been underrepresented in PTSD research. “PTSD for a long time was mostly studied in men, in part because it was mainly studied in veterans, who were mostly men,” Prof Rieder said.

As well as its relevance to diagnosis, knowing how the menstrual cycle affects PTSD symptoms could be useful for both clinicians and patients, according to Prof Rieder. “I think this is something that clinicians would want to know, so they can impart this knowledge as part of psychoeducation,” she said. “For women who are naturally cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Source: American Psychological Association

Categories : Gender General InterestTags :

Men and Women Have the Same Emotional Turbulence

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Contrary to widely held gender stereotypes, women are not more emotional than men, say researchers of a new study into emotional differences in gender.

Feelings such as enthusiasm, nervousness or strength are often interpreted differently between the two genders. It’s what being ’emotional’ means to men versus women that is part of a new University of Michigan study that dispels these biases.

For example, a man whose emotions fluctuate in a sporting event is described as “passionate” while a woman whose emotions change in any event, even if provoked, is considered “irrational,” said senior author Adriene Beltz, assistant professor of psychology.

Prof Beltz and colleagues followed 142 men and women over 75 days to learn more about their daily emotions, both positive and negative. The women were divided into four groups: one naturally cycling and three others who used different forms of oral contraceptives.

The researchers detected fluctuations in emotions three different ways, and then compared the sexes. Little to no differences were seen between the men and the various groups of women, suggesting that men’s emotions fluctuate to the same extent as women’s, although likely for different reasons.

“We also didn’t find meaningful differences between the groups of women, making clear that emotional highs and lows are due to many influences – not only hormones,” Prof Beltz said.

These findings could have implications for research, which has historically excluded women partly because ovarian hormone fluctuations result in variation, especially in emotion, which cannot be experimentally controlled, the researchers said.

“Our study uniquely provides psychological data to show that the justifications for excluding women in the first place (because fluctuating ovarian hormones, and consequently emotions, confounded experiments) were misguided,” Prof Beltz said.

Source: University of Michigan

Categories : Gender Substance UseTags :

Studies Find Females More Susceptible To Addiction

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Several new studies focusing on sex differences in pain and addiction suggest that females could be more susceptible to drug addiction and addiction-like behaviours than males. Researchers also investigated how sleep deprivation affected the likelihood of relapse, partly driven by hormone differences in females and males. The studies will be presented at the American Physiological Society’s seventh conference on New Trends in Sex and Gender Medicine from 19 to 22 October.

This study used a rat model to investigate the connection between opioid abstinence and persistent sleep loss and its impact on the body’s central stress response system. Researchers specifically found persistent sleep disruption may cause or perpetuate abnormalities in their hypothalamic-pituitary adrenal axis. These abnormalities increase the risk of vulnerability to relapse during oxycodone abstinence in some individuals. Scientists are now working to identify susceptibility factors that play a role in boosting the risk of relapse. Adequate sleep may be critical for successful recovery from opioid addiction.

Researchers conducting this study explored how the opioid epidemic in the US continues and evolved during the ongoing COVID pandemic. Women have made up the majority of those prescribed opioids for pain treatment. Prescribed opioids for pain management became the primary conduit to abuse and addiction for women, and the researchers found that mitigations in opioid prescriptions have been followed by increases in the use of other substances, such as heroin and fentanyl, in both men and women. While the rate of opioid use and overdose is higher in men, women have a higher rate of overdose death. Understanding how opioid use and addiction differ in their effect on men and women is key to ending the epidemic.

A rat model was also used to evaluate sex differences in vulnerability to addiction. Their results indicate activation of a specific subset of receptors for oestrogens enhances established cocaine-seeking behaviors in female rats. In male rats, the preference for cocaine under the same circumstances was reduced, involving the area of the brain linked to compulsive behaviours. Females show a greater response than males to stimulants such as amphetamine and cocaine in part due to the gonadal hormone oestradiol, which is one of the three forms of oestrogen. The hope is these results will lead to a better understanding of the mechanisms of addiction-related behaviors and the development of sex-specific treatments for addiction.

