Steroid secretion in healthy aging

Early Life Trauma, Emotion Dysregulation and Hormonal Sensitivity Across Female Reproductive Life Events

PURPOSE OF REVIEW

To explore the relationship between early life trauma, hormonal sensitivity, and psychiatric disorders across female-reproductive life events, with a focus on the neurobiological mechanisms.

RECENT FINDINGS

Childhood trauma significantly increases the risk of subsequent mood disorders during periods of intense hormonal fluctuation such as premenstrual, pregnancy, postpartum, and perimenopause. Neurobiological changes resulting from early trauma influence emotion regulation, which emerges as a key predisposing, exacerbating, and perpetuating factor to hormonal sensitivity and subsequent psychiatric symptoms. We identified altered stress response and allopregnanolone imbalance, bias in cognitive processing of emotions, neuroimage correlates and sleep disturbances as potential underlying neurobiological mechanisms. This review integrates cumulative findings supporting a theoretical framework linking early life trauma to hormonal sensitivity and mood disorders. We propose that some women might be more susceptible to such hormonal fluctuations because of emotion dysregulation following significant early life trauma.

Exercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition amongst females of reproductive age, leading to lifelong cardiometabolic, reproductive, psychological, and dermatologic symptoms as well as a reduced quality of life. Lifestyle interventions, which can include structured exercise programmes delivered by appropriately trained exercise professionals such as clinical exercise physiologists, are considered first-line strategies in PCOS management due to their therapeutic effects on various health outcomes and quality of life. This position statement builds on the 2023 International Evidence-based Guideline for the Assessment and Management of PCOS and describes the role of the exercise professional in the context of the multidisciplinary care team which includes physicians and allied health professionals. This position statement aims to equip exercise professionals with a broad understanding of the pathophysiology of PCOS, how it is diagnosed and managed in clinical practice, and evidence- and consensus-based recommendations for physical activity and exercise in PCOS management. In line with the physical activity recommendations for the general public, individuals with PCOS should aim to undertake between 150 to 300min of moderate-intensity or 75 to 150min of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week. Additionally, muscle-strengthening activities on two non-consecutive days per week are recommended to maintain health and prevent weight gain. For further health benefits and to achieve modest weight loss, individuals with PCOS should aim for a minimum of 250min of moderate-intensity or 150min of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week, plus muscle-strengthening activities on two non-consecutive days per week. Adolescents with PCOS should aim for a minimum of 60min moderate- to vigorous-intensity activity each day, incorporating muscle- and bone-strengthening activities three times per week. Finally, exercise professionals should consider the significant psychological burden, including weight stigma, and the high prevalence of comorbidities amongst individuals with PCOS and take appropriate measures to deliver safe and efficacious exercise interventions.

Longitudinal associations between depressive symptoms and cell deformability: do glucocorticoids play a role?

Cell deformability of all major blood cell types is increased in depressive disorders (DD). Furthermore, impaired glucocorticoid secretion is associated with DD, as well as depressive symptoms in general and known to alter cell mechanical properties. Nevertheless, there are no longitudinal studies examining accumulated glucocorticoid output and depressive symptoms regarding cell deformability. The aim of the present study was to investigate, whether depressive symptoms predict cell deformability one year later and whether accumulated hair glucocorticoids mediate this relationship. In 136 individuals (nfemale = 100; Mage = 46.72, SD = 11.28; age range = 20-65), depressive symptoms (PHQ-9) and hair glucocorticoids (cortisol and cortisone) were measured at time point one (T1), while one year later (T2) both depressive symptoms and hair glucocorticoids were reassessed. Additionally, cell deformability of peripheral blood cells was assessed at T2. Depression severity at T1 predicted higher cell deformability in monocytes and lymphocytes at T2. Accumulated hair cortisol and cortisone concentrations from T1 and T2 were not associated with higher cell deformability and further did not mediate the relationship between depressive symptoms and cell deformability. Elevated depressive symptomatology in a population based sample is longitudinally associated with higher immune cell deformability, while long-term integrated glucocorticoid levels seem not to be implicated in the underlying mechanism.

Sex Differences in Stress Response: Classical Mechanisms and Beyond

Neuropsychiatric disorders, which are associated with stress hormone dysregulation, occur at different rates in men and women. Moreover, nowadays, preclinical and clinical evidence demonstrates that sex and gender can lead to differences in stress responses that predispose males and females to different expressions of similar pathologies. In this curated review, we focus on what is known about sex differences in classic mechanisms of stress response, such as glucocorticoid hormones and corticotrophin-releasing factor (CRF), which are components of the hypothalamicpituitary- adrenal (HPA) axis. Then, we present sex differences in neurotransmitter levels, such as serotonin, dopamine, glutamate and GABA, as well as indices of neurodegeneration, such as amyloid β and Tau. Gonadal hormone effects, such as estrogens and testosterone, are also discussed throughout the review. We also review in detail preclinical data investigating sex differences caused by recentlyrecognized regulators of stress and disease, such as the immune system, genetic and epigenetic mechanisms, as well neurosteroids. Finally, we discuss how understanding sex differences in stress responses, as well as in pharmacology, can be leveraged into novel, more efficacious therapeutics for all. Based on the supporting evidence, it is obvious that incorporating sex as a biological variable into preclinical research is imperative for the understanding and treatment of stress-related neuropsychiatric disorders, such as depression, anxiety and Alzheimer's disease.

The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions

The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.

Epigenetics of the far northern Yakutian population

BACKGROUND

Yakuts are one of the indigenous populations of the subarctic and arctic territories of Siberia characterized by a continental subarctic climate with severe winters, with the regular January average temperature in the regional capital city of Yakutsk dipping below - 40 °C. The epigenetic mechanisms of adaptation to such ecologies and environments and, in particular, epigenetic age acceleration in the local population have not been studied before.

RESULTS

This work reports the first epigenetic study of the Yakutian population using whole-blood DNA methylation data, supplemented with the comparison to the residents of Central Russia. Gene set enrichment analysis revealed, among others, geographic region-specific differentially methylated regions associated with adaptation to climatic conditions (water consumption, digestive system regulation), aging processes (actin filament activity, cell fate), and both of them (channel activity, regulation of steroid and corticosteroid hormone secretion). Further, it is demonstrated that the epigenetic age acceleration of the Yakutian representatives is significantly higher than that of Central Russia counterparts. For both geographic regions, we showed that epigenetically males age faster than females, whereas no significant sex differences were found between the regions.

