Alterations in sex hormone levels may play a role in differences in neural mechanisms underlying alcohol use in males and females. It is known that progesterone and its metabolites regulate neuronal function and interact with other neurotransmitter systems, including GABA, DA, and serotonin systems, to modulate the effect of alcohol on the brain (for review see (Peltier et al., 2019). Increasing evidence suggests that ovarian hormones account for SG differences in alcohol-motivated behavior, possibly through these mechanisms (Anker & Carroll, 2010; Becker, Perry, & Westenbroek, 2012). Women with consistently greater estradiol levels (mean=375.5 pmol/liter) demonstrate greater alcohol consumption than women with lower estradiol levels (mean=353.3 pmol/liter) (Muti et al., 1998), and this may be related to the mediating role of estradiol on DA efflux in women but not men (Yoest, Cummings, & Becker, 2014).
