Query: sex differences hormones eating disorders

title: Effects of Estrogens on Central Nervous System Neurotransmission: Implications for Sex Differences in Mental Disorders.
abstract: Nearly one of every five US individuals aged 12 years old or older lives with certain types of mental disorders. Men are more likely to use various types of substances, while women tend to be more susceptible to mood disorders, addiction, and eating disorders, all of which are risks associated with suicidal attempts. Fundamental sex differences exist in multiple aspects of the functions and activities of neurotransmitter mediated neural circuits in the central nervous system (CNS) Dysregulation of these neural circuits leads to various types of mental disorders. The potential mechanisms of sex differences in the CNS neural circuitry regulating mood, reward, and motivation are only beginning to be understood, although they have been largely attributed to the effects of sex hormones on CNS neurotransmission pathways. Understanding this topic is important for developing prevention and treatment of mental disorders that should be tailored differently for men and women. Studies using animal models have provided important insights into pathogenesis, mechanisms, and new therapeutic approaches of human diseases, but some concerns remain to be addressed. The purpose of this chapter is to integrate human and animal studies involving the effects of the sex hormones, estrogens, on CNS neurotransmission, reward processing, and associated mental disorders. We provide an overview of existing evidence for the physiological, behavioral, cellular, and molecular actions of estrogens in the context of controlling neurotransmission in the CNS circuits regulating mood, reward, and motivation and discuss related pathology that leads to mental disorders.

title: Sex Differences in Binge Eating: Gonadal Hormone Effects Across Development.
abstract: Eating disorders are highly sexually differentiated disorders that exhibit a female predominance in risk. Most theories focus on psychosocial explanations to the exclusion of biological/genetic influences. The purpose of this descriptive review is to evaluate evidence from animal and human studies in support of gonadal hormone effects on sex differences in binge eating. Although research is in its nascent stages, findings suggest that increased prenatal testosterone exposure in males appears to protect against binge eating. Although pubertal testosterone may exert additional protective effects, the prenatal period is likely critical for the decreased risk observed in males. By contrast, studies indicate that, in females, it is the lack of prenatal testosterone coupled with the organizational effects of pubertal ovarian hormones that may lead to increased binge eating. Finally, twin data suggest that changes in genetic risk may underlie these hormone influences on sex differences across development.

title: Sex Differences in Adolescent Anorexia and Bulimia Nervosa: Beyond the Signs and Symptoms
abstract: of ReviewWe review research related to sex differences in eating disorders (EDs) in adolescents. Prior work has explored clinical differences; thus, we examine literature in areas identified as playing an etiological or maintenance role in EDs including: genetics, hormones, neurocognitive inefficiencies, and reward circuitry.Recent FindingsSex steroids appear to a play role in the unmasking of genetic risk for development of EDs and puberty may be a heightened period of risk for females. While neurocognitive differences have been well studied in adults with ED, research with adolescents has been less conclusive. Recent work suggests that neural circuitry involved in reward and punishment may play role in development and maintenance of EDs in females. Males are underrepresented in these areas of research.SummaryGiven known sex differences in healthy adolescents, it is likely there are sex differences in the putative biological etiology/maintenance of EDs. Males should be included in future research.

title: Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross Sex Hormone Treatment
abstract: Many transgender people experience high levels of body dissatisfaction, which is one of the numerous factors known to increase vulnerability to eating disorder symptoms in the cisgender (non trans) population. Cross sex hormones can alleviate body dissatisfaction so might also alleviate eating disorder symptoms. This study aimed to explore risk factors for eating disorder symptoms in transgender people and the role of cross sex hormones. Individuals assessed at a national transgender health service were invited to participate (N 563) Transgender people not on cross sex hormones reported higher levels of eating disorder psychopathology than people who were. High body dissatisfaction, perfectionism, anxiety symptoms, and low self esteem were risk factors for eating psychopathology, but, after controlling for these, significant differences in eating psychopathology between people who were and were not on cross sex hormones disappeared. Cross sex hormones may alleviate eating disorder psychopathology. Given the high prevalence of transgender identities, clinicians at eating disorder services should assess for gender identity issues.

title: Sex differences in motivated behaviors in animal models
abstract: Sex differences exist in the motivation for sexual behavior, food, parental care and motivation to take drugs. There are also sex differences in the likelihood of exhibiting motivational disorders such as anhedonia, depression, addictive behavior, and eating disorders. This brief review summaries recent studies on sex differences in all motivated behaviors in social and non social contexts, focusing on animal models. We also discuss the roles of gonadal hormones and the nonapeptides (nine amino acid peptides) in modulating sex differences in motivation. We propose that sex differences in the neural mechanisms mediating endogenous motivation for food, sex, partners and care of offspring underlie sex differences in all motivated behaviors.

