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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Behav. Neurosci.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Behavioral Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Behav. Neurosci.</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">1662-5153</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fnbeh.2025.1655725</article-id><article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading"><subject>Mini Review</subject></subj-group>
</article-categories>
<title-group>
<article-title>Sex differences in G protein-coupled estrogen receptor-mediated mechanisms in preclinical models of anxiety and fear</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Tran</surname>
<given-names>AnBinh S.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/3116147"/>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="investigation" vocab-term-identifier="https://credit.niso.org/contributor-roles/investigation/">Investigation</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing &#x2013; original draft</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; review &amp; editing" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-review-editing/">Writing &#x2013; review &#x0026; editing</role>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Maeng</surname>
<given-names>Lisa Y.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/1263273"/>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Funding acquisition" vocab-term-identifier="https://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="supervision" vocab-term-identifier="https://credit.niso.org/contributor-roles/supervision/">Supervision</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; review &amp; editing" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-review-editing/">Writing &#x2013; review &#x0026; editing</role>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label><institution>Department of Psychology, University of Massachusetts Boston</institution>, <city>Boston, MA</city>, <country country="us">United States</country></aff>
<aff id="aff2"><label>2</label><institution>Department of Psychology, Developmental and Brain Sciences Program, University of Massachusetts Boston</institution>, <city>Boston, MA</city>, <country country="us">United States</country></aff>
<author-notes><corresp id="c001"><label>&#x002A;</label>Correspondence: Lisa Y. Maeng, <email xlink:href="mailto:lisa.maeng@umb.edu">lisa.maeng@umb.edu</email></corresp></author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2025-11-11">
<day>11</day>
<month>11</month>
<year>2025</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2025</year>
</pub-date>
<volume>19</volume>
<elocation-id>1655725</elocation-id>
<history>
<date date-type="received">
<day>28</day>
<month>06</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>14</day>
<month>10</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 Tran and Maeng.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Tran and Maeng</copyright-holder>
<license><ali:license_ref start_date="2025-11-11">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Sex differences are well-documented in the prevalence of psychiatric disorders, with anxiety and stress-related conditions more common in women. Growing evidence highlights the role of sex hormones, particularly estradiol (E2), and its receptor mechanisms as contributing factors to this disparity. Estrogen exerts its effects through three main receptors: estrogen receptor alpha (ER&#x03B1;), estrogen receptor beta (ER&#x03B2;), and the G protein-coupled estrogen receptor (GPER). While the classical receptors ER&#x03B1; and ER&#x03B2; have been widely studied in the context of fear and anxiety, the role of GPER remains less understood. Moreover, estrogen receptors themselves may be sexually dimorphic, adding complexity to their functional roles. Preclinical research has been valuable in advancing our understanding of these mechanisms; therefore, this review mostly focuses on findings from rodent studies. Here we discuss the influence of sex and E2 on anxiety and fear-related behavior, highlight emerging research on sex differences in GPER modulation of fear and anxiety in mice, rats, and humans, and explore GPER as a potential therapeutic target for anxiety and stress-related disorders.</p>
</abstract>
<kwd-group>
