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Prolonged activation of this axis contributes to sex-specific patterns of stress-induced hormonal imbalance, with significant implications for mental health. Recent studies, primarily conducted in mice but increasingly complemented by human data, have sought to elucidate the biological mechanisms underlying sex-dependent differences in HPA axis responses to stress. Central to these differences is the adrenal gland, a key component of the HPA axis that exhibits pronounced sexual dimorphism. Dimorphic traits of the adrenal cortex, spanning from tissue physiology, metabolism, and steroidogenesis to tissue turnover, progenitor recruitment, and the local microenvironment, shape the gland's adaptive capacity and hormonal output under stress. This review summarizes current knowledge on the sexually dimorphic hormonal response of the adrenal gland and the HPA axis, highlighting adrenocortical traits that underlie sex-differential steroidogenic responses to stress.<\/jats:p>","DOI":"10.1093\/ejendo\/lvag104","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:39:23Z","timestamp":1781613563000},"page":"R123-R126","source":"Crossref","is-referenced-by-count":0,"title":["Sexual dimorphism in the adrenal cortex: implications for stress responsiveness"],"prefix":"10.1093","volume":"194","author":[{"given":"Panagiota","family":"Siatra","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , 01307 Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan R","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , 01307 Dresden ,","place":["Germany"]},{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London , London WC2R 2LS ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , 8091 Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9635-4860","authenticated-orcid":false,"given":"Charlotte","family":"Steenblock","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , 01307 Dresden 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