Researchers Claim That Women with PTSD Symptoms May be On Their Period

Based on a small study that included no women with PTSD, researchers suggest that women have worse PTSD symptoms at the start of menstruation--and that this might explain why they are more vulnerable to PTSD than men.

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Are women more likely to experience PTSD because they menstruate? And is that distress worse during their period?

That’s the conclusion that might be drawn from a tiny, flawed study in Psychological Trauma: Theory, Research, Practice, and Policy. The study was reported in the media by Medscape.

The researchers, led by Jenna K. Rieder at the City University of New York, first note that women are more likely to experience PTSD than men. The reason? They theorize that it’s because of hormone levels during menstruation.

“Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity,” they write.

They conducted a small study, ostensibly to test this idea. They recruited a particular population: 40 women, 18 to 33 years old, who were described as having “regular menstrual cycles.” Women on hormonal birth control were excluded, as were those who were pregnant or lactating within the previous year. Women who took psychiatric drugs were also excluded.

However, an obvious flaw with the study is that it did not include women with PTSD. Although all 40 women had experienced a self-reported “traumatic event,” none of them had been diagnosed with PTSD.

In the absence of a diagnosis, the researchers did their own trauma assessment. They found that only eight of the women qualified for a “provisional diagnosis,” and even they were “at the lower end of the symptom severity range.”

Rieder and colleagues measured estradiol levels based on saliva samples (estradiol is an estrogen hormone associated with the menstrual cycle). Then, they correlated that with self-reported PTSD symptoms (participants kept a log five times per day for 10 days).

After gathering data, the researchers excluded three participants whose estradiol levels didn’t match what they expected and another seven who didn’t fill out their self-survey enough times, leaving the analysis with only 30 participants.

The researchers found that low estradiol levels (generally, at the start of menstruation) were associated with worse PTSD symptoms and more re-experiencing symptoms.

However, they also found that estradiol levels were not associated with “more severe reexperiencing symptoms, total symptom severity, the number or severity of arousal symptoms, or the number or severity of negative alterations in cognitions and mood symptoms.”

So, at best, a mixed finding, in a small group of women, none of whom had been diagnosed with PTSD.

Still, Rieder and the other researchers concluded that their finding could have an impact on PTSD assessment—suggesting that clinicians should ask women if they’re on their period when women report feeling distressed after traumatic events:

“Clinicians might improve diagnostic accuracy by accounting for client menstrual cycle phase at the time of assessment,” they write.
They add, “Clinicians who work with PTSD populations could gather information about clients’ recent menstrual cycles to predict when clients might experience more frequent aversive daily experiences, including symptoms.”

The researchers themselves acknowledge that their sample was flawed, particularly because it only included women without PTSD. They write that women who actually meet the criteria for PTSD might have more consistent symptoms:

“It is also possible that women with PTSD experience symptoms more consistently across the cycle, with no alleviation of symptoms during high estradiol phases.”

No research yet on whether men who experience PTSD have hormonal changes that affect their symptoms.

 

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Rieder, J., Kleshchova, O., Weierich, M. (2021). Estradiol, Stress Reactivity, and Daily Affective Experiences in Trauma Exposed Women. Psychological Trauma: Theory, Research, Practice, and Policy. (Link)

11 COMMENTS

  1. Yes, women and men are different, but this is absolutely the stupidest study I have ever seen described on the MIA website. Yes, stupid studies in medicine, health, science and psychiatry seem to be growing by leaps and bounds lately. Are we just bored or what? Perhaps, the best thing might be to figure out better ways to help those who allegedly have PTSD—drug free and stigma free non therapy ways— especially since it hits our war veterans and first responders so intensely—irregardless of gender or anything else. Why not spend the money to see how we can better help those who fought in Afghanistan especially after recent irresponsible developments in that country? Thank you.

  2. I would laugh except it’s not funny (the comment about the Onion is funny). I was given PTSD by criminal psychiatry (clear violation of state law), after child rearing years. Without justice, I experience terror attacks due to imposed realities (ex. poverty, hopelessness), years after my menstrual period stopped. The connection between psychiatry and oppressive patriarchy is too strong. And too painful.

  3. We published a “review” of the study because we thought it exemplified bad science, and how biological psychiatry seems to always be looking at the “flawed” biology of the individual (rather than trauma which is, even in the diagnosis, said to be the cause of the disorder), and this study seemed particularly idiotic because it didn’t include women with PTSD! I am not sure that came across as clear to all our readers.

  4. Some have commented that this idiot study reflects sexism and “oppressive patriachry” but the lead researcher of this “study” is a woman; “Jenna Rieder.” Also, it may not have been a good idea for these “scientists” to include women who may have PTSD because they would probably be taking psych drugs that usually essentially eliminate or drastically reduce “menstrual periods.” So, the more you consider this “study” you have got to laugh all the way down the halls of academia and realize it’s not patriarchy or even sexism that we are up against but the rapid decline of intelligent thought in the once allegedly hallowed halls of academia. The ivory tower never looked so dirty; however perhaps it never was clean. Thus, in all the hilarity of this “study” the truth emerges about how it was our mistake to ever put our faith in “academia” at all. Thank you.

    • Just to be clear, there are plenty of women who embrace “patriarchy,” and also plenty of men who don’t. Internalized oppression is a very real thing, and there is no reason that a woman can’t engage in sexist behavior or operate on sexist assumptions and values. Remember Anita Bryant? I’d have to say that even proposing the idea that PTSD is caused by women being on their periods is offensive on the face of it. Though the I agree with the rest of what you said – the lack of “common sense” in such a study is startling!

  5. Perhaps, our most human mistake has been to cast almost everything in the light of whether it’s patriarchal, or matriarchal or sexist or racist or “fill in the blank.” I say this because in the end, it does lead to faulty and stupid alleged studies like this which lead to useless, non-sensical conclusions. Additionally, it leads to unhealthy divisions amongs people and a general unhealthiness overall and individually. That is why I have portrayed this as more a fault in academia, but describing the fault of this study in other ways may lead to a similar conclusion. The stupidity of a study like this affects us all regardless of all the descriptors we might apply to ourselves or other people. The fault really lies in that this and even other more valid studies usually disregard the individual and devalue the individual. This, to me, is primarily the fault of psychiatry and other institutions including government, education, and healthcare in general and there’s a lots of etc. here, too. We suffer because our natural unique individual strengths and non-strengths are completely and utterly devalued, etc. Until, we consider how each person is uniquely and individual suited to contribute to the body as a whole; rather than capricously just considering the body and throwing in the unique individuality of each person as just a fleeting afterthought, stupid studies like this already common will become as common as ants at a picnic. Thank you.

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