title: Gonadal hormone contributions to individual differences in eating disorder risk.
abstract: Females experience eating disorders at substantially higher rates than males. Although sociocultural factors have traditionally been thought to underlie this sex disparity, accumulating evidence implicates differential exposure to gonadal hormones early in life. Gonadal hormones also impact within sex variability in disordered eating, helping to explain why not all women develop an eating disorder, and some men do. We review recent findings regarding these gonadal hormone effects and their implications for the etiology of eating disorders.  Males are exposed to significantly higher testosterone levels than females perinatally, and this exposure appears to protect against later binge eating in males relative to females. Within sex, higher estradiol levels among females and higher testosterone levels among males appear to be protective. Progesterone exhibits minimal direct phenotypic effects on disordered eating but appears to counteract the protective effects of estrogen in adult females. Importantly, gonadal hormone effects may be moderated by psychosocial factors.  Evidence suggests that gonadal hormones play a critical role in the etiology of disordered eating. Overall, higher testosterone and estrogen appear to be protective across development. Additional research is needed to identify mechanisms underlying these effects and further explore interactions between hormonal and psychosocial risk.

title: The emergence of sex differences in risk for disordered eating attitudes during puberty: a role for prenatal testosterone exposure.
abstract: Research suggests that prenatal testosterone exposure may masculinize (i.e. lower) disordered eating (DE) attitudes and behaviors and influence the lower prevalence of eating disorders in males versus females. How or when these effects become prominent remains unknown, although puberty may be a critical developmental period. In animals, the masculinizing effects of early testosterone exposure become expressed during puberty when gonadal hormones activate sex typical behaviors, including eating behaviors. This study examined whether the masculinizing effects of prenatal testosterone exposure on DE attitudes emerge during puberty in 394 twins from opposite sex and same sex pairs. Twin type (opposite sex vs. same sex) was used as a proxy for level of prenatal testosterone exposure because females from opposite sex twin pairs are thought to be exposed to testosterone in utero from their male co twin. Consistent with animal data, there were no differences in levels of DE attitudes between opposite sex and same sex twins during pre early puberty. However, during mid late puberty, females from opposite sex twin pairs (i.e. females with a male co twin) exhibited more masculinized (i.e. lower) DE attitudes than females from same sex twin pairs (i.e. females with a female co twin) independent of several "third variables" (e.g. body mass index [BMI] anxiety) Findings suggest that prenatal testosterone exposure may decrease DE attitudes and at least partially underlie sex differences in risk for DE attitudes after mid puberty.

title: Purging Behavior Modulates the Relationships of Hormonal and Behavioral Parameters in Women with Eating Disorders
abstract: There is ample consensus that there is a neurophysiological basis for eating disorders (ED) Traits of personality translate into behavioral traits, purging being a well defined transversal example. The direct implication of steroid hormones on ED has seldom been studied, despite their effects on behavior.  After psychological interview analysis, 57 ED female patients (31 purgative and 26 nonpurgative) and 17 female controls were studied. Metabolic parameters and analysis of androgen, estrogen and glucocorticoid hormones were determined in parallel to the psychopathological profile (EDI 2 and SCL 90 R) and anthropometric measurements.  Psychometric tests showed clear differences between ED and controls, but there were few hormonal metabolic significant differences. In purgative ED there were repeated (significant) positive correlations with corticosteroid binding globulin (CBG) and negative correlations with sex hormone binding globulin (SHBG) versus eating and general psychopathology. In nonpurging ED there were positive correlations for deoxycortisol, free fatty acids and albumin and negative for aspartate aminotransferase and psychopathological traits.  The data suggest that CBG/corticosteroids and sexual hormones/SHBG are involved in purging behavior and its psychopathology and severity scores. Correlations of selected psychometric data and the CBG/SHBG levels in purging may eventually result in clinical markers. This approach may provide additional clues for understanding the pathogenesis of ED.

title: Sex differences in salivary cortisol in response to acute stressors among healthy participants, in recreational or pathological gamblers, and in those with posttraumatic stress disorder
abstract: Sex differences in incidence and severity of some stress related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic pituitary adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or posttraumatic stress disorder (PTSD) Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress related experiences, will be the subject of future investigation.

title: Preliminary evidence that gonadal hormones organize and activate disordered eating
abstract: Eating disorders are more common in females than in males. Gender differences may be due to organizational (i.e. prenatal) and activational (i.e. post natal) gonadal hormone effects that influence sex differences in behavior. This preliminary set of studies examined these effects by investigating relationships between eating disorder symptoms, prenatal testosterone exposure, and adult levels of estrogen in women.  We examined organizational associations by investigating relationships between disordered eating and finger length ratios, which are known to be somatic markers of prenatal testosterone exposure. Participants included 113 adult female twins drawn from the community. Disordered eating was assessed with the total score from the Minnesota Eating Behavior Survey (MEBS) Finger lengths were hand scored using a ruler and photocopies of both hands. We also investigated activational influences by examining associations between circulating levels of estradiol and disordered eating symptoms. Two independent samples of adult females (n's=24 and 25) drawn from the community were used for this study. Disordered eating was again assessed with the MEBS total score, while saliva samples were used for assessing estradiol.  Positive associations were found between disordered eating and both finger length ratios and circulating estradiol levels.  Findings suggest that lower levels of prenatal testosterone exposure and higher adult levels of estradiol are associated with increased eating disorder symptoms. We hypothesize that the relatively low level of testosterone before birth in females permits their brains to respond to estrogens at puberty, when the hormones activate the genes contributing to disordered eating in vulnerable girls.