PTSD in Women: Symptoms, Causes, and More
The DSM-5-TR defines Post-Traumatic Stress Disorder (PTSD) as a condition where individuals experience persistent symptoms of trauma-related distress, avoidance, and altered arousal and reactivity after exposure to a traumatic event, including direct or indirect exposure. These symptoms must persist for at least one month and cause significant distress or functional impairment.
Post-traumatic stress disorder (PTSD) can develop after a person has exposure to a traumatic event. While anyone can develop PTSD, significant research shows that women are at a higher risk. Studies have consistently demonstrated that women are more likely than men to develop PTSD following exposure to trauma.
According to the National Center for PTSD, approximately 10% of women will experience PTSD in their lifetime compared to about 4% of men. This disparity persists across various cultures and populations, highlighting a significant difference in the prevalence of PTSD. This is due to the specific types of trauma women are more likely to be exposed to, which have a higher prevalence for risks of PTSD such as rape, sexual trauma, childhood abuse, physical abuse, stalking, and being subjected to intimate partner abuse. One study found that the effects of sexual assault are so damaging that 94% of women victims experienced PTSD symptoms within the first two weeks following the incident.
Unique Symptoms and Presentation in Women
While the core symptoms of PTSD such as re-experiencing the traumatic event, avoidance of reminders, negative variations in mood and cognition, and hyperarousal can be present in any individual exposed to trauma, these symptoms can often exhibit differently in women. Additionally, research also shows that women are more likely to experience the following symptoms:
Re-Experiencing Symptoms: Women may have more vivid flashbacks and intrusive memories of the traumatic event.
Hyperarousal: Increased symptoms of anxiety such as irritability, and heightened startle responses are often reported by women. “Women with PTSD had greater fear-conditioning responses than did men with PTSD” (Inslicht, S. S., et al. 2012).
Negative Mood and Cognition: Women often report feelings of guilt, shame, and emotional numbness.
Dissociation: Women demonstrate high rates of dissociative symptoms, such as feeling detached from reality and memory challenges.
Hormonal fluctuation may also play a part in the differences in symptom expression. For instance, estrogen has been shown to affect the brain's response to stress.
Impact of PTSD on Women's Health
The effects PTSD can also have impact on other aspects of women’s health.
Research indicates higher reports of symptoms of anxiety and depression in women with PTSD compared to men who are more likely to report externalizing disorders like substance abuse.
Physical Health: Women with PTSD are at increased risk for chronic conditions such as cardiovascular disease, gastrointestinal disorders, and autoimmune diseases.
Reproductive Health: In women who have experienced trauma during pregnancy, PTSD has been connected to adverse pregnancy outcomes such as premature birth and low birth weight.
Social and Occupational Functioning: PTSD could impair women's ability to maintain relationships and perform daily activities, leading to challenges in their daily environments and isolation.
Cultural and Social factors
Some studies have found that PTSD can be more predominant in groups that practice traditional gender roles, where there’s an imbalance of power and women are in the more vulnerable group. (National Alliance on Mental Illness, n.d.)
In addition, women are likely to reach out to their support networks as way to cope. Women who do not belong to communities that have strong support networks will have a higher likelihood of PTSD symptoms. Other cultural norms can also influence ways of coping with trauma and affect someone’s ability to seek help or report symptoms.
Cultural Trauma:
Some cultural groups experience unique forms of trauma, such as colonization, genocide, or ongoing systemic oppression, which can have profound and lasting impacts on their mental health.
Treatment Approaches for Women with PTSD
Psychotherapy: A holistic approach to therapy that includes somatic approaches and addressing trauma-related thoughts and behaviors can significantly reduce and even eliminate the hyper and hypo-arousal symptoms associated with the fight, flight, freeze response caused by trauma. Group therapy can provide a supportive and safe environment for women to share experiences and learn coping strategies.
Medication: Commonly used to treat PTSD symptoms and paired with therapy.
Support Systems: Social support plays a vital part in recovery. Strong support networks, like family, friends, and community resources can have a positive influence in the healing process
How to seek help
Understanding the unique presentation of PTSD in women including the combination of biological, psychological, and social factors is critical for recognizing the effects of PTSD in your daily life. Remember you are not alone and seeking help is a courageous first step to healing, creating helpful coping techniques and reducing the impact of trauma in your life. Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Brainspotting, Eye Movement Sesensitization and Reprocessing Therapy (EMDR), Dialectical Behavior Therapy (DBT), Cognitive Processing Therapy (CPT), and Internal Family Systems Therapy (IFS) are among some of the modalities used to process trauma and developing helpful coping techniques.
References
National Alliance on Mental Illness. (n.d.). PTSD is more likely in women than men. National Alliance on Mental Illness. Retrieved May 18, 2025, from https://www.nami.org/stigma/ptsd-is-more-likely-in-women-than-men/\
Inslicht, S. S., et al. (2012). Gender differences in PTSD risk may be due to heightened fear conditioning in women. UC San Francisco. Retrieved from https://www.ucsf.edu/news/2012/11/98730/gender-differences-ptsd-risk-may-be-due-heightened-fear-conditioning-women
Galovski, T. E., et al. (2011). Gender differences in the clinical presentation of PTSD and its concomitants in survivors of interpersonal assault. Journal of Traumatic Stress, 24(3), 302-310. https://doi.org/10.1177/0886260510365865
Verywell Health. (2024). PTSD symptoms in women. Retrieved from https://www.verywellhealth.com/ptsd-in-women-8623400/
Verywell Mind. (2008). Causes and risk factors of PTSD. Retrieved from https://www.verywellmind.com/ptsd-causes-and-risk-factors-2797397/
Olff, M., & Langeland, W. (2022, April 27). Why men and women may respond differently to psychological trauma. Psychiatric Times, 39(4), 11–12. Retrieved May 18, 2025, from https://www.psychiatrictimes.com/view/why-men-and-women-may-respond-differently-to-psychological-trauma
Glover, E. M., Jovanovic, T., & Norrholm, S. D. (2015). Estrogen and extinction of fear memories: Implications for posttraumatic stress disorder treatment. Biological Psychiatry, 78(3), 178–185. https://doi.org/10.1016/j.biopsych.2015.02.007
U.S. Department of Veterans Affairs. (n.d.). Research on women, trauma, and PTSD. National Center for PTSD. Retrieved May 18, 2025, from https://www.ptsd.va.gov/professional/treat/specific/ptsd_research_women.asp