Why men and women react differently to stress

Have you ever wondered why stress seems to hit men and women differently? The answer may lie deep within our brains, in a small but mighty area called the insula.

For the first time, University of California researchers have delved into how the insula reacts to stress differently in men and women, potentially unlocking new doors to personalized medicine.

Valsalva maneuver

In order to analyze the insula, the researchers employed a straightforward but powerful technique known as the Valsalva maneuver. This is a simple breathing exercise anyone can do. During the technique, you take a deep breath, hold it, and squeeze your nose and mouth shut. It’s like holding your breath while straining.

When you hold your breath like this, parts of your brain responsible for controlling your heart and blood pressure (like the insula) light up in the brain scans. This area is like a central hub, receiving information about your heart rate and blood pressure, and then telling your body how to adjust to keep things stable.

Doctors use this technique to check heart health, and athletes do it unknowingly when lifting weights or straining. Scientists are particularly interested in how it affects brain activity.

Functions of the insula

The insula plays a major role in everything from your heartbeat and breathing to how you feel emotions and understand others.

Different areas within it specialize in different tasks. One area might help you feel pain when you stub your toe, while another helps you understand when a friend is sad. 

This versatility allows the insula to influence many things, like how you make decisions, how aware you are of yourself, and even how you experience consciousness. 

When the delicate balance of connections within the insula is disrupted, it can set the stage for a cascade of negative emotions, including depression, anxiety, and even addiction.

Focus of the study

The researchers wanted to see if men and women’s brains react differently when they take the Valsalva maneuver test. To do this, they carefully picked 57 healthy adults (37 men, 20 women) with no major health problems.

During the maneuver, every participant’s heart rate, breathing pressure, and brain activity was monitored.

Structural differences in the insula

A key finding of the study is that the structure of insula differed in both men and women. Specifically, the middle short gyrus (MSG) region in the insula, is more pronounced in males compared to females. 

This observation suggests a wider range of sex-related differences that could potentially affect how our brains function in various ways.

Empathy and consciousness

Women typically have more “gray matter” in a part of the brain called the right insular cortex. This area is linked to emotions, empathy, and understanding your own body. More gray matter there could mean women are better at processing these things.

Men, on the other hand, tend to have more “folds” in their brains, called gyri. These folds allow them to fit more brain cells into the same space, potentially boosting their processing power in areas like thought, memory, and consciousness. 

The researchers also studied how this region responded to blood pressure changes in men and women. They focused on the front-right part, responsible for managing stress and keeping heart rate and blood pressure high. Here’s the surprising finding: men showed increased activity in this area during the test, while women’s activity stayed low.

“This is such a critical brain area and we hadn’t expected to find such strong differences between men and women’s brains,” said study lead author Dr. Paul Macey. 

“This region, the front-right insula, is involved with stress and keeping heart rate and blood pressure high. It’s possible the women had already activated this region because of psychological stress, so that when they did the physical test in the study, the brain region could not activate any more. However, it’s also possible that this region is wired differently in men and women.”

Emotions and body control

The study also focused on “insula fibers,” a brain component involved in emotions, senses, and body control. These fibers connect the insula to other brain areas, allowing it to process information from various sources.

The experts found differences in brain wiring between males and females, specifically in connections between the insula and a brain area involved in movement control. Females tend to have fewer connections in this pathway than males, suggesting hormones shape brain wiring differently in each sex.

These differences in wiring might explain why males and females sometimes respond differently to emotions, senses, and stress. For example, fewer connections between the insula and movement control area in females could influence how they integrate sensory information with physical responses like emotional expression or stress reactions.

Role of hormones

Sex hormones, like estrogen and testosterone, play a big role in how the insula works. They basically tell the insula’s cells which things to build and how, shaping how it’s wired.

Since men and women have different hormone levels, especially during puberty and later in life, the insula ends up wired differently in each.

For example, estrogen makes the insula’s connections grow and branch out more in women. This network is better at processing pain and feelings together leading to more women getting migraines than men. 

Predicting health risks

This research suggests that men and women might be at different risks for certain health problems, and that treatments might need to be tailored accordingly.

“This raises several questions for us, such as why is there a difference in brain pattern and might it reflect differences in health issues for men and women, particularly in cardiovascular disease variations,” said Dr. Macey.

For instance, the insula is important for heart health, so understanding how it differs between men and women could help explain why some diseases, like stroke, are more common in women later in life. This means we might need different approaches to prevent and treat heart problems in men and women.

Study implications

The study also helps us understand the insula’s role in certain mental health conditions like depression and anxiety. Since the insula is involved in emotions, figuring out how it works differently in men and women could lead to better treatments for these conditions.

Moreover, the insula also plays a role in how we feel pain, which is especially important for conditions like migraines that affect many more women than men. This knowledge could help develop new pain treatments that consider these sex differences.

Overall, this research highlights the importance of considering sex differences in medicine.  By understanding how men and women’s bodies work differently, we can create more personalized and effective treatments for everyone.

The study is published in the journal Frontiers in Neurology.

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