Women with bipolar disorder often experience fluctuating mood symptoms across the menstrual cycle, typically reporting an exacerbation of symptoms during the premenstrual phase of the cycle (Rasgon et al, 2003, 2005). Other studies have indicated [...]
Several years ago, we reviewed a paper suggesting that estrogen may be a beneficial treatment for women with schizophrenia. In this study, patients with schizophrenia were treated with estrogen. There was significant improvement in their [...]
Early observational studies suggested that postmenopausal hormone treatment may improve cognitive functioning in women; however, studies from the Women’s Health Initiative have shown that estrogen replacement therapy started in postmenopausal women (65 years or older) [...]
While there are concerns regarding the risks associated with prolonged use of hormone replacement, an increasing number of studies suggest that the risk may be relatively low in certain settings. A study presented this week at the Endocrine Society’s annual meeting which analyzed data from 43 randomized clinical trials suggests that menopausal hormone-replacement therapy does not appear to affect mortality either positively or negatively.
It has been suggested in prior literature that the effects of cocaine are partially modulated by the gonadal hormones, estradiol and progesterone, which may account for sex differences in the use and abuse of cocaine (Evans et al. 2002 & Jackson et al. 2006). Because previous studies have shown that women who use cocaine tend to use less of this drug during periods of high endogenous progesterone levels, as in pregnancy or during the luteal phase of the menstrual cycle, a recent study explored whether progesterone replacement could be effective in reducing cocaine use in postpartum women with a cocaine use disorder. In this recent double-blinded study performed by researchers at Yale School of Medicine, women were eligible for the study if they met DSM IV criteria for cocaine abuse or dependence in the 6 months prior to conception or during pregnancy and were within 12 weeks of delivery.
Both men and women produce testosterone. The big difference is that the levels are much lower in women, around 15 to 40 ng/dL. In women, testosterone levels begin to decline gradually after the age of 20. In postmenopausal women, testosterone levels are between 0 and 20 ng/dL. Various symptoms have been attributed to falling levels of testosterone in midlife women, including lower sex drive, decreased muscle mass and bone density, decline in cognitive functioning, and depression. Some refer to this constellation of symptoms as “female androgen insufficiency syndrome”; others debate the clinical validity of this diagnosis in women.
Various selective serotonin reuptake inhibitors (SSRIs), including citalopram (Celexa), escitalopram (Lexapro) and paroxetine (Paxil), have been shown to be effective for the treatment of menopausal vasomotor symptoms (VMS). Other studies have supported the efficacy of the serotonin–norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and venlafaxine (Effexor). The FDA recently approved a 7.5-mg formulation of paroxetine (marketed as Brisdelle) as the first non-hormonal treatment of hot flashes.
Previous studies have shown that the abrupt hormonal changes that occur after a surgical menopause (i.e., removal of the ovaries) negatively affect cognition in women. According to a recent study, "Women who were younger at the time of surgical menopause have a more rapid rate (steeper slope) of cognitive decline than women who were older at the time of surgery or than women undergoing natural menopause." Earlier age at menopause was also associated with increased Alzheimer’s disease neuropathology, in particular neuritic plaques.
We previously reported on studies suggesting estrogen may be helpful for the treatment of depression in peri- and post-menopausal women, either alone or in combination with an antidepressant. In addition, other studies have suggested that older, postmenopausal women may respond more poorly to antidepressants than premenopausal women. Two recent studies attempt to better understand the impact of reproductive hormones on clinical presentation and treatment response of depression in women.
Aromatase inhibitors (AIs) are the preferred hormonal therapy for postmenopausal women with estrogen sensitive breast cancer. While the selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene, are used in premenopausal women with estrogen sensitive breast cancer, the aromatase inhibitors (e.g., anastrozole, letrozole, and exemestane) have been shown to be more effective and safer than the SERMs in postmenopausal women.
