“…Therefore, considering the normal or high levels of estradiol during perimenopause, the use of extra doses of estrogen to ameliorate mood disorders in perimenopausal women is counterintuitive. Thus, to clarify this question, we raise three possibilities: (1) estradiol can increase the expression of PRs ( MacLusky and McEwen, 1978 ; Helena et al, 2009 ), thus, it is reasonable to suggest that estrogen therapy, by increasing PR expression, compensates for the low plasma levels of progesterone; (2) as estrogen effects on mood predominately occur through ERβ ( Bansal and Chopra, 2015 ; Bastos et al, 2015 ; Benmansour et al, 2016 ), estradiol therapy during perimenopause may positively modulate ERβ expression; and (3) because estrogens increases the activity of tryptophan hydroxylase (TPH), the rate-limiting enzyme in serotonin synthesis ( Hiroi et al, 2006 ), it may rectify potential deviations in serotonin synthesis in the dorsal raphe nucleus (DRN), a central nucleus for the control of emotions. To test these hypotheses, we used an animal model of perimenopause in which the natural follicle depletion is accelerated by the 4-vinylcycloxene diepoxide (VCD) retaining residual ovarian tissue ( Lohff et al, 2005 ).…”