<kwd>GPER</kwd>
<kwd>estradiol</kwd>
<kwd>GPR30</kwd>
<kwd>fear</kwd>
<kwd>anxiety</kwd>
<kwd>stress</kwd>
<kwd>sex differences</kwd>
</kwd-group><funding-group><award-group id="gs1"><funding-source id="sp1"><institution-wrap><institution>University of Massachusetts Boston</institution><institution-id institution-id-type="doi" vocab="open-funder-registry" vocab-identifier="10.13039/open_funder_registry">10.13039/100012005</institution-id></institution-wrap></funding-source></award-group><funding-statement>The author(s) declare that financial support was received for the research and/or publication of this article. This work is supported by internal project awards from the University of Massachusetts Boston.</funding-statement></funding-group><counts>
<fig-count count="1"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="62"/>
<page-count count="7"/>
<word-count count="6020"/>
</counts>
<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Behavioral Endocrinology</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<title>Introduction</title>
<p>Estrogens, particularly 17&#x03B2;-estradiol (E2), are steroid hormones that significantly influence the neurobiological mechanisms underlying emotional learning and memory. E2, the most potent form of estrogen, is present in both sexes, but most research on its effects on these processes has been conducted in females. Emerging evidence suggests that E2 may exert sex-specific effects, potentially contributing to observed sex differences in the prevalence of anxiety and stress-related disorders, such as post-traumatic stress disorder (PTSD). For instance, low E2 levels have been associated with heightened anxiety in women, whereas elevated E2 levels in men have been linked to increased depressive symptoms (<xref ref-type="bibr" rid="ref56">Stanikova et al., 2018</xref>).</p>
<p>E2 acts through classical genomic pathways via nuclear estrogen receptors such as estrogen receptor alpha (ER&#x03B1;) and estrogen receptor beta (ER&#x03B2;), as well as rapid, non-genomic mechanisms involving membrane-bound receptors. One such receptor, the G protein-coupled estrogen receptor (GPER), notable for its distinct structure and role in neurophysiology, has been implicated in the modulation of anxiety, fear behaviors, stress responses, and memory consolidation&#x2013; crucial processes in the pathophysiology of PTSD and other anxiety-related disorders. This review examines current preclinical findings on E2&#x2019;s role in mediating sex differences in stress- and fear-related behaviors, focusing on GPER&#x2019;s potential involvement and its sex-specific mechanisms.</p>
<sec id="sec2">
<title>Sex and estradiol influences on animal behavior</title>
<p>Various well-established behavioral paradigms have been used to model fear and anxiety in rodents, providing insights into the mechanisms underlying conditions such as PTSD and anxiety disorders. Sex differences have been reported in the behavioral outcomes of these paradigms and appear to be sensitive to E2&#x2019;s modulatory effects. These paradigms highlight how sex hormones, particularly E2, influence fear and anxiety responses.</p>
<sec id="sec3">
<title>Elevated plus maze test</title>
<p>The elevated plus maze (EPM) test measures anxiety-like behavior by assessing a rodent&#x2019;s exploration of open arms versus enclosed arms, with more time spent in the open arms suggesting lower anxiety (<xref ref-type="bibr" rid="ref52">Pellow et al., 1985</xref>). Adult female Wistar rats spend more time and make more open arm entries than males, indicating less anxiety-like behavior (<xref ref-type="bibr" rid="ref31">Johnston and File, 1991</xref>; <xref ref-type="bibr" rid="ref38">Knight et al., 2021</xref>). Circulating gonadal hormones may mediate these sex differences. Female rats in proestrus spent significantly more time in the open arms of the EPM than male rats, OVX rats, or rats in other estrous stages. E2 administration to rats in diestrus also increased open-arm time (<xref ref-type="bibr" rid="ref44">Marcondes et al., 2001</xref>), suggesting an anxiolytic effect.</p>
</sec>
<sec id="sec4">
<title>Open field test and light&#x2013;dark test</title>
