Hormonal Changes, Depression: What Is The Connection?

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Women are more susceptible to mood disorders and depression during hormonal transitions, such as pregnancy, postpartum and perimenopause, according to a new report by the Society for Women's Health Research, a Washington, D.C.-based advocacy organization, released at a media briefing held at the Palace Hotel in New York City today.

The report summarizes a June 2007 thought leaders' roundtable of eight national experts convened by the Society and the National Institute of Mental Health to discuss current efforts to understand the effects of hormonal transitions on mood disorders in women and to make recommendations for future research.

"Women need to be critically aware of changes in their moods during key life cycle events," said Sherry Marts, Ph.D. and vice president of scientific affairs for the Society. "The roundtable kicked off a much needed discussion about the relationship between hormonal transitions and mood disorders. Through the media briefing and the publishing of this report we hope to generate a broader understanding of how we can use this knowledge to improve health outcomes for women."

Leading women's health experts and roundtable participants Peter Schmidt, M.D., an investigator in the National Institute of Mental Health's Reproductive Endocrine Studies Unit, and Zachary Stowe, M.D., an associate professor of psychiatry and behavioral sciences and gynecology and obstetrics at Emory University School of Medicine in Atlanta, Ga., reconvened at the briefing to discuss their research findings detailed in the report. They were joined on the briefing panel by Meir Steiner, M.D., Ph.D., a professor of psychiatry and behavioral neurosciences, obstetrics and gynecology at McMaster University in Hamilton, Ontario, Canada. Marts moderated the session.

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The panelists noted that while it is natural for women to experience changes in their feelings and mood during life cycle transitions, hormonal fluctuations in some women may trigger mild to severe mood disorders such as depression and bipolar disorder, particularly during pregnancy, postpartum and perimenopause. The report notes that postpartum depression affects 10-15 percent of women any time from a month to a year after childbirth and its cause remains unknown. Researchers suspect that the dramatic shifts in hormone levels during pregnancy and immediately afterward may result in chemical changes in the brain leading to postpartum depression. Similarly, perimenopause transitions in women may also increase risk of depression, and subsequently could lead to cardiovascular mortality.

"Science has revealed clues as to why these changes may occur in some women but further research is needed to definitively show what causes depression and mood disorders in women during hormonal transitions," said Schmidt. "The report outlines directions for further research, as recommended by myself and the roundtable participants."

According to the report, areas of research that need further exploration include:

-- Pregnancy: Research is needed to better distinguish symptoms of depression from normal responses to the stressful experiences of pregnancy.

-- Postpartum: Registries of collected reproductive safety information on antidepressant, antipsychotic and anticonvulsant medications must be created.

-- Perimenopause: Research is needed to uncover the susceptibility markers that predict which women are at risk for developing depression during perimenopause.

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