Source: American Physiological Society

Categories : Cardiovascular Disease GenderTags :

Not Enough Women in Stroke Clinical Trials

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A new study published in Neurology shows that women are underrepresented in stroke clinical trials compared to the proportion who have strokes in the general population. 

“Making sure there are enough women in clinical studies to accurately reflect the proportion of women who have strokes may have implications for future treatment recommendations for women affected by this serious condition,” said study author Cheryl Carcel, MD, of The George Institute for Global Health in Sydney, Australia. “When one sex is underrepresented in clinical trials, it limits the way you can apply the results to the general public and can possibly limit access to new therapies.”

The study analysed 281 stroke trials conducted between 1990 and 2020, with a total of 588 887 participants. Of these, only 37.4 % were women. The average prevalence of stroke in women across the countries included was 48%.

Results were calculated in participation-to-prevalence ratio, a relative measure that weights the percentage of women in a trial compared to their proportion in the total population with that disease. A ratio of one indicates that the percentage of women in the study is the same as the percentage of women with the disease in the general population. An acceptable range for an ideal ratio of female participation is between 0.8 and 1.2.

Overall, women were found to be underrepresented relative to their prevalence in the underlying population, with a consistent ratio of 0.84 over time. They found the greatest differences in trials of intracerebral haemorrhage, with a ratio of 0.73; trials with average participant age under 70, with a ratio of 0.81; non-acute interventions, with a ratio of 0.80; and rehabilitation trials, with a ratio 0.77.

“Our findings have implications for how women with stroke may be treated in the future, as women typically have worse functional outcomes after stroke and require more supportive care,” Dr Carcel said. “We will only achieve more equitable representation of women in clinical trials when researchers look at the barriers that are keeping women from enrolling in studies and actively recruit more women. People who fund the research also need to demand more reliable, sex-balanced evidence.”

Source: American Academy of Neurology

Categories : Gender General InterestTags :

Gender Behavioural Differences Strengthened in Lockdown

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‘Stereotypical’ gender behaviour differences were exaggerated during the COVID lockdown in Austria, according to a recent study published in Scientific Reports. 

Men and women conducted themselves differently in the wake of the COVD lockdown in Austria, with women spending more time on the phone while men returned to crowded and public areas more quickly.

Using mobile phone data from 1.2 million devices in Austria (representing 15% of the population) across the first phase of the COVID pandemic, researchers quantified gender-specific patterns of communication intensity, mobility, and circadian rhythms. They noted the resilience of behavioural patterns with respect to the shock imposed by a strict nation-wide lock-down that Austria experienced in the beginning of the crisis with severe implications on public and private life. They found significant differences in gender-specific responses during the different phases of the pandemic. They found that following lockdown, gender differences in mobility and communication patterns increased massively, while circadian rhythms tended to synchronise.

In particular, women had fewer but longer phone calls than men during the lock-down. Phone calls involving women lasted significantly longer on average, with big differences depending on who was calling whom. After the first lockdown in Austria was imposed on March 16, calls between women were up to 1.5 times longer than before the crisis (140% increase), while calls from men to women lasted nearly twice as long. Conversely, when women called men, they talked 80 percent longer, while the duration of calls between men rose only by 66 percent.

“Of course, we don’t know the content or purpose of these calls,” says Georg Heiler, a researcher at CSH and TU Wien, who was responsible for data processing. “Yet, literature from the social sciences provides evidence — mostly from small surveys, polls, or interviews — that women tend to choose more active strategies to cope with stress, such as talking with others. Our study would confirm that.”

Mobility declined massively for both genders, however, women tended to restrict their movement stronger than men. Women also showed a stronger tendency to avoid shopping centres and more men frequented recreational areas. 

After the lockdown, males returned back to normal quicker than females; and young and adolescent age-cohorts returned much quicker. An age stratification highlights the role of retirement on behavioural differences. They found that the length of a day for men and women is reduced by one hour. 

Source: Complexity Science Hub Vienna

Categories : Gender PaediatricsTags :

Study Highlights Role of Sex Hormones in Behavioural Development

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A new study shows that sex hormones are important for developing gender role behaviours in boys, such as active play.

