Menstrual Cycle Effects on Mental Health Outcomes: A Meta-Analysis

Jang, Daisung; Elfenbein, Hillary Anger

doi:10.1080/13811118.2018.1430638

Cited by 38 publications

(28 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The estrogen protection hypothesis predicts that psychotic disorders worsen at times in the cycle when estrogen is low, around menstruation ( 43 ) and several publications support this assumption. A recent meta-analysis of studies with women with psychiatric diagnoses demonstrated worse mental health outcomes around the time of menstruation ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Schizophrenia and Sex Hormones: What Is the Link?

Brzezinski-Sinai

Brzezinski

2020

Front. Psychiatry

View full text Add to dashboard Cite

The involvement of gonadal hormones in the pathogenesis of schizophrenia has long been suspected because the psychosis differs in women and men and the illness first makes its appearance shortly after puberty. Changes in sex hormones have been linked with increased vulnerability to mood disorders in women, while testosterone have been associated with increased sexual drive and aggressiveness in men as well as women. Some studies have found abnormal levels of estrogens and testosterone in schizophrenia patients, but the results have been inconsistent and sometimes attributed to the hyperprolactinemia effect of antipsychotics, which may interfere with sex hormones production. The purpose of this review is to present the current knowledge on the link between blood levels of sex-hormones in women during the various stages of the female reproductive life (i.e. puberty, menstrual cycle, pregnancy, contraception, and menopause) and the course of schizophrenia. We also attempt to optimize the clinical approach to women with schizophrenia at these different stages.

show abstract

Section: Discussionmentioning

confidence: 99%

Schizophrenia and Sex Hormones: What Is the Link?

Brzezinski-Sinai

Brzezinski

2020

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…While our data showed that increase brain estrogen (Thy1-Ar female mice) had less depression-like behavior, other report demonstrated a significant increase in depression-like behavior in homozygous aromatase knockout (Ar −/− ) female mice compared to WT (Dalla et al, 2004). However, how essential does the level of endogenous estrogen plays in depression is unclear since studies demonstrated estrogen level-related mood and behaviors changes during the menstrual cycle in reproductive women (Jang and Elfenbein, 2018), as well as in female animals (Estrada-Camarena et al, 2011). As the changes of endogenous estrogen level in Ar +/− and Thy1-Ar mice are much greater than that occurred in regular estrous cycles for WT mice, we hypothesize that the behaviors changes in FST from these aromatase animal models might be influenced not only by the level of estrogen, but also the imbalanced sex hormones in our study.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Antidepressant Effect of Sertraline in Transgenic Mouse Models

Jiang

et al. 2019

Front. Cell. Neurosci.

View full text Add to dashboard Cite

The main purpose of this study is to explore sex differences in the antidepressant effect of sertraline in genetic knockout or overexpression estrogen-synthesizing enzyme aromatase (Ar) gene mouse models in the forced swim test (FST). Our results demonstrated a significant reduction of depression-like behavior in the mice with overexpression of brain aromatase (Thy1-Ar) compared to sex- and age-matched Ar+/− mice or wild type control mice. Using HPLC analysis, we also found an association between the brain estrogen-related antidepressive behavior and the regulation of serotonin (5-HT) system. Interestingly, a single dose administration of sertraline (10 mg/kg, i.p.) induced reduction of immobility time was found in all genotypes, except male Ar+/− mice. While the underlying mechanisms of sex-specific response on antidepressive effect of sertraline remain to be investigated, our data showed that female mice appear to be more sensitive to sertraline-induced changes of 5-HT system than male mice in the prefrontal cortex (PFC) and the hippocampus (HPC). Further investigation of sex-specific effect of brain estrogen on antidepressant is needed.

show abstract

“…Consistent with previous meta-analyses 14 we standardized to a 28-day cycle where day 1 was defined as the first day of menstruation and day 24–day 5 was pre-specified as the perimenstrual phase. While we initially intended to analyze the premenstrual phase (day 24–day 28) and menstrual phase (day 1–day 5) separately, as per Jang and Elfenbein, 11 this was not possible because only 3 studies distinguished between these phases.…”

Section: Methodsmentioning

confidence: 99%

“…3,4,9,10 A recent meta-analysis pooling data across studies of women with psychiatric diagnoses (psychotic disorders, affective disorders, drug-related disorders) and those with no specific diagnosis (patients presenting with self-harm or suicidal behaviors) demonstrated worse mental health outcomes around the time of menstruation. 11 However, this study examined a sample of women with different psychiatric disorders; the extent to which this relationship is evident in those with psychotic disorders is not known. In the present study, we sought to address this issue by conducting a systematic review of the evidence for menstrual exacerbation of psychotic disorders and synthesizing the evidence by meta-analysis.…”

Section: Introductionmentioning

confidence: 98%

Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

Reilly

Bastida

Joyce

et al. 2019

Schizophrenia Bulletin

View full text Add to dashboard Cite

Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31–1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

show abstract

Menstrual Cycle Effects on Mental Health Outcomes: A Meta-Analysis

Cited by 38 publications

References 54 publications

Schizophrenia and Sex Hormones: What Is the Link?

Schizophrenia and Sex Hormones: What Is the Link?

Sex Differences in Antidepressant Effect of Sertraline in Transgenic Mouse Models

Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

Contact Info

Product

Resources

About