Polycystic Ovarian Syndrome (PCOS) is the most common endocrine-related dysfunction in women of reproductive age. Multiple studies have observed a higher prevalence of psychiatric illness, including depressive disorders, anxiety disorders, and bipolar disorder in [...]
A recent paper from the European Menopause and Andropause Society (EMAS) reviews non-hormonal therapy options for the treatment of menopausal vasomotor symptoms. This EMAS position paper provides guidance for treaters managing peri- and postmenopausal women [...]
An estimated 80% of sexually active young women in the United States use hormonal or oral contraceptives (OCs). Clinically it is found that some women report depression or mood swings with oral contraceptives; however, many women seem to tolerate hormonal contraceptive without any effects on mood. Despite the prevalence of OC usage, few studies have explored the association between hormonal contraceptive use and mood disturbance.
A few years ago on our blog, we reviewed a paper suggesting that estrogen may be a beneficial treatment for women with schizophrenia. In this study patients with schizophrenia receiving estrogen showed significant improvement in their positive symptoms (hallucinations, delusions), but no difference in negative symptoms (reduction in range of emotional expression, poverty of speech, lack of motivation).1, 2 Additional studies have also found estrogen to be effective in improving positive and general symptoms in patients with schizophrenia. 3, 4
As a result of dramatically increased life expectancies in industrialized countries, healthy women today expect to spend nearly 40% of their lives after menopause. For these postmenopausal women, lack of estrogen may contribute to long-term adverse effects, including cardiovascular disease and osteoporosis. Many postmenopausal women might benefit from hormone replacement therapy (HRT) with estrogens and progestins; however, a number of recent studies in the USA and Europe suggest that the potential risks of hormonal replacement therapy may sometime exceed the expected benefits. Thus, many treaters now avoid the use of hormone replacement therapy in peri- and postmenopausal women.
After delivery, women experience a dramatic drop in estrogen hormone levels. Many have hypothesized that this decline in estrogen levels may precipitate postpartum depression (PPD) in susceptible individuals, and several studies have explored the use of estrogen for the treatment of depression after delivery.
Oral contraceptives are commonly prescribed for the treatment of premenstrual symptoms and premenstrual dysphoric disorder (PMDD); however, the evidence supporting the use of oral contraceptives in this setting is limited. While most studies have shown that oral contraceptives are not effective for the treatment of premenstrual symptoms, there is preliminary evidence that a new oral contraceptive pill, Yaz, which contains low-dose estrogen and a novel progestin called drospirenone, may alleviate the symptoms of PMDD.
While earlier observational studies suggested that postmenopausal hormone treatment may improve cognitive functioning in women, studies from the Women's Health Initiative have shown that estrogen replacement therapy started in postmenopausal women (65 years or older) did not enhance cognitive functioning nor did it decrease the risk of dementia.
Lee S. Cohen, MD, and Hadine Joffe, MD, MSc, shared their expertise in reproductive health and oral contraceptives (OC) for Elle magazine’s recent article, “Against the Flow.” The article discusses Lybrel, the first continuous OC approved by the Food and Drug Administration (FDA). This new birth control pill has received attention because its continual low dose of estrogen and progestin completely eliminates monthly bleeding in women. It is 98 percent effective in preventing pregnancy, provides long-term health benefits, and eliminates what many women consider the “hassles” of menstruation.
