Seven to eight percent of the U.S. population will have post-traumatic stress disorder (PTSD) at some time in their lives.
It comes with symptoms that significantly affect daily life, such as intrusive memories, avoidance, and extreme stress.
PTSD is a disorder that can look very different in men versus women. The contrast in symptoms displayed between genders can even cause PTSD to look like two separate disorders.
It’s important to know about the gender differences in PTSD, so you’re better able to recognize it in yourself or a loved one. The differences also matter when it comes to treatment.
What Is PTSD?
Post-traumatic stress disorder is caused by experiencing a terrifying event. A triggering event might include:
- Serious car accidents
- Sexual assault
- Witnessing or experiencing domestic violence
- A natural disaster
About 60% of men and 50% of women will experience at least one trauma—like those above—in their lives, some people experience trauma and only struggle with the memories for a short time.
Other people go on to develop PTSD and have significant trouble in relationships, at work, or at school.
A few general symptoms of PTSD are:
- Flashbacks, or reliving the traumatic event
- Negative beliefs about oneself or the world
- Avoiding people, places, or activities that bring back unwanted memories
- Difficulty concentrating
- Difficulty sleeping
- Having dreams or nightmares about the event
These symptoms can vary based on many factors. Gender is one of them. Below is an overview of the key gender differences between PTSD in women and men.
Is PTSD Different for Men and Women?
While more men experience trauma, PTSD affects many more women. The lifetime prevalence of PTSD is 10% to 12% in women and 6% to 8% in men. Traumatic events happen to both sexes and can result in the same symptoms.
The differences depend on when the trauma happens, what type of trauma it is, and biological factors unique to women versus men. These things determine whether someone who goes through trauma develops PTSD.
Nature of Trauma
High-impact trauma is a severe type of trauma likely to lead to PTSD symptoms.
Women are generally exposed to more high-impact trauma than men are. One of the traumas most likely to lead to PTSD is sexual assault. One in four women are raped by age 44; 8% of men are.
Women are also more likely to experience sexual abuse at an earlier stage of life. The earlier a person experiences trauma, the more it impacts personality and brain development.
Women are also more likely to experience other high-impact traumas, like domestic violence.
One of the reasons these types of trauma are more likely to lead to PTSD is because feelings of shame and self-blame often accompany sexual and interpersonal violence. While men also experience traumas like sexual assault, abuse, and domestic violence, they do so at a lower rate.
Combat trauma, with which PTSD is most associated, affects men much more often than it does women. It also generally produces less shame and other negative feelings about oneself. The same is true for car accidents and natural disasters.
Stress responses activate a hormonal pathway in the brain called the hypothalamic/adrenal/pituitary (HPA) axis.
This releases the stress hormone cortisol. The more severe the trauma, the more cortisol released. In individuals with PTSD, the HPA axis response is dysregulated.
People with PTSD generally have lower amounts of cortisol circulating through their bodies. These levels spike when a traumatic memory is recalled, and the memories don’t fade over time like they would in people with normal-functioning HPA axis responses.
The HPA axis is more sensitive and responds more strongly to stress in females than males, especially during certain points in the menstrual cycle. If a woman is later in her cycle, her brain will release more cortisol.
Therefore, if a traumatic event happens to a woman while she is in the luteal phase of her menstrual cycle instead of follicular, she’s more likely to develop flashback symptoms and PTSD.
Men are vulnerable to developing post-traumatic stress disorder in other ways. The hippocampus—the part of the brain that forms memories—decreases in volume in individuals with PTSD.
The decrease is more pronounced in men than in women. This means that women with PTSD have less memory loss and cognitive impairment as a result of trauma than men do.
Men also appear to have a more sensitive hyperarousal system. This means they’re more likely to experience symptoms like paranoia and impulsivity.
PTSD Symptoms That Differ Based on Gender
Women are more likely to experience:
- Emotional numbness
- Avoidance symptoms
- Comorbid mood and anxiety disorders
- Shame and self-blame
Men are more likely to experience:
- Comorbid substance use disorders
- Exaggerated startle response
All symptoms of PTSD can be experienced by men or women.
These are only trends for which symptoms appear most commonly.
How people cope with post-traumatic stress can also be based on society. Women may feel more comfortable talking about their feelings with loved ones, while men may turn to substances or become irritable—even angry—at others to try to cope.
How Is PTSD Treated in Men and Women?
Despite the different ways trauma affects brain chemistry in each gender, research has shown that the same medications that work for one sex tend to work for the other. The same is true for therapy and transcranial magnetic stimulation (TMS).
Men and women might have different reactions to therapy, however. As described above, women are more likely to be open with their feelings than men, who tend to internalize.
For that reason, fully participating in therapy may be more difficult for males than females.
Effective treatments for PTSD include:
Cognitive Behavioral Therapy (CBT)
This talk therapy involves learning about the relationship between thoughts, feelings, and actions. Clients learn to respond differently to their flashbacks or negative beliefs about themselves and the world.
A variety of coping skills are taught, like meditation and self-soothing. If there’s a co-occurring mental health disorder, CBT can help with it as well.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
EMDR helps desensitize clients to the painful emotions that come from trauma. Clients are directed to remember their traumatic events while watching a therapist use a repetitive motion, like moving his or her hand across the client’s field of vision.
Clients are trained to replace the negative emotions and beliefs with positive ones during this time.
Selective serotonin reuptake inhibitors (SSRIs) are effective in treating PTSD for men and women. Fluoxetine or sertraline help decrease painful emotions that come with trauma, like anxiety and depression. Prazosin is a medication that can help with insomnia and nightmares.
Transcranial Magnetic Stimulation (TMS)
TMS for PTSD targets the areas of the brain responsible for symptoms like flashbacks, nightmares, and intense anxiety. During a TMS session, a technician gently places a coil on the client’s head.
The coil delivers magnetic stimulation to the specific areas of the brain affected by trauma and helps to correct brain chemistry. Success TMS Treatment Centers offers TMS for PTSD at a variety of locations.
The brain chemistry and the number of events that can lead to PTSD can seem complicated overwhelming. Fortunately, treatment for PTSD doesn’t have to be.
No matter your gender, there are treatments that can get you feeling better quickly. Don’t hesitate to reach out to Success TMS to see if TMS therapy may be right for you.