CONCLUSIONS

We performed the first study of the epigenetic data of the Yakutia cohort, paying special attention to region-specific features, aging processes, age acceleration, and sex specificity.

60 years of healthy aging: On definitions, biomarkers, scores and challenges

BACKGROUND AND OBJECTIVE

As the proportion of aging people in our population increases steadily, global strategies accompanied by extensive research are necessary to tackle society and health service challenges. The World Health Organization recently published an action plan: "Decade of healthy aging 2020-2030", which calls for concerted collaboration to prevent poverty of older people to provide quality education, job opportunities, and an age-inclusive infrastructure. However, scientists worldwide still struggle to find definitions and appropriate measurements of aging per se and healthy aging in particular. This literature review aims to compile concepts of healthy aging and provide a condensed overview of the challenges in defining and measuring it, along with suggestions for further research.

MATERIALS AND METHODS

We conducted three independent systematic literature searches covering the main scopes addressed in this review: (1) concepts and definitions of healthy aging, (2) outcomes and measures in (healthy) aging studies and (3) scores and indices of healthy aging. For each scope, the retrieved literature body was screened and subsequently synthesized.

RESULTS

We provide a historical overview of the concepts of healthy aging over the past 60 years. Furthermore, we identifiy current difficulties in identifying healthy agers, including dichotomous measurements, illness-centered views, study populations & designs. Secondly, markers and measures of healthy aging are discussed, including points to consider, like plausibility, consistency, and robustness. Finally, we present healthy aging scores as measurements, which combine multiple aspects to avoid a dichotomous categorization and display the bio-psycho-social concept of healthy aging.

DISCUSSION AND CONCLUSION

When deducting research, scientists need to consider the diverse challenges in defining and measuring healthy aging. Considering that, we recommend scores that combine multiple aspects of healthy aging, such as the Healthy Ageing Index or the ATHLOS score, among others. Further efforts are to be made on a harmonized definition of healthy aging and validated measuring instruments that are modular, easy to apply and provide comparable results in different studies and cohorts to enhance the generalization of results.

Evaluation of a male-specific psychotherapeutic program for major depressive disorder compared to cognitive behavioral therapy and waitlist: study protocol for a six-arm randomized clinical superiority trial examining depressed eugonadal and hypogonadal men receiving testosterone

Background

Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogonadal (e.g., total testosterone levels <12.1 nmoL/L). Therefore, it is recommended to examine depressed men with regard to their testosterone status and if hypogonadism is present to combine psychotherapy with testosterone treatment (TT).

Aim

This project aims to evaluate a male-specific psychotherapeutic program (MSPP) for MDD in depressed eugonadal and hypogonadal men receiving testosterone in comparison to a standard cognitive behavioral therapy (CBT) for MDD and a Waitlist.

Methods

The study presents a 2×3 factorial study design. In total, 144 men aged between 25 and 50 will be stratified by testosterone status (eugonadal/hypogonadal) and then randomized into one of the three conditions (MSPP, CBT, or Waitlist). Additionally, a healthy control group of 100 men will be recruited, which will undergo only baseline assessments. Both standardized psychotherapy programs will encompass 18 sessions delivered in a weekly manner. Aligned with the TT-related medical visits of the 72 hypogonadal men, all participants will be followed up with clinical assessments and bio sampling at weeks 0, 6, 15, 24, and 36.

Expected results

Compared to Waitlist control groups, treatment groups are expected to be more effective and efficacious (depression score reduction of ≥50%) at week 24 and at the follow-up at week 36. The MSPP is expected to show higher effectiveness and efficacy for depressive symptoms and higher acceptability (lower dropout rate) as compared to CBT.

Discussion

This study represents the first attempt to test a male-specific psychotherapy for MDD in a single-setting compared to standard CBT and a Waitlist control condition using randomized clinical trial methodology. In addition, the potential positive adjunct effect of psychotherapy to TT in reducing depressive burden and improving quality of life in hypogonadal depressed men represents a neglected research area and might introduce new hypogonadism screening procedures in depressed men and combined treatment approaches for depressed men suffering from hypogonadism. Limitations are the rigorous inclusion and exclusion criteria, which limit the generalizability of the study results to first episode treatment naïve depressed men.

Clinical Trial Registration

ClinicalTrials.gov, identifier NCT05435222.

Gender Differences in Attachment Anxiety and Avoidance and Their Association with Psychotherapy Use—Examining Students from a German University

Attachment anxiety and avoidance might explain gender differences in psychotherapy use, which is generally lower in men. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal. A total of 4894 students completed an online survey answering questions regarding psychotherapy use and completing the PHQ-D identifying psychological syndromes. In addition, the ECR-RD12 was used to measure attachment anxiety and avoidance. Significant gender differences for attachment anxiety and avoidance emerged, showing higher attachment anxiety in female students and higher attachment avoidance in male students. Male students used psychotherapy significantly less than female students. Male students’ attachment anxiety and avoidance predicted psychotherapy use, while for female students, only attachment anxiety emerged as a significant predictor. Attachment anxiety is positively associated with psychotherapy use, and lower attachment anxiety in men may explain lower psychotherapy use in male students.

Why Does Psychotherapy Work and for Whom? Hormonal Answers

The questions of for whom and why psychotherapy is effective have been the focus of five decades of research. Most of this knowledge is based on self-report measures. Following the biopsychosocial model of mental disorders, this article explores the potential of hormones in answering these questions. The literature on cortisol, oxytocin, and oestradiol in psychotherapy was systematically searched, focusing on (a) baseline hormonal predictors of who may benefit from psychotherapy and (b) hormonal changes as indicators of therapeutic change. The search was limited to depression and anxiety disorders. In sum, the findings show that, of all three hormones, the role of cortisol is most established and that both cortisol and oxytocin are implicated in psychotherapy, although a causal role is still waiting to be demonstrated. Moreover, there is a differential role of hormones in the psychotherapy of depression versus anxiety. The directions of research mapped in this article may elucidate how psychotherapy can be selected to match patients’ endocrine states and how hormonal levels can be manipulated to improve outcomes.