<p>The open field test (OFT) and light&#x2013;dark test (LDT) are also used to assess anxiety behavior. In the LDT, spending more time in the dark compartment suggests higher anxiety (<xref ref-type="bibr" rid="ref8">Bourin and Hasco&#x00EB;t, 2003</xref>), whereas in the OFT, more time spent in the center versus the periphery indicates reduced anxiety (<xref ref-type="bibr" rid="ref50">Ohl, 2003</xref>). Sex differences and gonadal hormone influences have been noted in anxiety-related behaviors in the OFT (<xref ref-type="bibr" rid="ref5">Blizard et al., 1975</xref>). <xref ref-type="bibr" rid="ref38">Knight et al. (2021)</xref> reported that adult female Wistar rats traveled more to and spent more time in the center of the OF than males. In addition, female mice given E2 subcutaneously spent significantly more time in the OFT center and significantly more time in the LDT lit area (<xref ref-type="bibr" rid="ref59">Walf and Frye, 2010</xref>), indicating anxiolytic E2 effects.</p>
</sec>
<sec id="sec5">
<title>Fear conditioning and extinction</title>
<p>Fear conditioning is a paradigm for investigating mechanisms underlying fear control, which is impaired in PTSD and anxiety (<xref ref-type="bibr" rid="ref47">Milad and Quirk, 2012</xref>; <xref ref-type="bibr" rid="ref64">Zoladz et al., 2012</xref>). Learning how to reduce or regulate fear responses once a threat is removed, a process known as fear extinction, has been integral to treatments for fear-related disorders, while poor extinction learning and memory are characteristic of PTSD (<xref ref-type="bibr" rid="ref47">Milad and Quirk, 2012</xref>).</p>
<p>E2 levels influence sex differences in fear extinction. High E2 female rats display greater fear extinction retention in a manner similar to males, and both outperform low E2 females (<xref ref-type="bibr" rid="ref46">Milad et al., 2009</xref>). In contextual and auditory fear conditioning, male rodents have exhibited stronger conditioned fear acquisition compared to female rodents (<xref ref-type="bibr" rid="ref45">Maren et al., 1994</xref>), which was unaffected by castration (<xref ref-type="bibr" rid="ref3">Anagnostaras et al., 1998</xref>). Alternatively, ovariectomized (OVX) female rats have shown enhanced fear expression, suggesting E2 may reduce fear expression (<xref ref-type="bibr" rid="ref23">Gupta et al., 2001</xref>). Additionally, females in proestrus and estrus have displayed more rapid rates of successful fear extinction compared to males and diestrus females. E2-treated OVX females had more rapid rates of successful fear extinction when compared to control and OVX females treated with progesterone (<xref ref-type="bibr" rid="ref12">Chang et al., 2009</xref>). Together, these data highlight E2&#x2019;s capability to regulate fear.</p>
</sec>
<sec id="sec6">
<title>Single prolonged stress model</title>
<p>A preclinical model used to study neurobiological mechanisms underlying PTSD is the single prolonged stress (SPS) paradigm. Rodents are subjected to a sequence of stressors, including forced swim, restraint stress, and anesthesia, followed by a post-stress incubation period. After SPS, rodents show enhanced fear responses and impaired fear extinction, similar to symptoms observed in PTSD patients (<xref ref-type="bibr" rid="ref40">Liberzon et al., 1997</xref>). Female rats administered an estrogen receptor antagonist before SPS did not exhibit the typical SPS-induced impairment in extinction (<xref ref-type="bibr" rid="ref4">Biddle and Knox, 2023</xref>). E2-treated SPS females also showed no change in freezing levels during extinction training, whereas E2 reduced freezing in non-SPS control rats (<xref ref-type="bibr" rid="ref4">Biddle and Knox, 2023</xref>). These data indicate that E2 can modulate SPS-induced effects on fear extinction (<xref ref-type="bibr" rid="ref35">Keller et al., 2015</xref>).</p>
<p>Together, these findings support a modulatory role of E2 in fear and anxiety. E2 contributes to sex differences observed in fear extinction and anxiety-like behavior and may confer resilience against stress-induced impairments, particularly in females. This highlights the importance of investigating the receptor mechanisms underlying E2&#x2019;s effects in both sexes.</p>
</sec>
</sec>
<sec id="sec7">
<title>GPER&#x2019;S discovery, mechanism, signaling effects, and function</title>
