Cortisol, Dehydroepiandrosterone, and Estradiol Measured Over 24 Hours in Women With Childhood Sexual Abuse-Related Posttraumatic Stress Disorder

Abstract

Preclinical studies have shown long-term alterations in several hormonal systems including cortisol, dehydroepiandrosterone (DHEA) and DHEA-Sulfate, and estradiol. The purpose of this study was to assess cortisol, DHEA, and estradiol over a 24-hour period in women with early childhood sexual abuse and posttraumatic stress disorder (PTSD); with early abuse and without PTSD; and women without early abuse or PTSD. Forty-three women with early childhood sexual abuse and PTSD, early abuse without PTSD, and without abuse or PTSD, underwent a comprehensive assessment of hormones in plasma at multiple time points over a 24-hour period. Abused women with PTSD had lower concentrations of cortisol during the afternoon hours (12-8 p.m.) compared with women with abuse without PTSD and women without abuse or PTSD. DHEA-Sulfate was elevated throughout the 24-hour period in PTSD women, although this was of marginal statistical significance. There were no differences between groups in DHEA or estradiol. PTSD women also had increased cortisol pulsatility compared with the other groups. These findings suggest that a resting hypocortisolemia in the afternoon hours with increased cortisol pulsatility is associated with childhood abuse-related PTSD in women.

The impact of childhood maltreatment on biological systems: Implications for clinical interventions

“…In agreement with the latter evidence in children, adults with a history of childhood maltreatment consistently demonstrate lower morning cortisol levels and a flattening of the diurnal cycle (16)(17)(18). Lower afternoon and evening cortisol levels were reported in abused women with a history of PTSD compared with nonabused control groups (16,17).…”

“…Lower afternoon and evening cortisol levels were reported in abused women with a history of PTSD compared with nonabused control groups (16,17). In addition, in a longitudinal epidemiological study following a cohort of individuals from childhood to middle age, high levels of reported maltreatment were associated with lower cortisol levels 45 min after awakening in both men and women, and a less steep morning decline in cortisol levels in women, but not in men (18).…”

Social isolation dysregulates endocrine and behavioral stress while increasing malignant burden of spontaneous mammary tumors

“…Beginning in early adulthood and continuing throughout midlife of the female rat, we found that the adrenal axis of socially isolated animal was dysregulated, first manifesting as a higher corticosterone response and ultimately as markedly low baseline corticosterone levels indicative of hypocortisolemia (28). This was followed by high and sustained levels of corticosterone in response to a moderate stressor.…”

Structural and functional plasticity of the human brain in posttraumatic stress disorder

“…Some studies (Yehuda et al, 1991b(Yehuda et al, , 1994(Yehuda et al, , 1996, but not others (Young and Breslau, 2004a, b) found decreased cortisol in 24 h urines or in diurnal salivary samples. Two studies using comprehensive measurement of plasma cortisol at multiple time points found lower cortisol concentrations in the afternoon (Yehuda et al, 1996;Bremner et al, 2007). Women with early childhood sexual abuse and PTSD were found to have lower afternoon cortisol and an increase in cortisol pulsatility compared to controls (Bremner et al, 2007).…”