Synthesis, In Silico, and Biological Evaluation of a Borinic Tryptophan-Derivative That Induces Melatonin-like Amelioration of Cognitive Deficit in Male Rat

Preclinical and clinical evidence supports melatonin and its analogues as potential treatment for diseases involving cognitive deficit such as Alzheimer's disease. In this work, we evaluated by in silico studies a set of boron-containing melatonin analogues on MT1 and MT2 receptors. Then, we synthesized a compound (borolatonin) identified as potent agonist. After chemical characterization, its evaluation in a rat model with cognitive deficit showed that it induced ameliorative effects such as those induced by equimolar administration of melatonin in behavioral tests and in neuronal immunohistochemistry assays. Our results suggest the observed effects are by means of action on the melatonin system. Further studies are required to clarify the mechanism(s) of action, as the beneficial effects on disturbed memory by gonadectomy in male rats are attractive.

Carving the senescent phenotype by the chemical reactivity of catecholamines: An integrative review

Macromolecules damaged by covalent modifications produced by chemically reactive metabolites accumulate in the slowly renewable components of living bodies and compromise their functions. Among such metabolites, catecholamines (CA) are unique, compared with the ubiquitous oxygen, ROS, glucose and methylglyoxal, in that their high chemical reactivity is confined to a limited set of cell types, including the dopaminergic and noradrenergic neurons and their direct targets, which suffer from CA propensities for autoxidation yielding toxic quinones, and for Pictet-Spengler reactions with carbonyl-containing compounds, which yield mitochondrial toxins. The functions progressively compromised because of that include motor performance, cognition, reward-driven behaviors, emotional tuning, and the neuroendocrine control of reproduction. The phenotypic manifestations of the resulting disorders culminate in such conditions as Parkinson's and Alzheimer's diseases, hypertension, sarcopenia, and menopause. The reasons to suspect that CA play some special role in aging accumulated since early 1970-ies. Published reviews address the role of CA hazardousness in the development of specific aging-associated diseases. The present integrative review explores how the bizarre discrepancy between CA hazardousness and biological importance could have emerged in evolution, how much does the chemical reactivity of CA contribute to the senescent phenotype in mammals, and what can be done with it.

Steroid Hormone Secretion Over the Course of the Perimenopause: Findings From the Swiss Perimenopause Study

Background: Perimenopause is characterized by a decline in the steroid hormones, estradiol, and progesterone. By contrast, the steroid hormone cortisol, a marker of the hypothalamic–pituitary–adrenal (HPA) axis, increases. Recent longitudinal studies reported fluctuations in steroid hormone levels during perimenopause, and even increases in estradiol levels. To understand these confounding results, it is necessary to conduct a longitudinal, highly standardized assessment of steroid hormone secretion patterns in perimenopausal women.

Methods: This longitudinal study investigated 127 perimenopausal women aged 40–56 years for 13 months. Estradiol, progesterone, and cortisol were assessed using saliva samples, which were collected for two (during months 2 and 12 for estradiol and progesterone) or three (during months 2, 7, and 12 for cortisol) non-consecutive months over the course of the study. A total of 14 saliva samples per participant were analyzed to investigate the courses of estradiol and progesterone. Cortisol awakening response and fluctuations of cortisol throughout the day were measured using a total of 11 saliva samples per participant (on awakening, +30 min, +60 min, at 12:00 p.m., and before going to bed) for months 2, 7, and 12.

Results: Multilevel analyses revealed variance in intercept and slope across participants for estradiol [intercept: SD = 5.16 (95% CI: 4.28, 6.21), slope: SD = 0.50 (95% CI: 0.39, 0.64)], progesterone [intercept: SD = 34.77 (95% CI: 25.55, 47.31), slope: SD = 4.17 (95% CI: 2.91, 5.99)], and cortisol (intercept: SD = 0.18 (95% CI: 0.14, 0.23), slope: SD = 0.02 (95% CI: 0.01, 0.02)]. Time predicted cortisol levels [b = −0.02, t₍₉₇₉₎ = −6.63, p < 0.0001]. Perimenopausal status (early vs. late) did not predict estradiol [b = −0.36, t₍₁₆₀₈₎ = −0.84, p = 0.400], progesterone [b = −4.55, t₍₁₇₂₃₎ = −0.87, p = 0.385], or cortisol [b = 0.01, t₍₁₁₂₄₎ = 0.61, p = 0.542] scores over time.

Discussion: Our results are consistent with previous findings emphasizing highly individual fluctuations of estradiol and progesterone levels during perimenopause. However, our findings do not suggest a continuous decline during the observed transition phase, implying relatively stable periods of fluctuating hormone levels. Furthermore, given the lack of significant group differences, it may not be necessary to differentiate between early and late perimenopause from the standpoint of hormonal progression.

Female Intrasexual Competition and Its Link to Menopausal Stage, Sex Hormone Levels, and Personality Characteristics

Background: Female intrasexual competition (ISC) represents a unique form of social interaction. It describes behaviors primarily applied to enhance a woman's ability to outcompete other women. Previous research suggests that female ISC is influenced by personality characteristics and sex hormones. Although these factors most likely interact to predict female ISC, no previous study has investigated those factors in parallel in order to link theories from social psychology and biology. Women at the end of the reproductive lifespan represent the ideal study population, as they allow for a controlled hormonal environment.

Materials and Methods: Healthy pre- (N = 53) and postmenopausal (N = 56) women were classified according to the Stages of Reproductive Aging Workshop (STRAW+10) criteria. In the follicular phase (for premenopausal women) or on a random day (for postmenopausal women), questionnaires were administered to assess the general tendency to compete intrasexually and the tendency to compete on appearance, attention/interpersonal success, and competence. Additionally, personality characteristics (neuroticism, extraversion, openness, agreeableness, conscientiousness, and self-esteem) were assessed. On the same day, each subject provided an 8 a.m. saliva sample for estradiol, testosterone, progesterone, and dehydroepiandrosterone sulfate. T-tests tested for between-group differences and separate multiple linear regression models tested for an effect of continuous hormone levels and personality characteristics on ISC. Further models were run, testing for an interaction with menopausal stage.

Results: No group differences in ISC were evident (all p > 0.05). In premenopausal women, estradiol levels positively predicted the competition for attention (β = 2.103, p = 0.022). In postmenopausal women, self-esteem predicted the tendency to compete overall (β = −0.208, p < 0.001), on appearance (β = −0.061, p = 0.01), on competence (β = −0.087, p < 0.001), and on attention/interpersonal success (β = −0.060, p = 0.01).