In laboratory animals, sex differences in behaviour arise from different hormone levels produced by males and females influence patterns of gene expression in the developing brain. However, the origins of sex differences in human behaviour are not as well understood.

“In the lab, you can do experiments on how these hormones affect animal brains and perform other experimental manipulations. We can’t do those things to people, so we looked to a natural experiment,” explained study leader David Puts, associate professor of anthropology.

Prof Puts and his collaborators made use of a natural experiment called isolated GnRH deficiency (IGD), a rare endocrine disorder. Individuals with IGD lack sex hormones from the second trimester of development right through until they begin hormone replacement therapy to induce puberty. However, as the external genitals develop earlier, during the first trimester, people with IGD are clearly male or female at birth, and are raised according to their sex. 

IGD therefore presents the chance to study the behaviour of those raised as boys but exposed to low testicular hormones, or raised as girls but exposed to low ovarian hormones.

The researchers compared 97 individuals with IGD (a small number due to its rarity) to 1665 individuals with typical hormonal development. Differences in behaviour were investigated; boys being encouraged toward active play, girls pushed to more passive pursuits. The researchers asked subjects to recall behaviours they had as children.

“We asked them, ‘When you read a book, were you the male or female in the story?’, ‘Where your friends boys or girls?’, ‘Did you play with dolls or trucks?’,” said Talia N Shirazi, doctoral recipient in anthropology now working in the reproductive health industry.

These childhood gender role behaviours are among the largest differences in behaviour between sexes, Prof Puts said. Typically, males will say they were the male character, played with other boys and preferred trucks, while females will say they were the female character, played with other girls and preferred dolls.

However, males with IGD reported more gender non-conforming in this regard. The researchers found in that men with IGD recalled a higher level of childhood gender non-conformity than typical men, while women with IGD did not differ from typical women in childhood gender conformity.

‘”We don’t see this effect in the women with IGD,” said Shirazi, indicating that low levels of ovarian hormones does not significantly impact childhood gender role behaviours.

“Our results suggest that in humans, androgens, such as testosterone produced by the testes, influence male brain development directly as they do in other mammals, rather than only indirectly by influencing external appearance and consequently gender socialisation,” said Prof Puts. “Both the direct influence of androgens on the developing brain and gender socialisation probably play important roles in producing sex differences in childhood behaviour.”

Prof Puts and Shirazi agree that despite their modest sample of participants with IGD, they are encouraged that the results were very similar in subjects who came from a clinical setting and those recruited from support groups.

“It would be nice to be able to identify people with IGD when they are younger, before they reach what should be puberty,” said Shirazi. “We need to focus on recruitment for our studies because there is a lot that can be learned about the cause of gender behaviours.”

Source: Penn State

Categories : Diet and Nutrition GenderTags :

In Women, Avocado Consumption Reduces Abdominal Visceral Fat

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An avocado a day could help reduce abdominal visceral fat in women and result in health benefits, researchers wrote in the Journal of Nutrition.

In a randomised study, women who consumed avocado as part of their daily meal experienced a reduction in deeper visceral abdominal fat, though glucose tolerance markers were unchanged.

Study leader Naiman Khan, professor of kinesiology and community health, at University of Illinois Urbana-Champaign said:

“The goal wasn’t weight loss; we were interested in understanding what eating an avocado does to the way individuals store their body fat. The location of fat in the body plays an important role in health,” Prof Khan said.

“In the abdomen, there are two kinds of fat: fat that accumulates right underneath the skin, called subcutaneous fat, and fat that accumulates deeper in the abdomen, known as visceral fat, that surrounds the internal organs. Individuals with a higher proportion of that deeper visceral fat tend to be at a higher risk of developing diabetes. So we were interested in determining whether the ratio of subcutaneous to visceral fat changed with avocado consumption,” he said.

The participants were divided into two groups; one received meals incorporating a fresh avocado, and the other received a meal that had nearly identical ingredients and similar calories but without avocado. At the beginning and end of the trial, the researchers measured participants’ abdominal fat and their glucose tolerance, a measure of metabolism and a marker of diabetes.

