Bozzatello, P., Garbarini, C., Rocca, P., & Bellino, S. (2021). Borderline Personality Disorder: Risk Factors and Early Detection. Diagnostics (Basel, Switzerland), 11(11), 2142. https://doi.org/10.3390/diagnostics11112142

Saint Olaf College

Hormonal dysregulation is a significant area of research in Borderline Personality Disorder (BPD), with findings pointing to several key anomalies:

 Hypothalamic-Pituitary-Adrenal (HPA) Axis Activity: Individuals with BPD often display abnormal activity in the HPA axis (Bozzatello et al., 2021). These anomalies are thought to arise primarily from traumatic environments or experiences of maltreatment, leading to elevated cortisol levels (Bozzatello et al., 2021). While genetic predisposition was once considered a major factor, current research suggests that the strenuous climate may play a more significant role in adapting neurobiology.

Cortisol Levels:
Elevated in Trauma: Studies have revealed significantly higher cortisol levels in children with BPD who have experienced child abuse compared to those who have not. This reinforces the idea that the environment likely contributes to increased cortisol levels in individuals with BPD.

Comparison with Eating Disorders: Unlike BPD, where environmental factors are linked to higher cortisol, in eating disorders, particularly Anorexia Nervosa (AN), cortisol levels tend to decrease as individuals establish regular eating patterns gradually (Steiger, 2004). However, individuals with BPD also show frequent disruptions in cortisol levels, similar to those seen in eating disorders.

Testosterone Levels: A unique study by Dyson et al. (2023) identified that women with BPD specifically tend to have higher levels of testosterone. This finding is not commonly observed among individuals with eating disorders.

Recognizing these hormone imbalances is crucial, as these findings may help in elucidating potential medications that could enhance the daily lives of individuals with BPD.


Hormone Disruption in BPD and EDs

Borderline Personality Disorder: Risk Factors, Early Detection, and Hormone Disruption.

Dyson Tori, Thomas Susan J., Townsend Michelle L., Finch Adam, South Alexandra, Barkus Emma, Walter Emma, Mendonca Carley, Grenyer Brin F. S., Pickard Judy A. (2023). Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention. Frontiers in Psychology, 14(14). https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1195187

Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention. 

Steiger, H. (2004). Eating disorders and the serotonin connection: state, trait, and developmental effects. Journal of psychiatry & neuroscience: JPN, 29(1), 20–29.

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