Discussion: These results, though cross-sectional, suggest that women continue to compete intrasexually in postmenopause, giving rise to new questions about the function of female ISC. If confirmed, the findings will indicate that hormones guide competitiveness in fertile women, whereas self-esteem accounts for individual differences in competitiveness post-reproduction. Particularly the function of postmenopausal ISC warrants further investigation.

Pulsed administration for physiological estrogen replacement in mice

Estrogens are important regulators of body physiology and have major effects on metabolism, bone, the immune- and central nervous systems. The specific mechanisms underlying the effects of estrogens on various cells, tissues and organs are unclear and mouse models constitute a powerful experimental tool to define the physiological and pathological properties of estrogens. Menopause can be mimicked in animal models by surgical removal of the ovaries and replacement therapy with 17β-estradiol in ovariectomized (OVX) mice is a common technique used to determine specific effects of the hormone. However, these studies are complicated by the non-monotonic dose-response of estradiol, when given as therapy. Increased knowledge of how to distribute estradiol in terms of solvent, dose, and administration frequency, is required in order to accurately mimic physiological conditions in studies where estradiol treatment is performed. In this study, mice were OVX and treated with physiological doses of 17β-estradiol-3-benzoate (E2) dissolved in miglyol or PBS. Subcutaneous injections were performed every 4 days to resemble the estrus cycle in mice. Results show that OVX induces an osteoporotic phenotype, fat accumulation and impairment of the locomotor ability, as expected. Pulsed administration of physiological doses of E2 dissolved in miglyol rescues the phenotypes induced by OVX. However, when E2 is dissolved in PBS the effects are less pronounced, possibly due to rapid wash out of the steroid.

The moderating effect of cortisol and dehydroepiandrosterone on the relation between sleep and depression or burnout

For poor sleep quality (SQ) as well as major depressive disorder (MDD) and burnout, a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been identified. Although poor SQ is often reported as an early symptom of MDD or burnout, it is not clear whether HPA axis-related hormones can influence the association between SQ and MDD or burnout. This manuscript addresses this question by examining HPA axis-related hormones as potential moderators influencing the association between SQ and MDD or burnout.

In the fourth annual examination wave of the Dresden Burnout Study, we measured general SQ (including sleep duration and efficiency), depressive and burnout symptoms, and obtained hair samples for quantification of long-term integrated steroid concentrations (cortisol [hC], cortisone [hCn], dehydroepiandrosterone [hDHEA]) from 462 participants (67% female). Data on SQ, depressive and burnout symptoms were available from 342 participants from the preceding examination wave (average time span between examinations 13.2 months).

Cross-sectional analyses showed that the negative association between sleep duration and depressive symptoms was buffered by higher levels of hC, and hCn, whereas the negative association between sleep duration and burnout symptoms was buffered by higher levels of hDHEA. The negative association between sleep efficiency and burnout symptoms was intensified by higher levels of hC and hC/hCn ratio and the negative association between general SQ and burnout symptoms was intensified by higher levels of hC/hCn ratio. With regard to longitudinal data, a significant interaction effect between sleep duration and hC/hCn ratio could be detected for burnout symptoms.

Our results suggest opposed moderation effects of hair glucocorticoids on the association between SQ and depressive or burnout symptoms. This points toward opposed glucocorticoid receptor functioning in depression and burnout. To fully elucidate the negative consequences of poor SQ on MDD and burnout, the complex underlying mechanisms of action including HPA axis-related hormones need to be investigated in MDD and burnout separately.

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hC and hDHEA are not directly related to depression, burnout, or sleep symptoms.

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Higher hC levels buffer the relation between poor sleep quality (SQ) and depression.

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Higher hC levels intensify the relation between poor SQ and burnout.

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Higher hDHEA levels buffer the relation between poor SQ and burnout.

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hC and hDHEA exhibit contrary effects on the relation between SQ and burnout.

Hair-based biomarkers in women with major depressive disorder: Glucocorticoids, endocannabinoids, N-acylethanolamines, and testosterone

Background

Stress-related alterations in the regulation of several endocrine systems, including the hypothalamus-pituitary-adrenal (HPA) and -gonadal (HPG) axes and the endocannabinoid system are proposed to be involved in the etiology of major depressive disorder (MDD). Therefore, this study examines whether altered concentrations of glucocorticoids, testosterone, endocannabinoids, and related N-acylethanolamines accumulated in hair are present in MDD.

Methods

Female participants (range: 19–59, Mdn = 30.5 years) were recruited, including n = 21 with a current MDD episode and n = 27 nondepressed controls without any current mental disorder. Weight-standardized samples of 3 cm hair segments were analyzed which equals to three months of retrospectively assessed biomarkers in hair. Concentrations of cortisol, cortisone, testosterone, endocannabinoids (i.e., anandamide [AEA], 2-arachidonylglycerol [2-AG]), and selected N-acylethanolamines (i.e., stearoylethanolamide [SEA], oleoylethanolamide [OEA], palmitoylethanolamide [PEA]) were measured using mass spectrometry.

Results

Female MDD patients exhibited lower cortisol and cortisone levels in hair than nondepressed controls, whereas the hair concentrations of endocannabinoids, N-acylethanolamines, and testosterone did not differ between the groups.

Conclusions

Our results add to the heterogeneous body of findings on alterations in hair-stored glucocorticoids and endocannabinoids in MDD. As in previous studies, there was no evidence of altered testosterone concentrations in the hair of MDD patients. Larger and longitudinal studies are needed to comprehensively explore the overall picture of endocrine alterations in MDD.

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Analysis of hair-based markers of endocrine alterations in female MDD outpatients.

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Lower hair cortisol and cortisone concentrations in mild to moderately severe MDD.

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No differences in endocannabinoid, N-acylethanolamine, and testosterone hair levels.

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Testosterone and cortisone levels were linked to higher stress/trauma exposure.

Men's Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress

Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = −0.41, p = 0.029), whereas AtTMRN was not (men: β = −0.04, p = 0.818; women: β = −0.25, p = 0.064). Higher externalizing depression symptomatology (β = −0.68, p = 0.005), but not prototypical depression symptomatology (β = −0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology.

