This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kudielka, B. M. Articles by Kirschbaum, C. Search for Related Content PubMed PubMed Citation Articles by Kudielka, B. M. Articles by Kirschbaum, C.

Sex Differences in Endocrine and Psychological Responses to Psychosocial Stress in Healthy Elderly Subjects and the Impact of a 2-Week Dehydroepiandrosterone Treatment¹

Center for Psychobiological and Psychosomatic Research, University of Trier (B.M.K., J.H., D.H.H., O.T.W., K.-M.P., C.K.), Trier, Germany; the Department of Psychiatry and Psychotherapy, Semmelweis University of the Medical Sciences (E.V.), Budapest, Hungary; and the Department of Psychiatry, University of Göttingen (J.P.), Göttingen, Germany

Address all correspondence and requests for reprints to: Dr. Clemens Kirschbaum, Center for Psychobiological and Psychosomatic Research, University of Trier, Dietrichstrasse 10–11, 54290 Trier, Germany. E-mail: kirschba{at}uni-trier.de

Evidence from animal as well as human studies has suggested that significant sex differences exist in hypothalamus-pituitary-adrenal axis (HPA) activity. As gonadal steroids could be important modulators of HPA sex differences, stress responses were investigated in subjects of advanced age after dehydroepiandrosterone (DHEA) or placebo treatment.

After a 2-week treatment with 50 mg DHEA daily or placebo, 75 men and women (mean age, 67.6 yr) were exposed to the Trier Social Stress Test (TSST). The TSST is a brief psychosocial stress that consists of a free speech and mental arithmetic task in front of an audience. The results show that the TSST induced significant increases in ACTH, salivary free cortisol, total plasma cortisol, norepinephrine, and heart rates (all P < 0.0001) as well as decreased positive affect in the elderly (P = 0.0009). Men showed larger stress responses in ACTH (P = 0.004), salivary free cortisol (P = 0.044), and plasma total cortisol (P = 0.076) compared to women. No sex differences were observed in norepinephrine, epinephrine, or heart rate responses. In contrast to ACTH and cortisol response differences, women reported that they were significantly more stressed by the TSST than men (P = 0.0051).

Women treated with DHEA showed ACTH stress responses similar to those of men, but significantly enhanced compared to those of women taking placebos (P < 0.009). No other stress response differences emerged between DHEA and placebo groups. Finally, DHEA treatment did not result in an improvement of subjective well-being.

We conclude that elderly men show larger HPA responses than women to psychosocial stress, as studied in the TSST. Estrogen effects on hypothalamic CRF-producing neurons might be responsible for these sex differences.

This article has been cited by other articles:

				J. M. Kaufman and A. Vermeulen The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications Endocr. Rev., October 1, 2005; 26(6): 833 - 876. [Abstract] [Full Text] [PDF]

				P. A. Deuster, M. M. Faraday, G. P. Chrousos, and M. A. Poth Effects of Dehydroepiandrosterone and Alprazolam on Hypothalamic-Pituitary Responses to Exercise J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4777 - 4783. [Abstract] [Full Text] [PDF]

				K. Putnam, G. P. Chrousos, L. K. Nieman, and D. R. Rubinow Sex-Related Differences in Stimulated Hypothalamic-Pituitary-Adrenal Axis during Induced Gonadal Suppression J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4224 - 4231. [Abstract] [Full Text] [PDF]

				R. M Reynolds, B. R Walker, H. E Syddall, R. Andrew, P. J Wood, and D. I W Phillips Is there a gender difference in the associations of birthweight and adult hypothalamic-pituitary-adrenal axis activity? Eur. J. Endocrinol., February 1, 2005; 152(2): 249 - 253. [Abstract] [Full Text] [PDF]

				S. Wust, E. F. C. van Rossum, I. S. Federenko, J. W. Koper, R. Kumsta, and D. H. Hellhammer Common Polymorphisms in the Glucocorticoid Receptor Gene Are Associated with Adrenocortical Responses to Psychosocial Stress J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 565 - 573. [Abstract] [Full Text] [PDF]

				M. Heinrichs, G. Meinlschmidt, I. Neumann, S. Wagner, C. Kirschbaum, U. Ehlert, and D. H. Hellhammer Effects of Suckling on Hypothalamic-Pituitary-Adrenal Axis Responses to Psychosocial Stress in Postpartum Lactating Women J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4798 - 4804. [Abstract] [Full Text] [PDF]

				J. T. Noteboom, M. Fleshner, and R. M. Enoka Activation of the arousal response can impair performance on a simple motor task J Appl Physiol, August 1, 2001; 91(2): 821 - 831. [Abstract] [Full Text] [PDF]

				S. S. C. Yen Dehydroepiandrosterone sulfate and longevity: New clues for an old friend PNAS, July 17, 2001; 98(15): 8167 - 8169. [Full Text] [PDF]

				W. Arlt, F. Callies, J. C. van Vlijmen, I. Koehler, M. Reincke, M. Bidlingmaier, D. Huebler, M. Oettel, M. Ernst, H. M. Schulte, et al. Dehydroepiandrosterone Replacement in Women with Adrenal Insufficiency N. Engl. J. Med., September 30, 1999; 341(14): 1013 - 1020. [Abstract] [Full Text] [PDF]

				C. Kirschbaum, B. M. Kudielka, J. Gaab, N. C. Schommer, and D. H. Hellhammer Impact of Gender, Menstrual Cycle Phase, and Oral Contraceptives on the Activity of the Hypothalamus-Pituitary-Adrenal Axis Psychosom Med, March 1, 1999; 61(2): 154 - 162. [Abstract] [Full Text] [PDF]