Evaluating the Effect of Depression, Anxiety, and Post-Traumatic Stress Disorder on Anti-Müllerian Hormone Levels Among Women Firefighters

Objective: To assess whether depression, anxiety, and post-traumatic stress disorder (PTSD) are associated with serum anti-Müllerian hormone (AMH) levels. Study Design: We used data from a sample of women firefighters from the Fire Fighter Cancer Cohort Study. Participant demographics, reproductive history, and self-reported clinical diagnosis of anxiety, depression, and PTSD were collected with serum for AMH analysis at enrollment. Main Outcome Measure: Linear regression models were used to estimate the association between anxiety, depression, and PTSD and log transformed AMH levels adjusted for age years (continuous and squared) and body mass index. Percent difference in AMH was calculated by [exp(β) - 1] × 100. Results: Among 372 participants, with mean ± standard deviation age 32.54 ± 6.32, clinical diagnoses were reported as follows: depression (15%), anxiety (18.2%), or PTSD (8.7%). No statistically significant association was observed between depression and AMH levels (-22%Δ, 95% confidence interval [CI]: -47.3, 14.5). Women firefighters with a history of anxiety (-33%Δ, 95% CI: -53.5, -4.2) and PTSD (-66%Δ, 95% CI: -79.1, -44.6) had lower serum AMH compared with participants without those conditions. When individuals with concurrent PTSD were excluded, the association between anxiety ceased to be statistically significant (26.7%Δ, 95% CI: -17.9, 92.6). Conclusion: A history of clinically diagnosed anxiety or PTSD was associated with statistically significantly lower AMH levels. This association offers insight into the potential biological mechanisms through which mental health conditions may influence reproductive health.