Estradiol and progesterone as resilience markers? - Findings from the Swiss Perimenopause Study

While resilience seems to be associated with a variety of biological markers, studies assessing such correlates in women during the perimenopause are lacking. The perimenopause constitutes a phase of major biopsychosocial changes, during which the sex hormones estradiol (E2) and progesterone (P4) eventually decrease significantly. The aim of this study was to examine the extent to which the declining levels of E2 and P4 serve as resilience markers in perimenopausal women. In 129 healthy perimenopausal women aged 40-56 years, saliva samples were collected on every fourth day over a period of four weeks in order to investigate E2 and P4 levels. All participants completed psychosocial questionnaires including variables related to resilience, well-being, and mental health. Perimenopausal status was determined using the Stages of Reproductive Aging Workshop (STRAW) criteria. The results indicate that P4 is linked to psychosocial resilience. More precisely, women with higher P4 levels seem to be more resilient than women with lower P4 levels, irrespective of the perimenopausal status. No such relation was found for E2 levels. Further analyses revealed that women with higher P4 levels experience significantly higher life satisfaction, lower perceived stress, and lower depressive symptoms than women with lower P4 levels. Accordingly, P4 can be considered as a biological marker of resilience in perimenopause.

Ex vivo glucocorticoid-induced secreted proteome approach for discovery of glucocorticoid-responsive proteins in human serum

PURPOSE

To identify glucocorticoid-responsive proteins measurable in human serum that may have clinical utility in therapeutic drug monitoring and the diagnosis of cortisol excess or deficiency.

EXPERIMENTAL DESIGN

A phased biomarker discovery strategy was conducted in two cohorts. Secretome from peripheral blood mononuclear cells (PBMC) isolated from six volunteers after ex vivo incubation ± dexamethasone (DEX) 100 ng/mL for 4 h and 24 h was used for candidate discovery and qualification using untargeted proteomics and a custom multiple reaction monitoring mass spectrometry (MRM-MS) assay, respectively. For validation, five candidates were measured by immunoassay in serum from an independent cohort (n = 20), sampled at 1200 h before and after 4 mg oral DEX.

RESULTS

The discovery secretome proteomics data generated a shortlist of 45 candidates, with 43 measured in the final MRM-MS assay. Differential analysis revealed 16 proteins that were significant in at least one of two time points. In the validation cohort, 3/5 serum proteins were DEX-responsive, two significantly decreased: lysozyme C (p < 0.0001) and nucleophosmin-1 (p < 0.01), while high mobility group box 2 significantly increased (p < 0.01).

CONCLUSIONS AND CLINICAL RELEVANCE

Using an ex vivo proteomic approach in PBMC, we have identified circulating glucocorticoid-responsive proteins which may have potential as serum biomarkers of glucocorticoid activity.

Depressive symptoms are not associated with long-term integrated testosterone concentrations in hair

OBJECTIVES

The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels from hair.

METHODS

Using data from a prospective cohort study, a total of 578 participants (74% female) provided complete data on depressive symptomatology, clinical features, and hair samples for quantification of testosterone concentrations at baseline. Available data of three annual follow-up examinations were used for longitudinal analyses.

RESULTS

Correlation analysis showed in both, men and women, hair testosterone across all the four time points not to be significantly related to depressive symptoms. Examined clinical features were not associated with testosterone levels, except for having a current diagnosis of a psychological disorder, which was associated with reduced testosterone levels in men, but not in women. Acceptable model fit for an autoregressive cross-lagged panel analysis emerged only for the female subsample suggesting inverse cross-relations for the prediction of testosterone by depressive symptomatology and vice versa.

CONCLUSIONS

Findings from this study add to the literature by showing no association between long-term integrated testosterone in hair and depressive symptomatology in men and women.

The relationship between testosterone and social cognition in younger and older adults

Testosterone (T) has been linked to poorer social cognition in younger adults. Because social cognition and T both decline with normal aging, a different type of relationship may exist between T and social cognition in late adulthood. To test this possibility, younger and older adults provided a salivary T sample and completed two social cognition tasks. The results showed that age-group was a significant moderator in the relationship between T and theory of mind (ToM) performance for males, such that T was a negative predictor of ToM in younger males and a positive predictor of ToM in older age. No relationships were identified for females. These findings show for the first time that T is differentially related to ToM in the early and later stages of the male adult lifespan, and are discussed in relation to prior work that suggests T may have neuroprotective effects in older age.

Psychosocial factors promoting resilience during the menopausal transition

Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R² = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R² = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R² = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R² = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R² = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R² = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause.

Sex and Age Effects on Neurobehavioral Toxicity Induced by Binge Alcohol

Historically, most alcohol neurotoxicity studies were conducted in young adult males and focused on chronic intake. There has been a shift towards studying the effects of alcohol on the adolescent brain, due to alcohol consumption during this formative period disrupting the brain's developmental trajectory. Because the most typical pattern of adolescent alcohol intake is heavy episodic (binge) drinking, there has also been a shift towards the study of binge alcohol-induced neurobehavioral toxicity. It has thus become apparent that binge alcohol damages the adolescent brain and there is increasing attention to sex-dependent effects. Significant knowledge gaps remain in our understanding of the effects of binge alcohol on the female brain, however. Moreover, it is unsettling that population-level studies indicate that the prevalence of binge drinking is increasing among American women, particularly those in older age groups. Although study of adolescents has made it apparent that binge alcohol disrupts ongoing brain maturational processes, we know almost nothing about how it impacts the aging brain, as studies of its effects on the aged brain are relatively scarce, and the study of sex-dependent effects is just beginning. Given the rapidly increasing population of older Americans, it is crucial that studies address age-dependent effects of binge alcohol, and given the increase in binge drinking in older women who are at higher risk for cognitive decline relative to men, studies must encompass both sexes. Because adolescence and older age are both characterized by age-typical brain changes, and because binge drinking is the most common pattern of alcohol intake in both age groups, the knowledge that we have amassed on binge alcohol effects on the adolescent brain can inform our study of its effects on the aging brain. In this review, we therefore cover the current state of knowledge of sex and age-dependent effects of binge alcohol, as well as statistical and methodological considerations for studies aimed at addressing them.

Fatherhood Is Associated with Increased Infidelity and Moderates the Link between Relationship Satisfaction and Infidelity

Background: Relationship satisfaction has been identified as an important factor in terms of extradyadic sexual involvement. However, in men, fatherhood might be associated with infidelity by leading to changes in relationship satisfaction and the social life of parents. To date, no study has focused on the association of fatherhood and infidelity, nor the influence of fatherhood on the association between relationship satisfaction and infidelity. Methods: Using a cross-sectional design, 137 fathers and 116 non-fathers were assessed regarding relationship satisfaction, infidelity, and potential confounds. Results: Significantly more fathers reported having been unfaithful in the current relationship than non-fathers (30.7% vs. 17.2%). Fathers also reported longer relationship duration, higher relationship satisfaction, and lower neuroticism than non-fathers. Furthermore, fatherhood moderated the association between relationship satisfaction and infidelity insofar that only in non-fathers reduced relationship satisfaction was associated with infidelity. Conclusions: The results suggest that fatherhood increases the risk of engaging in extradyadic sexual activities and moderates the link between relationship satisfaction and infidelity. However, results need to be interpreted with caution due to the cross-sectional study design and the lack of information about the specific time point of the infidelity incident(s).

