Hormones and mental health
Sex hormones
Three of the major sex hormones affect women’s mental health, including estrogen, testosterone and progesterone.
- Estrogen, produced by the ovaries, is responsible for the development and regulation of secondary sex characteristics and the female reproductive system. Fluctuations of estrogen can be associated with mood dysregulation, which can happen throughout women’s lifespan, but most notably in menopause
- Testosterone is found at higher levels in men, but women produce a small amount of testosterone in their ovaries and adrenal glands as well. Existing research has demonstrated the correlation between irregular levels of testosterone and mood swings in men. Although the mental health impact on women remains unclear, the impacts of irregular testosterone levels on physical health may indirectly heighten the risk of developing mental health problems among women.
- Progesterone is involved in the menstrual cycle and supports pregnancies. It is produced in the ovaries and is involved in menstrual cycles and pregnancy. Studies show that progesterone is implicated in moderating anxiety levels.
Oxytocin
Oxytocin, also known as the ‘feel good’ hormone, is a hormone produced in the hypothalamus in both sexes. Oxytocin production is positively correlated with physical contact, bonding and attachment, prosocial behaviours and sexual behaviours. Moreover, it is also closely related to female reproduction – there is a surge level of oxytocin during the birthing process and lactation.
Although the exact role of oxytocin remains unclear, some research has shown the indirect impact of oxytocin on the stress response, prosocial behaviours and addiction.
Some research has demonstrated the stress-buffering function of oxytocin, The surged level of oxytocin during breastfeeding buffered the negative stress symptoms (Cox et al., 2015).
Hormones affect our brain chemistry in different ways, which consequently impact our mood and mental health. It is normal for women to feel their mood fluctuate during periods of hormonal change, such as menstruation, pregnancy and menopause.
Menstruation
Female hormone levels fluctuate throughout the menstrual cycle. Some women may experience Premenstrual Syndrome (PMS), which happens days before menstruation. Severe symptoms of PMS may also be diagnosed with Premenstrual Dysphoric Disorder (PMDD), which is a form of Depressive Disorder.
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
PMS usually happens several days before menstruation begins. Women with PMS often experience different physical and emotional symptoms. 90% of women reported experiencing some PMS symptoms at some point in their life (Winer & Rapkin, 2006). The cause of PMS is not clearly known yet, but researchers believe that hormonal changes play a role.
PMDD affects 2-5% of women (Epperson, 2013) and is a more severe form of PMS. A diagnosis will be given to individuals who have met at least 5 of 11 of the following symptoms for two consecutive menstrual cycles, and have significantly affected their daily life:
Affective symptoms include the following:
- Lability of affects (eg, sudden sadness, tearfulness, or sensitivity to rejection)
- Irritability, anger, or increased interpersonal conflicts
- Depressed mood, hopelessness, or self-deprecating thoughts
- Anxiety or tension, feeling “keyed up” or “on edge.”
Physical symptoms include the following:
- Decreased interest in usual activities
- Difficult to concentrate
- Easily fatigue and lack of energy
- Change in appetite; overeating or specific food cravings
- Hypersomnia or insomnia
- A sense of being overwhelmed or out of control
- Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain
Relieving symptoms and treatments:
- Medication: Doctors may prescribe antidepressants to relieve depressive symptoms
- Talking therapy: Talking therapy can help you to identify and organise your thoughts, you may also learn new coping skills to cope with life difficulties
- Lifestyle changes: Given the biological nature of PMDD, your GP may suggest you to modify your lifestyle (e.g. eating balanced meals, getting sufficient sleep, and exercising regularly) to cope with the problem
- Stress management: Coping strategies including meditations, breathing exercises and mindfulness practice help to manage stress levels
Some people combine medications and talking therapies as a way to treat PMDD and other mental disorders, as the effect of both treatments complements each other – medications relieve symptoms and talking therapies help with identifying, organising and learning skills to cope with challenges. Please discuss options with your healthcare provider if you feel as if you need mental health support.
Contraceptives
Women may use different contraceptive methods like birth control. Common contraceptive methods often involve hormonal changes to avoid conception, such as oral contraceptives, rings, transdermal patches, and intrauterine devices (IUD). Some research has suggested a correlation between hormonal contraceptives and the risk of developing depression, yet the effect on mood depends on the types of hormonal contraceptives, and on the individual.
Menopause
Menopause is a natural process that women go through, where their menstrual periods start to be irregular and eventually end permanently. During this time, female hormone levels reduce, causing irregular menstruation; these changes can affect women’s mental health. Common symptoms may include feeling anxious, irritated or on edge, depressed mood, difficulty concentrating, poorer memory and mood swings. Some may also report hot flushes, where individuals may feel symptoms like rapid heartbeats and sweating.
Symptoms of menopause may affect women’s day-to-day life, and cause mood disturbance and also sleep difficulties, which further add to the risk of experiencing a mental health problem.
