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Coping with Anxiety and Phobi... Health Article

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Sex differences in anxiety

According to the National Institute of Mental Health, anxiety disorders generally affect women far more often than men. For example, over the course of a lifetime, the prevalence of generalized anxiety disorder is 6.6% in women, but just 3.6% in men. Women are also more prone to panic disorder, specific phobia, social phobia, and post-traumatic stress disorder. Depression and mood disorders, which often occur with anxiety, are likewise more prevalent among women.

Potential factors

The nature and causes of such sex-based differences are the subject of considerable research. Scientists are examining hormonal and biological factors, as well as differences in experiences.

The role of abuse. Girls and women are more likely than males to be victims of physical or mental abuse, and this experience is a known risk factor for post-traumatic stress disorder. Childhood abuse also seems to cause long-term changes in brain chemistry and structure. These changes may predispose such individuals to anxiety disorders (see "Hormones and the HPA axis"). One study found that sexually abused women also have abnormal blood flow in the hippocampus, which processes memories and emotions (see "Hippocampus"). Animal studies reveal that stress can actually harm cells in the hippocampus.

Hormones. Sex differences in the prevalence of anxiety disorders may also have something to do with differences in sex hormones. Scientists know that estrogen interacts with serotonin, but they're just beginning to tease out the relationship.

A study using rats found that stressful events induced different hormonal responses in females and males. Among the female rats, there was a rise in estradiol, a form of estrogen. The increased estradiol appeared to impair the rats' ability to learn. In male rats, stressful events stimulated an increase in adrenal steroids, which actually enhanced the rats' ability to learn. Thus, when subjected to stress, male rats seemed to cope better than females. However, this study didn't determine whether female rats are more easily stressed than males, and its results don't necessarily apply to humans.

Anxiety in men

Although anxiety affects women in greater numbers than men, it's by no means strictly a female problem. At some point, one in five men will develop an anxiety disorder.

For the most part, the symptoms of anxiety disorders are the same for men and women, but a study reported by the National Institute of Mental Health found some intriguing differences in social phobia. Men with severe social phobia were more likely to avoid calling someone they didn't know very well, whereas women were more likely to feel self-conscious. Women also had a greater tendency to report fear of authority figures and fear of being observed. Although social phobia is more common in women, men are more likely to seek treatment for it.

Anxiety can cause impotence in men. About 10%–20% of cases of erectile dysfunction have a psychological basis, such as anxiety, stress, or problems in the relationship. Medications such as sildenafil (Viagra) and sex therapy can often help men overcome anxiety-related sexual difficulties.