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How Does PTSD Impact Women?

More women than men have PTSD because of sexual trauma and interpersonal violence.
Helen Massy
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Helen Massy

Post-traumatic stress disorder (PTSD) is a complex condition that affects individuals who have experienced or witnessed a traumatic event.

Somia Zaman, a psychotherapist who specializes in PTSD in Manchester, England, explained that it often develops when we experience something that has overwhelmed our nervous system and, therefore, our ability to cope.

"People used to associate PTSD with major events like wars or natural disasters, but research has shown that PTSD can be caused by absolutely anything that overwhelms you and your ability to cope," she said. "This can include a whole range of events, such as bullying, racism or medical trauma."

When we experience something that overwhelms us, our nervous system can become dysregulated, she continued. This means the fear center in our brain can become hyperactive and our ability to calm and soothe ourselves will lessen. If this dysregulation continues, it can go on to become post-traumatic stress disorder.

While both men and women can develop PTSD, research suggests women may experience this disorder differently. The unique interplay of biological, psychological and sociocultural factors contributes to distinct patterns of symptom presentation and response to trauma in women.

A recent survey by the National Institute of Mental Health (NIMH) indicated women are twice as likely to experience PTSD than men, according to Ketan Parmar, M.D., a Mumbai-based psychiatrist and mental health expert at ClinicSpots. As many as 1 in 9 women have been diagnosed with the disorder at some point during their lifetime.

Let's focus on women and post-traumatic stress disorder and try to understand the differences between genders so that effective support and treatment tailored to the specific needs of the individual is provided.

Women and PTSD

There are several reasons why women may experience PTSD differently than men, according to Jana Wu, director of cultural integration at Mountainside Treatment Center in Chappaqua, New York. One major factor is that women are more likely to experience sexual trauma and interpersonal violence, leading to symptoms such as depression, anxiety and low self-esteem.

"Over a quarter of women aged 15 to 49 years, who have been in a relationship, have experienced physical and/or sexual violence by their intimate partner at least once in their lifetime since age 15," Wu said.

She added that a recent study from the Centers for Disease Control and Prevention (CDC) revealed that from 2017 to 2021, the number of teen girls in the United States who experienced sexual violence increased by 20 percent. Additionally, the study showed in 2021 that nearly 1 in 3 teen girls seriously considered attempting suicide.

Laura Rutledge, L.M.H.C., a Jackson, Mississippi-based licensed therapist at GIA Miami, agreed that women are more likely than men to experience interpersonal trauma, such as sexual assault or domestic violence. It can result in perpetual feelings of powerlessness and fear.

"This can make it more difficult to seek help," Rutledge said.

Although Wu said these statistics are alarming, she stressed if we continue to educate young people about consent, provide resources for survivors of sexual violence, and promote healthy relationships, we can work toward reducing the incidence of sexual violence and supporting those who have experienced trauma.

"It's important for women with PTSD to seek the support they need to manage their symptoms and improve their long-term health and well-being," she added.

What's crucial to recognize is that aside from women being more likely to experience domestic abuse and sexual assault, they can also experience post-traumatic stress disorder differently from men.

How do women experience PTSD?

Women generally experience more psychological symptoms, Parmar noted, including anxiety, depression, irritability, anger, guilt and shame, which are significantly worse than those experienced by men with the same condition.

"Studies have also shown that women with PTSD are more likely to report feeling overwhelmed or being unable to cope with daily activities and have greater difficulty regulating emotions," he added.

Women are more likely to develop co-morbid mental health conditions such as depression, anxiety disorder, substance use disorder or suicidal thoughts than men with the same condition.

Wu said studies suggested women may have different responses to trauma compared to men, such as higher rates of reexperiencing events, negative alterations in cognition or mood, and dissociative responses.

Traditionally, women struggling with post-traumatic stress disorder may internalize their feelings and experience greater moments of overwhelm and anxiety.

"Sometimes, their internalization and self-blame can lead to unhealthy coping habits such as eating disorders and self-harm," Wu said. "On the other hand, men tend to have more outward expressions of emotions like anger and frustration."

Therapeutic providers must consider these gender-specific differences when providing care for their clients.

The physical impact of PTSD

PTSD can have a range of physical effects on women. Wu listed some:

  • Changes in sleep patterns
  • Grinding their teeth
  • Increased inflammation
  • Increased risk of chronic pain

"Having prolonged inflammation can contribute to a range of health problems, including autoimmune disorders, chronic pain and cardiovascular disease," Wu said.

If you don't get enough sleep over time, it can cause issues such as cognitive impairment and fatigue. Plus, lack of sleep can make it hard to focus in school or work and complete everyday tasks.

