Sex Differences, Progesterone, and Ischemic Stroke

Abstract

The incidence, prevalence and outcomes of ischemic stroke differ between women and men. These differences between sexes are considered to partly result from the protective actions that estrogens exert on neural cells, whereas potential beneficial effects of progesterone are rarely taken into account. However, preclinical work provides strong evidence for the cerebroprotective efficacy of progesterone. Recently, we uncovered an important role of endogenous brain progesterone in the resistance of the male brain to ischemic injury. Surprisingly, progesterone well known as a female reproductive hormone, appears to play a more important protective role in male mice when compared to females. Although gonadal hormones and neurosteroids exert major influences on stroke incidence and outcomes, other age-related systemic health factors play important roles, such as metabolic dysfunction, high blood pressure, inflammatory state and alterations in brain structure.