Symptoms assessed in studies on perimenopausal depression: A narrative review

The menopausal transition constitutes a phase of major biopsychosocial changes associated with an elevated risk for the development of depression. Perimenopausal depression is highly prevalent and usually characterized by core symptoms of a major depressive disorder combined with menopausal complaints such as vasomotor symptoms or other physical complaints. However, a distinct definition of the condition is lacking. The aim of this review is to portray the symptoms assessed in studies on perimenopausal depression in order to provide relevant information on the current understanding of this condition. A literature search was conducted using the databases PubMed, Cochrane Library, and PsycINFO. A total of 37 studies were included. Various assessment tools have been used to measure symptoms related to perimenopausal depression. Fifteen symptoms were identified. Depressed mood was assessed across all studies. Low energy or sleep disturbances, as acknowledged symptoms of a major depressive disorder, were surveyed in most studies. However, the assessment of menopausal complaints was rather heterogeneous. While vasomotor symptoms were often measured, other menopausal symptoms such as mood swings or pain were investigated less frequently. Sexual problems were only rarely assessed. Studies on perimenopausal depression regularly include the assessment of core symptoms of a major depressive disorder, but the assessment of menopausal complaints is inconsistent. While certain symptoms are commonly measured, others are not assessed. Such inconsistencies underline an ambiguous understanding of perimenopausal depression, which in turn affects the evaluation and treatment of the condition. Thus, the use of the existing guidelines on perimenopausal depression is recommended.

Transcriptome analysis of liver provides insight into metabolic and translation changes under hypoxia and reoxygenation stress in silver sillago (Sillago sihama)

Hypoxia can lead to adverse effects on growth, reproduction, behavioral activities and survival in fish, and is one of the most critical factors in the aquatic environment. The liver is an important target organ for reducing toxin accumulation and hypoxia in fish. In this study, silver sillago (Sillago sihama) was exposed to normoxia (dissolved oxygen, DO = 8.0 mg/L), hypoxia for 1 h (hypoxia 1 h, DO = 1.5 mg/L), hypoxia for 4 h (hypoxia 4 h, DO = 1.5 mg/L) and reoxygenation for 4 h after hypoxia 4 h (reoxygenation 4 h, DO = 8.0 mg/L). Results showed that the expression of 506, 1721, and 1230 differentially expressed genes (DEGs) (|log₂₍fold change) > 1.0| and padj < 0.05) were identified at hypoxia 1 h, hypoxia 4 h, and reoxygenation 4 h in the liver, respectively. The enrichment analysis showed that the DEGs were significantly enriched in metabolic and translation changes pathways, including mapk signaling pathway, p53 signaling pathway, fatty acid metabolism, protein export, ribosome biogenesis in eukaryotes. The DEGs of 17 genes validated the RNA-seq results by quantitative real-time PCR (qRT-PCR). This study provides a comprehensive understanding of the transcriptional changes that occur in different hypoxia and insights into the mechanisms of hypoxia adaptation of the liver in S. sihama.

The Swiss Perimenopause Study - study protocol of a longitudinal prospective study in perimenopausal women

BACKGROUND

The perimenopause is associated with considerable biopsychosocial changes. The majority of women manage to adjust to these changes and cope well with the shift from reproductive to non-reproductive life. However, some women develop burdensome physical and psychological symptoms during the perimenopause. A strong link between menopausal complaints and depressed mood has been shown in this regard. To date, the decisive factors determining whether a woman will successfully achieve a healthy transition remain unclear. Thus, the purpose of this study is to investigate a range of theory-based markers related to health in perimenopausal women.

METHODS

The Swiss Perimenopause Study comprises a sample of 135 healthy perimenopausal women aged 40-56. A variety of health-related genetic, epigenetic, endocrinological, physiological, and psychosocial markers associated with the menopausal transition are investigated over a period of 13 months.

DISCUSSION

The Swiss Perimenopause Study will contribute to a better understanding of the biopsychosocial processes associated with the perimenopause, which should help to improve the clinical care of women undergoing the menopausal transition.

Sex Hormone Depletion Augments Glucocorticoid Induction of Tau Hyperphosphorylation in Male Rat Brain

Steroid hormones secreted by the gonads (sex steroids) and adrenal glands (glucocorticoids, GC) are known to influence brain structure and function. While levels of sex steroids wane in late adulthood, corticosteroid levels tend to rise in many individuals due to age-related impairments in their feedback on central mechanisms regulating adrenal function. These fluctuations in sex and adrenal steroid secretion may be relevant to age-related neurodegenerative disorders such as Alzheimer's disease (AD) in which hyperphosphorylation of Tau protein is a key pathological event. We here report that both, long-term GC deprivation (by adrenalectomy) and exogenous GC administration with natural or synthetic glucocorticoid receptor ligands (corticosterone and dexamethasone, respectively) induce Tau hyperphosphorylation in the hippocampus and frontocortical regions at epitopes associated with disruption of cytoskeletal and synaptic function. Interestingly, we observed that the changes in Tau induced by manipulation of the GC milieu of male rats were exacerbated by testosterone depletion (by orchiectomy). While this finding supports previous suggestions of a neuroprotective role of male sex hormones, this is the first study to address interactions between adrenal and sex steroids on Tau hyperphosphorylation and accumulation that are known to endanger neuronal function and plasticity. These results are particularly important for understanding the mechanisms that can precipitate AD because, besides being modulated by age, GC are elevated by stress, a phenomenon now established as a trigger of deficits in neural plasticity and survival, cognitive behaviour and AD-like Tau pathology.

