Hormone therapy for reproductive depression in women

Abstract

An email survey of patients attending a PMS and Menopause Centre produced 238 patients whose principal presenting symptom was depression. Seventy-seven percent claimed to have had severe or moderate depression, 17% had had at least one psychotic episode and 14% had attempted suicide. Fifty-eight percent had seen a psychiatrist. Seventy-one percent had received antidepressants and 17% had received mood stabilising drugs. Twelve percent had been admitted to a psychiatric hospital and 3.8% had received electroconvulsive therapy. Sixty-eight percent had premenstrual syndrome as a teenager and 145 women (89%) out of 165 women who had been pregnant had no depression during pregnancy but 110 (66%) developed postnatal depression. Ninety-seven women (58%) who had been pregnant had suffered both premenstrual depression and postnatal depression. All were treated with transdermal estrogens and 93% also had transdermal testosterone. One hundred and seventy-one patients had a uterus and received cyclical progestogen to protect the endometrium and 63% of these developed the premenstrual syndrome-type symptoms of progesterone intolerance during the progestogen days. Thirty-five percent of patients claimed to be cured and 55% had a considerable improvement with estrogen therapy. Only 3.7% reported that there was no improvement. For 94%, the hormone therapy was a life-changing event for the better. None were worse. Forty patients had hysterectomy and bilateral oophorectomy for progesterone intolerance or heavy uterine bleeding and 38 replied that it was life changing for the better with less or no depression. It is concluded that premenstrual and postnatal depressions appear in the same vulnerable women. These women are typically well during pregnancy and are a sub group of reproductive depression which also develops climacteric depression in the transition phase. These types of depression are the product of hormonal changes and respond well to transdermal hormone therapy.

Progesterone and anxiety during the oestrus cycle in rats genetically selected for high and low active avoidance

“…As we noted above, progesterone plays a key role in development, differentiation, and diverse reproductive and non-reproductive functions. Particularly in the CNS, where progesterone regulates various functions such as reproductive behaviour (Gómez-Camarillo et al 2011), learning and memory (Yousuf et al 2017), neuroprotection (Singh, Su 2013), and mood (Conway et al 2007;Dichtel et al 2017;Studd 2014). A.…”

Hormones and depression in women

“…The most severe symptom often occur two to three years before the cessation of periods in what is called the menopausal transition or the perimenopause. There are now many scienti ic studies con irming the ef icacy estrogens and certainly the experience of menopausal experts and their patients strongly indicates that estrogens are very effective for this problem should be irst line therapy [5].…”

Investigation of variants in estrogen receptor genes and perinatal depression

“…The major hormone that undergoes such fluctuations in level during these periods is estrogen, and studies have also found that estrogen therapy is effective in the treatment of postnatal depression. 11 , 12 It has also been shown in animal studies that estrogen deprivation led to the decreased expression of serotonin receptors, which could be restored by the administration of estrogen. 13 Estrogens act on target tissues by binding to estrogen receptors.…”