Female participants who consumed an avocado a day as part of their meal had a reduction in visceral abdominal fat and experienced a reduction in the ratio of visceral fat to subcutaneous fat, indicating a redistribution of fat away from the organs. However, in males there was no change in fat distribution, and neither males nor females had improvements in glucose tolerance.

“While daily consumption of avocados did not change glucose tolerance, what we learned is that a dietary pattern that includes an avocado every day impacted the way individuals store body fat in a beneficial manner for their health, but the benefits were primarily in females,” Prof Khan said. “It’s important to demonstrate that dietary interventions can modulate fat distribution. Learning that the benefits were only evident in females tells us a little bit about the potential for sex playing a role in dietary intervention responses.”

The next step would be to provide all of the participants’ daily meals and look at additional markers of gut health and physical health for a more complete understanding of metabolic impacts and whether this sex difference persists.

Source: University of Illinois Alabama

Categories : Addiction GenderTags :

Despite Smoking Less, Women Find it Harder to Quit

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A large study has found that women smoke fewer cigarettes than men but are less likely to quit.

Study author Ms Ingrid Allagbe, PhD student at the University of Burgundy, said: “In our study, women who used smoking cessation services had higher rates of overweight or obesity, depression, and anxiety compared to men and kicked the habit less often. Our findings highlight the need to provide smoking cessation interventions tailored to the needs of women.”

This study, presented at ESC Congress 2021, compared characteristics and abstinence rates of men and women visiting smoking cessation services between 2001 and 2018 in France, obtained from a nationwide database. The participants were smokers with at least one additional risk factor for cardiovascular disease: overweight/obese (body mass index [BMI] 25 kg/m² or above); high cholesterol; diabetes; high blood pressure; history of stroke, heart attack or angina.

Participants were classified as having mild, moderate, or severe nicotine dependence. Smoking abstinence (at least 28 consecutive days) was self-reported and confirmed by measurement of exhaled carbon monoxide less than 10 parts per million (ppm).

Participant height, weight, age, education level, chronic conditions, and number of cigarettes smoked each day were recorded. Participants were classified as having anxiety and depression symptoms or not according to their medical history, use of anti-anxiety medication or antidepressants, and the Hospital Anxiety and Depression Scale (HADS).

A total of 37 949 smokers were included in the study, of whom 43.5% were women. The average age of women in the study was 48 years, while the average age of men was 51 years. More women (55%) reported a bachelor’s degree level of education or higher compared to men (45%).

Both men and women had a high burden of cardiovascular risk factors. High cholesterol was more common in men (33%) than women (30%), as was high blood pressure (26% vs 23%, respectively) and diabetes (13% vs 10%, respectively).

Women were more likely (27%) to be overweight or obese compared to men (20%), and more likely (37.5%) to have symptoms of anxiety or depression than men (26.5%). Chronic obstructive pulmonary disease was more common in women (24%) compared to men (21%) as was asthma (16% vs 9%, respectively).

However, women smoked fewer cigarettes per day (23) than men (27). Severe nicotine dependence was less common, 56% of women compared to 60% of men, and abstinence was less common in women (52%) than men (55%).

Ms Allagbe said: “The findings suggest that despite smoking fewer cigarettes and being less nicotine dependent than men, women find it more difficult to quit. Possible contributors could be the higher prevalence of anxiety, depression and overweight or obesity among women. It has previously been reported that women may face different barriers to smoking cessation related to fear of weight gain, sex hormones, and mood.”

She concluded: “The results indicate that comprehensive smoking cessation programmes are needed for women that offer a multidisciplinary approach involving a psychologist, dietitian, and physical activity specialist.”

Source: European Society of Cardiology

Categories : Gender Metabolic DisordersTags :

Australian Women with Diabetes Incur Significant Expenses

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A new study from at the University of Technology Sydney (UTS) and the University of South Australia has found that women with diabetes incur significant out-of-pocket expenses in managing their health, with costs rising as the disease continues.

Researchers found middle-aged and older women spend almost $500 a year from their own funds, visiting a diverse range of health services to manage their diabetes. Their findings were published in the journal PLOS One.

