“While these findings do not directly address why women have higher rates of PTSD,” Inslicht said, “our study suggests that there are sex differences in reactivity of a major stress response system, and that reproductive hormones may interact with stress responses,” which could help to at least partially explain sex differences in PTSD rates.

Hormones may also contribute to sex differences via their impact on sleep quality, which, when impaired, is itself a risk factor for PTSD. “Research has shown that sex hormones influence sleep, and both sleep and sex hormones affect memory and learning processes critical to the development of and recovery from PTSD,” said Kobayashi.


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“One of important topics future research should focus on is elucidating roles of men and women’s unique physiology such as sex hormones and the menstrual cycle in PTSD development, maintenance, and recovery,” she added. Regardless of whether trauma survivors develop PTSD, both men and women commonly experience sleep problems like nightmares and insomnia, so it is important to assess for these problems in such cases and offer treatment if necessary.

A study published in January in the European Journal of Psychotraumatology investigated the role of PTSD risk factors in the differing responses between men and women following a bank robbery.4

“We found that most of the increased PTSD severity reported by women — 83% — could be contributed to the finding that women had higher levels of risk factors present in the time before, during, and after the bank robbery than men,” study co-author Dorte M. Christiansen, MSc, a PhD fellow at the Research Center for Psychotraumatology at the University of Southern Denmark, told Psychiatry Advisor.