<p>The classical genomic nuclear receptors, ER&#x03B1; and ER&#x03B2;, have been extensively studied for their role in modulating anxiety and fear behaviors (<xref ref-type="bibr" rid="ref13">Cover et al., 2014</xref>; <xref ref-type="bibr" rid="ref7">Borrow and Handa, 2017</xref>). However, the G protein-coupled receptor, also known as GPER and GPR30 (<xref ref-type="bibr" rid="ref1">Alexander et al., 2008</xref>), is the focus of this review due to its recent implication in these processes. GPER was first identified and cloned in the 1990s (<xref ref-type="bibr" rid="ref49">O'Dowd et al., 1998</xref>; <xref ref-type="bibr" rid="ref11">Carmeci et al., 1997</xref>) and was found to mediate E2&#x2019;s rapid non-genomic effects (<xref ref-type="bibr" rid="ref19">Filardo et al., 2000</xref>; <xref ref-type="bibr" rid="ref20">Filardo et al., 2002</xref>). The selective GPR30 agonist, G1, and selective antagonists, G15 and G36, were developed between 2006 and 2011 (<xref ref-type="bibr" rid="ref6">Bologa et al., 2006</xref>; <xref ref-type="bibr" rid="ref15">Dennis et al., 2009</xref>; <xref ref-type="bibr" rid="ref16">Dennis et al., 2011</xref>), and they have been integral to understanding GPER function.</p>
<p>Diverging from classical ER&#x03B1; and ER&#x03B2; genomic mechanisms, GPER activates pathways via a nongenomic mechanism (<xref ref-type="bibr" rid="ref30">Iqbal et al., 2024</xref>) and initiates rapid transcriptional responses, including quick activation of ion channels and second messenger pathways within seconds to minutes. Once an agonist, such as G1, binds to the receptor, G proteins divide into subunits G&#x03B1; and G&#x03B2;&#x03B3; (<xref ref-type="bibr" rid="ref42">Luo et al., 2023</xref>) as well as G&#x03B1;i/o and Gq/11 proteins (<xref ref-type="bibr" rid="ref9">Bushi et al., 2025</xref>). G&#x03B1; activates adenylyl cyclase (AC), an enzyme that converts adenosine triphosphate into cyclic adenosine monophosphate (<xref ref-type="bibr" rid="ref57">Thomas et al., 2005</xref>), which then activates protein kinase A (PKA), an enzyme regulating cellular processes (<xref ref-type="bibr" rid="ref57">Thomas et al., 2005</xref>). In contrast, G&#x03B1;i/o suppresses AC activity, resulting in lower cAMP levels and reduced activation of PKA, while simultaneously stimulating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway, aiding cell survival, growth, and metabolism (<xref ref-type="bibr" rid="ref9">Bushi et al., 2025</xref>). G&#x03B2;&#x03B3; recruits a steroid receptor coactivator, which activates metalloproteinases and causes the release of heparin-binding epidermal growth factors (HB-EGFs) from the cell surface (<xref ref-type="bibr" rid="ref53">Prossnitz et al., 2008</xref>). These HB-EGFs transactivate an EGF receptor, resulting in PI3K/Akt, ERK1/2, and MAPK pathway activations (<xref ref-type="bibr" rid="ref19">Filardo et al., 2000</xref>; <xref ref-type="bibr" rid="ref10">Bustamante-Barrientos et al., 2021</xref>; <xref ref-type="bibr" rid="ref9">Bushi et al., 2025</xref>). G&#x03B2;&#x03B3; also participates in regulation of potassium and calcium ion flow across the cell membrane, processes critical for cellular excitability, function, and responsiveness. Additionally, PLC&#x03B2; is activated by G&#x03B2;&#x03B3;, enhancing inositol trisphosphate (IP3) and diacylglycerol (DAG) production. The Gq/11 signaling pathway activates phospholipase C, which also catalyzes the formation of IP3 and DAG. IP3 facilitates the release of calcium ions from the endoplasmic reticulum into the cytosol, increasing intracellular calcium and initiating calcium-dependent activities. Concurrently, DAG activates protein kinase C, which phosphorylates target proteins involved in functions such as secretion, gene transcription, and cell proliferation (<xref ref-type="bibr" rid="ref9">Bushi et al., 2025</xref>).</p>
<p>Sex differences in GPER signaling pathways have been described. GPER activation enhances object recognition (OR) and spatial memory performance in gonadectomized (GDE) male and female mice via different signaling mechanisms. Behavioral effects of GPER involved C-Jun N-terminal kinase (JNK) signaling in the dorsal hippocampus (DH) in females; however, CREB levels, but not JNK, were increased in the DH in males, indicating sex-specific signaling pathways in the DH (<xref ref-type="bibr" rid="ref37">Kim et al., 2016</xref>; <xref ref-type="bibr" rid="ref43">Machado et al., 2024</xref>).</p>
