Trauma-related moderators of associations between sex hormones and PTSD symptoms: a replication-extension

<b>Background:</b> Post-traumatic stress disorder (PTSD) disproportionately affects women and recent evidence suggests that unique associations between sex hormones (e.g. estradiol and progesterone) and PTSD symptoms may contribute to this difference. In addition, trauma characteristics such as age at trauma and trauma type may influence this association. We aimed to replicate and extend the findings of a prior study that identified trauma characteristics (sexual trauma and age at trauma) as moderators of associations between estradiol and PTSD symptoms.<b>Methods:</b> Sixty-five trauma-exposed individuals assigned female at birth were included (<i>M</i>_age = 31.45). Participants provided blood samples for estradiol and progesterone assays. The Clinician Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess trauma characteristics and PTSD symptoms.<b>Results:</b> There were no significant correlations between estradiol, progesterone, and PTSD symptom severity. Regression analyses revealed no moderation effects by sexual trauma or age at trauma for estradiol. However, age at trauma significantly moderated the relationship between progesterone and total PTSD severity.<b>Discussion:</b> Contrary to expectations, our results did not replicate prior research, as estradiol was not associated with PTSD severity in our sample. Progesterone was not directly associated with PTSD symptoms, but this relationship was moderated by age at trauma onset. Our findings suggest that trauma characteristics may influence the relationship between sex hormones and PTSD symptoms. While we didn't replicate previous associations between estradiol and PTSD symptoms, our study emphasizes the importance of considering trauma characteristics in understanding the relationship between sex hormones and PTSD.