Relationship between biological sex and the endocrine stress response following a binge-like dose of alcohol

IF 2.7 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.) Pub Date : 2025-08-01 DOI:10.1111/acer.70094

Robert M. Anthenelli, Mary J. Miles, Richard Hauger, Marc A. Schuckit, Benjamin S. McKenna

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Abstract

Background

Rates of heavy drinking in the United States are rising faster in young women than in men. When “binged” rapidly, larger amounts of alcohol may activate the sexually dimorphic, limbic-hypothalamic–pituitary–adrenal (LHPA) stress axis. We examined plasma adrenocorticotropic hormone (ACTH) and cortisol responses to high-dose alcohol in the lab to determine whether social drinkers exhibited sex-specific stress responses when intoxicated. Given that one-third of young women use hormonal contraceptives (HC), which also might affect stress hormone release, we explored in a post-hoc fashion whether HC use related to LHPA responsivity among women.

Methods

Fifty-one participants (M age = 22.5 ± 1.3 years, 53% women) consumed alcohol (M = 54.7 ± 11.5 gm, sex-adjusted) in a 20% by volume solution over 10 min at 0900 h. Breath alcohol concentration (BrAC), blood pressure, and heart rate readings were obtained serially. Blood samples were obtained at baseline and every 30 min for up to 4 h postconsumption. Repeated measures ANCOVA and area-under-the-curve models tested sex effects in hormones.

Results

Despite the sexes having nearly overlapping BrACs (peak = 0.12 gm/dL at 60-min postconsumption) throughout the lab session, men exhibited a significantly elevated plasma ACTH (sex-by-time effect, p = 0.023) and cortisol (p = 0.030) response to high-dose alcohol compared with women. Among the 27 women, a post hoc exploratory analysis found that use of combination (ethinyl estradiol + progestin) oral contraceptive pills (N = 7) was associated with higher baseline and postconsumption levels of cortisol compared with naturally cycling women (N = 11) and women (N = 9) using long-acting reversible contraceptives. However, removing those participants from the analysis did not change the sex-specific results.

Conclusions

A person's biological sex relates to the endocrine response to a binge-like drinking episode. Sex differences in LHPA axis reactivity to higher doses of alcohol might influence women's and men's proclivity to develop neuroendocrine tolerance when imbibing the drug more chronically.

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生理性别与狂饮后内分泌应激反应的关系

背景：在美国，年轻女性的酗酒率比男性上升得更快。当快速“狂欢”时，大量的酒精可能会激活两性二态，边缘-下丘脑-垂体-肾上腺（LHPA）压力轴。我们在实验室中检测了血浆促肾上腺皮质激素（ACTH）和皮质醇对高剂量酒精的反应，以确定社交饮酒者在醉酒时是否表现出性别特异性的应激反应。考虑到三分之一的年轻女性使用激素避孕药（HC），这也可能影响应激激素的释放，我们以事后的方式探讨了HC的使用是否与女性的LHPA反应有关。方法：51名参与者（M年龄= 22.5±1.3岁，53%为女性）在体积比为20%的溶液中饮用酒精（M = 54.7±11.5 gm，性别调整），时间为上午9点，时间为10分钟。呼吸酒精浓度（BrAC）、血压和心率读数依次获得。在基线和每30分钟采集一次血液样本，直至消耗后4小时。重复测量ANCOVA和曲线下面积模型测试了性别对激素的影响。结果：尽管在整个实验过程中，两性之间的brac几乎重叠（消费后60分钟峰值= 0.12 gm/dL），但与女性相比，男性对高剂量酒精表现出显著升高的血浆ACTH（按时间性别效应，p = 0.023）和皮质醇（p = 0.030）反应。在27名女性中，一项事后探索性分析发现，与自然循环的女性（N = 11）和长效可逆避孕药的女性（N = 9）相比，使用联合（乙炔雌二醇+黄体酮）口服避孕药的女性（N = 7）与更高的基线和消费后皮质醇水平相关。然而，将这些参与者从分析中剔除并没有改变性别差异的结果。结论：一个人的生理性别与内分泌对狂饮事件的反应有关。LHPA轴对高剂量酒精反应的性别差异可能会影响女性和男性在长期饮酒时产生神经内分泌耐受性的倾向。

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来源期刊

Alcohol (Hanover, York County, Pa.)

CiteScore

5.40

自引率

0.00%

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