<p>GPER activity can also impact physiological and hormonal stress responses. Inhibition of GPER via G15 treatment has been shown to prevent the rapid, non-genomic effects of corticosterone (CORT) in the infralimbic region of the medial prefrontal cortex in male mice (<xref ref-type="bibr" rid="ref32">Karst and Jo&#x00EB;ls, 2023</xref>). Given the sexually dimorphic nature of the hypothalamic&#x2013;pituitary&#x2013;adrenal (HPA) axis (<xref ref-type="bibr" rid="ref27">Heck and Handa, 2019</xref>), GPER may also play a role in mediating sex differences in stress-induced CORT responses. For example, GPER-knockout (GPER-KO) female rats exhibited significantly lower basal serum CORT levels compared to wild-type females, and this difference varied across the estrous cycle, suggesting estrous phase-dependent GPER effects on basal CORT (<xref ref-type="bibr" rid="ref63">Zheng et al., 2020</xref>). <xref ref-type="bibr" rid="ref63">Zheng et al. (2020)</xref> also found that after acute restraint stress exposure, GPER-KO females showed an increased adrenocorticotropic hormone (ACTH) response compared to WT females, an effect that was more pronounced in females than males, indicating a sex-dependent role for GPER in stress reactivity.</p>
</sec>
<sec id="sec8">
<title>GPER localization within the brain</title>
<p>GPER is widely expressed in various tissues and cell types. It is found in the hippocampus, cerebral cortex, hypothalamus, striatum, and amygdala of the central nervous system (<xref ref-type="bibr" rid="ref42">Luo et al., 2023</xref>). More specifically, it can be found in the perirhinal cortex, pituitary, substantia nigra, basolateral amygdala, as well as the cholinergic neurons of the basal forebrain (<xref ref-type="bibr" rid="ref24">Hammond and Gibbs, 2011</xref>; <xref ref-type="bibr" rid="ref26">Hazell et al., 2009</xref>; <xref ref-type="bibr" rid="ref58">Tian et al., 2013</xref>; <xref ref-type="fig" rid="fig1">Figure 1</xref>). It is also widely distributed on the subcellular level, with reports of expression in the cell membrane, endoplasmic reticulum, Golgi complex, and nucleus (<xref ref-type="bibr" rid="ref42">Luo et al., 2023</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>GPER localization in the rodent brain. GPER is found in the cerebral cortex, hippocampus, hypothalamus, basal forebrain, ventral striatum, amygdala, and pituitary. Created in <ext-link xlink:href="http://BioRender.com" ext-link-type="uri">BioRender.com</ext-link>.</p>
</caption>
<graphic xlink:href="fnbeh-19-1655725-g001.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Illustration of a brain highlighting different regions with colors: blue for cerebral cortex, green for hippocampus, yellow for hypothalamus, pink for ventral striatum, orange for amygdala, dark blue for pituitary, purple for basal forebrain. A key is included.</alt-text>
</graphic>
</fig>
<p>GPER distribution also appears to be sex-specific (<xref ref-type="bibr" rid="ref41">Llorente et al., 2020</xref>; <xref ref-type="bibr" rid="ref29">Hutson et al., 2019</xref>). GPER immunoreactive cells were higher in adult male Wistar rats than females in the posterodorsal medial amygdala and specific subdivisions of the CA1-CA3 and dentate gyrus of the DH (<xref ref-type="bibr" rid="ref41">Llorente et al., 2020</xref>); however, GPER expression was higher in the basolateral amygdala of females compared to males. Importantly, GPER expression appeared to differ in subregions of both the amygdala and DH across the estrous phases in females (<xref ref-type="bibr" rid="ref41">Llorente et al., 2020</xref>). These findings suggest that estradiol modulation via GPER activation in the limbic areas, amygdala, and DH may be sex- and estrous cycle-dependent.</p>
</sec>
</sec>
<sec id="sec9">
<title>Animal studies&#x2014;mice</title>
<sec id="sec10">
<title>GPER&#x2019;S role in fear behavior</title>
<p>GPER&#x2019;s role in fear memory appears to be sex- and age-dependent. In middle-aged male mice, GPER expression is significantly reduced in the hippocampus, the structure playing a key role in learning and memory (<xref ref-type="bibr" rid="ref62">Xu et al., 2018</xref>). Subcutaneous GPER agonist G1 treatment for 15&#x202F;days in intact male and female middle-aged mice improved contextual and cued fear memory in a dose-dependent manner through the activation of brain-derived neurotrophic factor/tropomyosin receptor kinase B (BDNF/TrkB) signaling, but not in 2-month-old male mice (<xref ref-type="bibr" rid="ref62">Xu et al., 2018</xref>). Although GPER activation appears to generally enhance memory consolidation in both sexes, age may limit its effects on contextual and cued fear memory processes in male mice.</p>