Parmar noted PTSD can also cause headaches, digestive problems, sleep disturbances, fatigue and changes in appetite.

Other physical symptoms can include:

  • A weakened immune system
  • An increased risk of heart disease and diabetes
  • An increased risk of substance use or self-harm

In addition, Wu pointed out that our reproductive health is deeply linked to stress responses.

"Someone with PTSD might feel less interested in sex or have trouble feeling pleasure during sexual activities, which can be perceived as 'cold' by their partners," she said.

They might experience pain during intercourse, making it uncomfortable or even scary to be intimate with someone.

Post-traumatic stress disorder can also affect a woman's menstrual cycle, making periods irregular or more painful than usual. Sometimes, Wu said, experiencing trauma early in life can predispose women to engage in compulsive sexual behavior that does not serve them or might be accompanied by shame.

"Women with PTSD are also at an increased risk of unwanted pregnancy due to decreased use of contraception and poor communication about sexual health with partners," Parmar said.

Wu noted it's important to remember that if you're experiencing any of these symptoms, you're not alone and there are ways to get help. There are many mental health professionals who specialize in working with people who have experienced trauma, and they can help you develop strategies to manage your symptoms and improve your sexual and reproductive health.

What happens if you don't treat PTSD?

Not treating post-traumatic stress disorder can pose a devastating impact on a woman's physical and mental health.

"Untreated PTSD leads to emotions becoming increasingly unmanageable," Rutledge said. "You might become more irritable and your behaviors more unpredictable."

As you begin to feel out of control, this could lead to increased substance use and relationships may decline due to your difficulty regulating emotions, managing compulsivity and isolation. Someone ignoring their PTSD also risks chronic depression and suicidal ideation.

Wu added that untreated post-traumatic stress disorder can interfere with many daily tasks and activities in a woman's life.

For example, women struggling with PTSD may have strained relationships with friends and family members because they have become withdrawn or avoidant, unwilling or unable to discuss their experiences with others. This can result in feelings of loneliness, isolation and disconnection, leading to further negative consequences for mental health and social functioning.

Physical health problems, such as chronic pain and inflammation, may also develop over time in individuals with untreated PTSD, leading to additional physical and emotional distress.

Getting support for PTSD

It may seem like an overwhelming step to take, but a huge network of resources is available to provide the support you need to battle post-traumatic stress disorder.

There is no one-size-fits-all treatment for post-traumatic stress disorder, Parmar said, but some treatments have been found to be effective for women. One such treatment is cognitive behavioral therapy (CBT), a type of therapy that helps patients identify and change negative thoughts and behaviors associated with PTSD.

Rutledge noted that when addressing PTSD, feeling safe and supported is most important in restoring a sense of agency that felt lost due to a traumatic event. She recommended eye movement desensitization and reprocessing (EMDR) as a highly effective form of treatment for post-traumatic stress disorder. Developed in the 1980s by Francine Shapiro, Ph.D., an American psychologist, EMDR was originally designed to alleviate the distress associated with traumatic memories.

"EMDR is a type of treatment in which the EMDR-trained or certified therapist guides you safely through the scarring memories that feel stuck in time to move you forward into more adaptable thoughts and behaviors," she explained.

EMDR recognizes the link between the body and trauma, allowing people to use their body's healing abilities during therapy, Wu said. With EMDR, the client is in the driver's seat, and it empowers them to play a large role in their own healing process. Women are able to work through past traumas and start moving toward a happier, healthier future.

Holistic and somatic therapies are crucial for helping women feel comfortable in their bodies again.

"It sounds silly, but getting a pedicure and allowing someone to touch your feet—an area of your body not many people see—can be a huge step in a positive direction," she added.

Although it might not be helpful for everyone, some women may be able to transition to a full-body massage as they learn to become more comfortable and trust others again. Somatic therapies use a mind-body connection that can be great at treating chronic unease and discomfort in the body. Rutledge added that yoga and mindfulness are powerful resources aiding in the healing process.

Parmar said there are numerous online resources available that can help find treatment options and connect with other people who have experienced similar traumas or struggles.

"Find a trauma-informed therapist who is licensed to practice in your state," Rutledge said. "Nami.org has many resources, from education on PTSD to finding a support group near you."

Depending on the severity of PTSD, trauma treatment programs can be particularly effective.

Various support options are available to women with post-traumatic stress disorder, including individual therapy, group therapy, support groups and online resources. Additionally, women with PTSD may benefit from support from family and friends, as well as accommodations in the workplace or other settings to help manage symptoms.

"With any treatment of PTSD, having the understanding and support of loved ones is the biggest help in the healing process," Rutledge said.