Age-Related Alterations in Endocrine Markers Do Not Match Changes in Psychosocial Measures: Findings From the Men's Health 40+ Longitudinal Study

While life expectancy continues to increase, aging can bring several distinct endocrine and psychosocial changes. The study aimed to investigate the interplay between biopsychosocial factors of healthy aging in specifically healthy aging men. Ninety-seven healthy aging men were investigated at two time points spanning 4 years. Participants completed questionnaires measuring several psychosocial dimensions and gave saliva samples for hormone quantification during a laboratory appointment. The study applied a random intercept mixed-model approach. Age-related changes were found in most endocrine markers (cortisol, testosterone, dehydroepiandrosterone-sulfate, and progesterone), except for estradiol. Psychosocial measures remained stable, except for increased social support. Further, changes in endocrine and psychosocial measures were independent of each other. The results suggest that in healthy aging men, age-related endocrine changes occur, but do not necessarily determine a change in psychosocial measures. Potentially, preventive interventions can be derived from these results.

Differential ESR1 Promoter Methylation in the Peripheral Blood-Findings from the Women 40+ Healthy Aging Study

Background Estrogen receptor α (ERα) contributes to maintaining biological processes preserving health during aging. DNA methylation changes of ERα gene (ESR1) were established as playing a direct role in the regulation of ERα levels. In this study, we hypothesized decreased DNA methylation of ESR1 associated with postmenopause, lower estradiol (E2) levels, and increased age among healthy middle-aged and older women. Methods We assessed DNA methylation of ESR1 promoter region from dried blood spots (DBSs) and E2 from saliva samples in 130 healthy women aged 40-73 years. Results We found that postmenopause and lower E2 levels were associated with lower DNA methylation of a distal regulatory region, but not with DNA methylation of proximal promoters. Conclusion Our results indicate that decreased methylation of ESR1 cytosine-phosphate-guanine island (CpGI) shore may be associated with conditions of lower E2 in older healthy women.

Serum testosterone levels in bipolar and unipolar depressed female patients and the role of medication status

Objective: to compare testosterone levels between female depressed patients and female bipolar patients.Methods: Sixty-one female patients with major depressive disorder (MDD) (n = 23) or bipolar disorder (BD) (n = 38) between 18 and 45 years old were included in the study. Participants were evaluated during a depressive or manic episode with the Hamilton depression rating scale (HDRS) or Young mania rating scale (YMRS), respectively. No patients in the MDD group were taken valproate while in the BD group 14 (36.84%) were taken valproate. Total testosterone (TT) and free testosterone (FT) levels were quantified during the early follicular phase of the cycle, with radioimmunoassay or solid phase enzyme-linked immunoassay. Data were collected from May 2016 to February 2017.Results: Mean TT serum levels were significantly higher in BD patients in comparison to MDD patients. Although age and diagnosis were related to TT levels, however when we added valproate use in the analysis, only the relation between TT and valproate use remained significant.Conclusions: In this sample, TT levels were related to valproate use in patients with BD. More studies regarding the role of testosterone in affective symptoms should be conducted to clarify the relation between testosterone, affective disorders, and medication.KeypointsWe observed that testosterone levels were significant higher in bipolar women compared to women with MDD.The use of valproate could be associated with the testosterone levels in female patients with BD.Evaluation of women suffering BD should include a testosterone levels determination, particularly when they are taking valproate.

The Relation Between Steroid Secretion Patterns and the Androgen Receptor Gene Polymorphism on Physical Health and Psychological Well-Being-Longitudinal Findings From the Men's Health 40+ Study

Research is increasingly focusing on promoting healthy aging and the related extension of the health span by targeting crucial biological processes responsible for age-related conditions. While age-related gradual changes in steroid hormones such as testosterone, estradiol, or cortisol are well described in men, their interactions among each other or with genetic markers have not been sufficiently investigated with regard to physical health or psychological well-being. More specifically, the examination of age-related alterations in hormone interactions and the androgen receptor polymorphism, which modulates androgen action on target cells, in relation to physical health and psychological well-being represents a promising avenue for research on healthy aging in men. A total of 97 healthy aging men provided complete data on psychometric health measures as well as hormonal and genetic parameters at baseline and a 4-year follow-up assessment. Fasting saliva samples were taken at 8:00 am under standardized laboratory conditions, while the androgen receptor gene polymorphism was analyzed from dried blood spots. Longitudinal analyses revealed that psychological well-being and physical health remained stable over time. Analyses indicated that E2 moderated the course of psychological well-being, while the androgen receptor gene polymorphism moderated the course of physical health. Further, T was a strong predictor of physical health. These results suggest that the hypothalamic-pituitary-gonadal (HPG) axis might be important for the maintenance of psychological well-being in men, while physical health depends more on interindividual differences in the androgen receptor gene and T.

Psychobiological indicators of the subjectively experienced health status - findings from the Women 40+ Healthy Aging Study

BACKGROUND

Healthy aging is particularly important in women, as their life-span is generally longer than men's, leaving women at higher risk for age-related diseases. Understanding determinants of women's healthy aging is therefore a major public health interest. Clinical utility of previous research is limited, through its focus on either single psychosocial or biological predictors. The present study investigated psychobiological predictors of women's healthy aging, for the first time including positive psychological traits and biomarkers of healthy aging.

METHODS

Totally, 121 generally healthy women aged 40 to 75 were investigated cross-sectionally. Healthy aging was operationalized via self-rated health (SRH). To gain a nuanced view of the particularities at the upper end of the illness-wellness continuum, women with excellent SRH and those with good SRH were analyzed as distinct groups. Socioeconomic and sociodemographic variables, health behavior, resilience, optimism, and self-worth as well as menopausal symptoms, and levels of steroid hormones and gonadotropins were considered as predictors of SRH. Binary logistic regression analyses using the forward conditional method were performed with the two health status groups as dependent variable.

RESULTS

Women with a lower body mass index (BMI; OR = .59, 95% CI = .33-1.03), higher intensive physical activity (OR = 2.27, 95% CI = 1.06-4.86), and higher resilience (OR = 2.37, 95% CI = 1.34-4.18) were more likely to rate their health as excellent compared to good. No clinically significant differences could be found regarding endocrine levels.

CONCLUSION

Psychobiological indicators (lower BMI, intensive physical activity, higher resilience) discriminated SRH at the top level of the health spectrum. In healthy women, the predictive value of endocrine markers seems to be secondary. Interventions targeting these indicators could promote women's healthy aging.