<p>GPER knockout revealed sex differences in fear behavior, with GPER-KO female mice freezing more than males when returned to the conditioning context after contextual fear conditioning (<xref ref-type="bibr" rid="ref39">Koitm&#x00E4;e et al., 2023</xref>). Freezing was also higher in GPER-KO female mice in the high E2 estrous cycle phase compared to those in low E2 phases. Further, there was enhanced long-term potentiation in GPER-KO female mice and increased spinophilin expression in the hippocampus of low E2 GPER-KO female mice (<xref ref-type="bibr" rid="ref39">Koitm&#x00E4;e et al., 2023</xref>). These findings suggest that GPER activity enhances contextual fear memory consolidation in both sexes, but its absence reveals sex differences and estrous phase-dependent changes in hippocampal synaptic plasticity and fear behavior.</p>
</sec>
<sec id="sec11">
<title>GPER&#x2019;S role in anxiety behavior</title>
<p>Findings on GPER&#x2019;s role in anxiety-related behaviors in mice are mixed, with some studies suggesting that GPER activation increases anxiety, whereas others demonstrate anxiety-reducing effects. <xref ref-type="bibr" rid="ref33">Kastenberger et al. (2012)</xref> reported that subcutaneous GPER agonist G1 administration induced anxiety-like behaviors in both intact male and OVX female mice, reducing open-arm exploration in the EPM and time and distance traveled in LDT. <xref ref-type="bibr" rid="ref34">Kastenberger and Schwarzer (2014)</xref> found that GPER-KO male mice had greater open-arm exploration and increased time in lit areas, indicating reduced anxiety. Further, GPER-KO female mice in estrus displayed more center time, distance traveled, and visits than WT mice in estrus in the OFT. GPER-KO female mice in proestrus also displayed increased center visits, but not center time or distance traveled in the OFT (<xref ref-type="bibr" rid="ref34">Kastenberger and Schwarzer, 2014</xref>), suggesting an anxiogenic role for GPER.</p>
<p>In contrast, <xref ref-type="bibr" rid="ref25">Hart et al. (2014)</xref> found that GPER activation with G1 treatment given 30&#x202F;min prior to testing reduced anxiety behaviors in the EPM in GDE males, suggesting an anxiolytic role for GPER (<xref ref-type="bibr" rid="ref25">Hart et al., 2014</xref>). This may reflect an impact of hormonal status, or the absence of circulating gonadal hormones in this case, on GPER&#x2019;s function. Further explorations should investigate whether the presence and levels of circulating gonadal hormones influence GPER&#x2019;s effects on behavior, possibly through interactions with other estrogen receptors. <xref ref-type="bibr" rid="ref25">Hart et al. (2014)</xref> also reported that GPER activation differentially enhanced ERK signaling in the DH of female mice, whereas ER&#x03B1; S118 phosphorylation was increased in the ventral hippocampus in male mice (<xref ref-type="bibr" rid="ref25">Hart et al., 2014</xref>). This highlights sex-dependent responses to GPER activation that may contribute to differences in anxiety behavior.</p>
<p>Stress exposure can alter GPER activity, with increased expression in the amygdala of OVX female mice displaying anxiety-like behavior following acute stress via restraint or forced swimming (<xref ref-type="bibr" rid="ref58">Tian et al., 2013</xref>). G1 infusions into the basolateral amygdala reversed anxiety-like behaviors, significantly increasing time spent in the EPM&#x2019;s open arms and time spent in the OF&#x2019;s center and suggesting anxiolytic GPER effects at this site (<xref ref-type="bibr" rid="ref58">Tian et al., 2013</xref>). Overall, these findings highlight sex- and site-specific GPER effects and the influence of circulating gonadal hormones. Additional GPER-KO studies are needed to identify specific contingencies leading to GPER&#x2019;s anxiogenic and anxiolytic properties and to clarify the receptor&#x2019;s mechanisms in these distinct behavioral effects.</p>
</sec>
</sec>
<sec id="sec12">
<title>Animal studies&#x2014;rats</title>
<sec id="sec13">
<title>GPER&#x2019;S role in fear behavior</title>