“Our findings were that most women (88.3 per cent) consulted at least one health care practitioner in the previous 12 months for their diabetes, including medical doctors, allied health practitioners and complementary medicine practitioners, spending on average $492.60 per woman a year,” said Distinguished Professor Jon Adams, deputy head of the School of Public Health at UTS.

He continued: “Our analysis suggests approximately $252 million is spent annually on out-of-pocket expenditure for diabetes management by Australian women aged 50 years and over. The results of this study provide important insights regarding public and private health care use by middle-aged and older Australian women living with diabetes.”

The economic burden these women are placed under warrants further investigation to understand how health care services (and the integration of such services) can better address their biopsychosocial needs, the researchers said.

However, the researchers said the economic burden of self-care of chronic illness by individuals and households is often overlooked in Australia in favor of analyses that center on the macro-economy and the cost to the Australian government.

Diabetes mellitus is a disease of inadequate control of blood levels of glucose. Type 1 and 2 diabetes are the main subtypes, each with different pathophysiology, presentation, and management, but both have a potential for hyperglycaemia. Poor management of diabetes can lead to other chronic health problems such as increased cardiovascular disease risk. 

Source: University of Technology Sydney (UTS)

Categories : Gender UrogenitalTags :

Treatment for Women with Frequent UTIs Found Wanting

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Women with frequent urinary tract infections report being unhappy at perceived overuse of antibiotics by their doctors and with the limited treatment options available to them, according to a new study.

The study highlights the need to get to the cause of women’s recurrent UTIs, to come up with prevention and to avoid unnecessary antibiotics use, which can eventually lead to resistance.

“Since there’s already a common treatment for UTIs – antibiotics – many doctors don’t see a need to do anything differently,” said senior author Dr Ja-Hong Kim, an associate professor at UCLA Health. “This study really gave us insight into the patient perspective and showed us those with recurrent UTIs are dissatisfied with the current management of the condition. Continued episodes can have a major impact on their quality of life.”

More than half of women will develop a UTI at some point, and roughly 1 in 4 will have repeat infections that can last for years. Many with recurrent infections will be prescribed antibiotics frequently over their lifetime.

The researchers conducted focus groups with 29 women with recurrent UTIs, which were defined as two infections in six months or three in a year. Participants were asked about their knowledge of UTIs and prevention strategies and about treatment impact on their quality of life. Two common themes were revealed: fear and frustration.

Participants were concerned foremost about antibiotic use, with a fear of unnecessary antibiotic prescriptions and developing resistance. Some also reported antibiotic treatment for symptoms which may have signified other genitourinary conditions, like an overactive bladder.

“Other bladder diseases can cause symptoms similar to recurrent UTIs, such as urination frequency and urgency, pain with urination and blood in the urine,” Dr Kim said. “These could be signs of an overactive bladder, interstitial cystitis, kidney or bladder stones, or something more serious, like bladder cancer. As physicians, we really need to be careful about not just giving patients with these symptoms antibiotics without verifying a UTI through a positive urine culture.”

SInce diagnoses take 48 hours, women can wait days for the correct prescription. This shows the need for better diagnostic tools, Dr Kim said.

Frustration and resentment toward their medical providers for “throwing antibiotics” at them without presenting alternative options for treatment and prevention, and for not understanding their experience with UTIs. In addition, many said their physicians did not properly educate them on the potential negative impacts of antibiotics; the women instead had to rely on information from the internet, magazines and TV.

Beyond improved diagnostics, treatment approaches and guidelines, better patient education is key, Dr Kim said. “We need to do a better job of letting patients know when antibiotics are necessary and when to consider alternative therapy for bladder conditions other than UTIs.”

Dr Kim and her colleagues are currently working to improve UTI diagnosis and management, including developing comprehensive patient-care pathways through which primary care physicians and general gynecologists and urologists will provide initial UTI patient education and management. They are also pursuing studies examining the relationship of the vaginal microbiome to lower urinary tract symptoms and are working to incorporate novel diagnostic methods to allow for point-of-care treatment for UTIs.

Source: UCLA