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What is the relationship between hormones and mental health?
What is the relationship between hormones and mental health?

Keywords: Reproductive mood disorders. Perinatal depression. Perimenopause. Depression. Anxiety. Pregnancy. Mood. Hormone sensitivity.

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Written by IAPMD
Updated over a week ago

There's a whole area of research on something called “hormone sensitivity”, which just means that someone has an abnormal response to normal hormone changes across the menstrual cycle, during pregnancy, or during the menopause transition.  We refer to these issues of hormone sensitivity collectively as “reproductive mood disorders”. There are lots of experimental and observational studies in this area, and they generally demonstrate that some females have abnormal mood and cognitive responses to hormone changes, but that these hormone changes have minimal negative effects for the average woman/AFAB individual — so we have to keep both sides of this in mind. 

Individuals with premenstrual dysphoric disorder (PMDD) for example do show extreme emotional symptoms across the menstrual cycle particularly when progesterone is fluctuating. Those with perinatal depression or anxiety develop symptoms during or after pregnancy, when hormone levels show a huge increase across pregnancy and then decrease with delivery. Individuals with menopausal-onset mood disorders often have their first or worst depressive episodes during the menopause transition, when both estrogen and prog are fluctuating wildly as the menstrual cycle ends. Females can have varying degrees of this sort of hormone sensitivity, and it may or may not result in a diagnosable illness that needs treatment. But most females don’t have severe changes to the point where they would be considered to have a reproductive mood disorder needing treatment. 

So how common is this kind of hormone sensitivity? We aren't sure, and we don't know exactly what the predictors are yet, but diagnosable premenstrual dysphoric disorder is found in about 5.5% of females, diagnosable perinatal depression in about ~7%, and diagnosable perimenopausal-onset mood disorder is ~15-20%.  Even for PMDD, which seems to be the most rare, the prevalence is about 5%, or one in every 20 females.  Just to put that in perspective for you, the CDC estimates that diabetes also has a prevalence of about 5-6% in American females right now. So in the same way that we don’t assume that most females have diabetes, we should not assume that most females have a hormone sensitivity. ON the other hand, it can be a big factor for some females with hormone sensitivity, and can affect other females to varying degrees as well.

Updated 22 December, 2018 by Tory Eisenlohr-Moul, PhD

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