<p>Effects of GPER on fear-related learning and memory in female rats have been understudied; however, evidence in male rats has suggested a critical role for GPER in inhibitory avoidance (IA) memory consolidation. In intact adult male rats, subcutaneous G1 administered immediately, but not 3 or 6&#x202F;h, after IA conditioning resulted in a longer latency to step down from the platform in a retention test 24&#x202F;h later (<xref ref-type="bibr" rid="ref14">de Souza et al., 2021</xref>). GPER also appears to enhance aversive learning and memory consolidation in male rats if activated within a specific time window post-training. Only a higher G1 dose (150&#x202F;&#x03BC;g/kg) significantly enhanced IA memory, demonstrating the importance of dose in GPER&#x2019;s effects (<xref ref-type="bibr" rid="ref14">de Souza et al., 2021</xref>).</p>
</sec>
<sec id="sec14">
<title>GPER&#x2019;S role in anxiety behavior</title>
<p>Few studies have investigated sex differences in GPER&#x2019;s function in anxiety-related behaviors in rats. In GPER-KO female rats, acute restraint stress triggered a greater release of adrenocorticotropic hormone than in WT controls, a response absent in GPER-KO male rats (<xref ref-type="bibr" rid="ref63">Zheng et al., 2020</xref>). GPER-KO male and female rats also display increased anxiety-like behaviors, demonstrated by a significant reduction in EPM open-arm duration and entries, following SPS. SPS decreased serum corticosterone in WT rats but had no effect in GPER-KO rats (<xref ref-type="bibr" rid="ref63">Zheng et al., 2020</xref>). These findings suggest that GPER activation may be important for regulating anxiety. Further, intracerebroventricular G1 injections in OVX female rats produced anxiolytic effects, with increased EPM open arm time and decreased closed arm time compared to OVX control rats (<xref ref-type="bibr" rid="ref60">Wang et al., 2021</xref>). This is likely mediated by rapid PKA signaling, which may distinguish GPER from ER&#x03B1; and ER&#x03B2; in E2&#x2019;s influence on anxiety behavior in female rats. Due to the limited number of rat studies, further work is needed to address species differences, discrepancies across animal models, and to determine whether GPER&#x2019;s anxiolytic effects in rats are sexually dimorphic.</p>
</sec>
</sec>
<sec id="sec15">
<title>Human studies</title>
<p>Though very few human studies have investigated GPER and its role in anxiety, existing research suggests its involvement and indicates the translational potential of preclinical findings. Investigations of GPER&#x2019;s role in patients with generalized anxiety disorder (GAD) have yielded mixed results. While <xref ref-type="bibr" rid="ref21">F&#x0131;nd&#x0131;kl&#x0131; et al. (2016)</xref> found serum GPER levels were significantly higher in GAD patients, which correlated with GAD severity, <xref ref-type="bibr" rid="ref28">Hur&#x015F;ito&#x011F;lu et al. (2025)</xref> found significantly decreased GPER levels and no correlation between GPER levels and symptom severity. <xref ref-type="bibr" rid="ref21">F&#x0131;nd&#x0131;kl&#x0131; et al. (2016)</xref> excluded women experiencing irregular menstrual cycles, and patients with endocrine disorders and/or receiving drugs influencing serum prolactin levels, whereas <xref ref-type="bibr" rid="ref28">Hur&#x015F;ito&#x011F;lu et al. (2025)</xref> excluded women on hormonal replacement therapy, in post-menopause, and pregnant but did not examine sex differences. Further exploration of GPER influences in GAD are necessary to determine whether these differences in hormonal status might underlie differences in the findings.</p>
<p>Elevated GPER serum levels were also found in patients with major depressive disorder (<xref ref-type="bibr" rid="ref22">Findikli et al., 2017</xref>) and bipolar disorder (<xref ref-type="bibr" rid="ref51">Orhan et al., 2018</xref>), but reduced levels in patients with attention deficit hyperactivity disorder (ADHD; <xref ref-type="bibr" rid="ref55">Sahin et al., 2018</xref>) and autism spectrum disorder (ASD; <xref ref-type="bibr" rid="ref2">Altun et al., 2017</xref>). Depression and bipolar II are more common in females (<xref ref-type="bibr" rid="ref18">Eaton et al., 2012</xref>; <xref ref-type="bibr" rid="ref17">Diflorio and Jones, 2010</xref>), and ADHD and ASD are more prevalent in males (<xref ref-type="bibr" rid="ref61">Willcutt, 2012</xref>; <xref ref-type="bibr" rid="ref48">Napolitano et al., 2022</xref>). Thus, variations in GPER levels across psychiatric disorders appear to follow sex-specific patterns.</p>