Do dehydroepiandrosterone, progesterone, and testosterone influence women's depression and anxiety levels? Evidence from hair-based hormonal measures of 2105 rural Indian women

Depressive and anxiety disorders substantially contribute to the global burden of disease, particularly in poor countries. Higher prevalence rates for both disorders among women indicate sex hormones may be integrated in the pathophysiology of these disorders. The Kshetriya Gramin Financial Services study surveyed a random sample of 4160 households across 876 villages in rural Tamil Nadu, India. An interviewer-administered questionnaire was conducted to quantify depressive (K6-D) and anxiety (K6-A) symptoms. Alongside, hair samples for sex hormone profiling were collected from a subsample of 2105 women aged 18-85 years. Importantly, 5.9%, 14.8%, and 46.3% of samples contained non-detectable hormone levels for dehydroepiandrosterone, progesterone, and testosterone, respectively. Our primary analysis imputes values for the non-detectable sample and we check robustness of results when non-detectable values are dropped. In this cohort of women from rural India, higher depressive symptomatology is associated with lower levels of dehydroepiandrosterone and higher depressive and anxiety symptoms are associated with higher levels of testosterone. Progesterone shows no clear association with either depressive or anxiety symptoms. These results support a potential protective effect of higher endogenous dehydroepiandrosterone levels. An important caveat on the potential negative effect of hair testosterone levels on women's mental health is that the testosterone analysis is sensitive to how non-detectable values are treated.

Testosterone and Dehydroepiandrosterone Treatment in Ageing Men: Are We All Set?

Although demographic statistics show that populations around the world are rapidly ageing, this rising life expectancy is accompanied by an increase in the number of people living with age-related chronic conditions, such as frailty, cognitive decline, depression, or sexual dysfunction. In men, a progressive decline in androgens occurs with increasing age, and low androgen levels are associated with age-related chronic conditions. However, androgen administration studies are inconclusive, showing differing results according to the androgen used (testosterone [T], dehydroepiandrosterone [DHEA]), the group of men examined (younger vs. older; eugonadal vs. hypogonadal) and the conditions studied (frailty, cognitive decline, depression, sexual dysfunction). In this review, the current state for the use of T and DHEA therapy in men for the age-related conditions is examined. Due to the progressive age-related decline in androgens leading to a higher rate of older men having low androgen levels, the effects of androgen treatment in elderly males will be of particular interest in this review. Dose-response relationships, the role of potential moderators, and the androgen treatment-related risk for adverse events will be discussed. Studies have suggested that T treatment - more so than DHEA treatment - may be an effective therapy against age-related chronic conditions in men with low T levels; especially older men. Such conditions include frailty, depression, or sexual dysfunction. However, T treatment does not emerge as an effective therapy against cognitive decline. Nevertheless, more high-quality, randomised controlled trials using T treatment for age-related chronic conditions are necessary if further conclusions are to be made.

Psychobiological Factors of Sexual Functioning in Aging Women - Findings From the Women 40+ Healthy Aging Study

Background: A variety of biological and psychosocial factors are associated with women’s sexual health in midlife and older age. Evidence suggests a decline in sexual functioning in the context of aging and the menopausal transition, including changes in sexual desire, arousal, lubrication, orgasm, pain, and/or contentment. However, not all women in midlife and older age experience such a decline, and it remains unclear how the endocrine environment and psychosocial aspects contribute to the maintenance of healthy sexual functioning. Therefore, the aim of this study was to examine psychobiological predictors of sexual functioning in healthy middle-aged and elderly females.

Methods: A total of 93 healthy, sexually active women aged 40–73 years completed a battery of validated psychosocial questionnaires, including measures of sexual functioning (Female Sexual Function Index) and of protective psychological traits and interpersonal variables. The steroid hormones estrogen, testosterone, progesterone and dehydroepiandrosterone sulfate were determined in saliva samples, while follicle-stimulating hormone, luteinizing hormone and sex hormone-binding globulin were determined in dried blood spots. The findings were statistically adjusted for multiple testing.

Results: Age and postmenopausal status were negatively associated with overall sexual functioning, arousal, and lubrication. Regression analyses revealed that relationship satisfaction, emotional support, self-esteem, optimism, and life satisfaction each significantly predicted overall sexual functioning or specific aspects of sexual functioning, including arousal, contentment, orgasm, and pain (all p < 0.029). For desire and lubrication, no associations were found with the tested psychosocial factors. In terms of steroid hormones, testosterone was positively linked to orgasm (p = 0.012). In this sample, 79.6% reported to have healthy sexual functioning according to the questionnaires’ cutoff. Younger age (OR = 0.911, 95% CI 0.854–0.970, p = 0.004) and a higher level of emotional support (OR = 1.376, 95% CI 1.033–1.833, p = 0.029) were associated with the presence of healthy sexual functioning.

Discussion: Although aging and menopause negatively affected aspects of sexual functioning, the accompanying endocrine correlates were not predictive for sexual functioning in this healthy sample of middle-aged and older females. Instead, our findings suggest that sexual functioning is highly dependent on psychosocial aspects related to well-being. Accordingly, personality traits such as optimism, and interpersonal aspects such as emotional support and relationship satisfaction were identified as important predictors of sexual functioning.

Associations between digit ratio (2D4D), mood, and autonomic stress response in healthy men

The ratio between the length of the second (index) and the fourth (ring) finger (2D4D) is a putative biomarker of prenatal testosterone (T) exposure, with higher exposure leading to a smaller ratio. 2D4D has further been linked to mental and somatic disorders. Healthy male Swiss recruits (N = 245; M_age = 20.30 years) underwent a psychosocial stress test. Mood and salivary alpha-amylase (sAA) were assessed before and after the stress test, while heart rate (HR) and heart rate variability (HRV) were measured continuously. Additionally, 2D4D (right: R2D4D; left: L2D4D) was determined and divided into quartile groups. Correlation analysis showed no associations between R/L2D4D and outcome measures. Comparing calculated quartiles for R2D4D, subjects in the lowest R2D4D quartile expressed trendwise (p < 0.10) lower positive and higher negative affect, significantly elevated sAA activity (p < 0.05), but no HR and HRV differences at baseline as compared to subjects in the upper three quartiles. With regard to acute stress, subjects in the lowest as compared to subjects in the upper three R2D4D quartiles showed a higher increase of negative affect and a stronger cardiac response (p < 0.05), but no alterations in positive affect and sAA activity. Young healthy men in the lowest R2D4D quartile revealed a more negative affect and increased physiological activity at baseline and in response to acute stress. An exposure to high levels of prenatal T might constitute a risk factor potentially increasing vulnerability to stress-related disorders in men.