</sec>
<sec sec-type="discussion" id="sec16">
<title>Discussion</title>
<p>Despite limited research on GPER&#x2019;s role in aversive learning and memory, current findings suggest that GPER enhances memory consolidation in both male and female rodents (summarized in <xref ref-type="supplementary-material" rid="SM1">Supplementary Table 1</xref>). Interestingly, its blockade or elimination leads to sex-specific effects depending on the type of learning and memory. Further, GPER&#x2019;s effects may also be age-dependent, and the timing of GPER manipulation after emotional learning appears critical for memory consolidation.</p>
<p>GPER&#x2019;s effects on anxiety behavior have yielded mixed results. Rat studies consistently support an anxiolytic role for GPER, whereas mouse studies show conflicting effects influenced by sex, the presence of circulating hormones, and genetic knockout conditions. These discrepancies point to sex-dependent, and likely hormone-modulated, mechanisms of GPER action, with some downstream effects relying on the JNK pathway and others on the PKA pathway. Additionally, GPER localization within the brain supports its site-specific behavioral effects. Together, these findings call for further research to clarify the mechanisms underlying GPER&#x2019;s sex and site-specific functions, its role in aversive learning and memory, and critical timing for its most pronounced effects. Addressing these gaps could inform therapeutic strategies targeting GPER for disorders involving emotional dysregulation and anxiety.</p>
<sec id="sec17">
<title>Future directions</title>
<p>Future research should further clarify GPER&#x2019;s role in fear and anxiety-related behaviors by using selective agonists and antagonists under time-controlled or site-specific experimental conditions. Evidence of sex-specific downstream effects of GPER activation and their influence on anxiety-related and fear behaviors highlights the need to conduct more studies in both sexes. Because hormonal status across the estrous cycle may also affect GPER effects, future studies should also investigate how GPER may interact with classical estrogen receptors and influence downstream signaling pathways. Together, these approaches could provide valuable insight into the therapeutic potential of GPER modulation in treating psychiatric disorders.</p>
</sec>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="sec18">
<title>Author contributions</title>
<p>AT: Conceptualization, Investigation, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. LM: Conceptualization, Funding acquisition, Supervision, Writing &#x2013; review &#x0026; editing.</p>
</sec>

<ack><title>Acknowledgments</title>
<p>The authors thank members of the Maeng Lab, especially Aanya Vishwanath, at the University of Massachusetts Boston for their constructive feedback on this manuscript.</p>
</ack>
<sec sec-type="COI-statement" id="sec20">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="sec21">
<title>Generative AI statement</title>
<p>The author(s) declare that no Gen AI was used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec sec-type="disclaimer" id="sec22">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec sec-type="supplementary-material" id="sec23">
<title>Supplementary material</title>
<p>The Supplementary material for this article can be found online at: <ext-link xlink:href="https://www.frontiersin.org/articles/10.3389/fnbeh.2025.1655725/full#supplementary-material" ext-link-type="uri">https://www.frontiersin.org/articles/10.3389/fnbeh.2025.1655725/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Table_1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" xmlns:xlink="http://www.w3.org/1999/xlink"/>
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</ref-list><fn-group><fn id="fn0001" fn-type="custom" custom-type="edited-by"><p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/108804/overview">Nikolaos Kokras</ext-link>, National and Kapodistrian University of Athens, Greece</p></fn>
<fn id="fn0002" fn-type="custom" custom-type="reviewed-by"><p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/2994055/overview">Pavlina Pavlidi</ext-link>, National and Kapodistrian University of Athens, Greece</p></fn></fn-group></back>
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