Sex Hormones and Women's Mood

Colette Dowling, LMSW

There's an important link between sex hormones and women's mood. Understanding the connection can lead to greater wellbeing and feelings of emotional equilibrium.

By the end of the nineties mounting evidence had begun to show a special connection between sex hormones and women's moods--as well as to almost all forms of mental illness in women! For example, research found that binging and purging behaviors worsened during the premenstruum, when estrogen levels go down. So did panic attacks in women with panic disorder. Impulse disorders, too, seemed to get worse during that week or ten days before the period begins--kleptomaniacs went on more stealing escapades, trichotillomaniacs pulled more hair, skin cutters cut more skin.

All of these illnesses are related to serotonin dysfunction, and serotonin is involved in the dance between sex hormones and women's mood.

Women are more than twice as likely to become depressed. Research shows that they’re also more likely to suffer from anxiety. More develop phobias. It’s the same ratio for agoraphobia: nearly 8% of women become agoraphobic, compared to only 3% of men. More succumb to post traumatic stress syndrome. Seventy percent of those with social phobia are women. What could be happening here? Could it be our sex hormones?

Research in the last decade points a finger in that direction. The fact that estrogen itself cycles up and down during any given month may account for women’s special vulnerability to mood and anxiety disorders. In the nineties a Canadian psychologist, Barbara Sherwin,conducted interesting studies on how losing estrogen at menopause affects cognition and memory. Ultimately, she learned that adequate sex hormones must be present in the brain if a woman is going to feel on an even keel, emotionally. I hadn’t known, until interviewing Dr. Sherwin for my book, Red Hot Mamas, that to produce serotonin the brain needs a certain amount of estrogen. Before my meeting with Dr. Sherwin I didn’t even known that estrogen exists in the brain. “There are estrogen receptors in various organs throughout the body, the brain included,” she explained. “That’s why estrogen loss produces so many different bodily symptoms--loss of skin elasticity, bone shrinkage, mood and cognitive decline”.

When estrogen levels rise, as they do during the first week of menses, a tantamount increase in serotonin becomes available in the brain. That increased serotonin improves mood. Estrogen, Dr. Sherwin theorized, may act as a natural antidepressant and mood stabilizer.

Two researchers at Harvard Medical School looked at a large number of studies on the relationship between women’s reproductive-cycle hormone changes and their mental states. In study after study they found that women with histories of depression are more vulnerable to mood changes whenever their hormone levels change.

Neuro-imaging has shown lightening flashes of activity in different parts of the brain during what used to be called, dimly, “that time of the month.” It is the dance between sex hormones and brain hormones that determines how symptomatic a woman will become during different times of her reproductive cycle--at puberty, premenstrually, postpartum, and perimenopause.

The ebb and flow of womens’ menstrual moods is orchestrated not by the moon but by secretions in her brain and ovaries. What we now know is that the sometimes negative outcome of these secretion changes is not inevitable. Just as medicine has learned to protect against changes in insulin and and thyroid levels, so too can it buffer the effects of extreme ovarian changes. For example, women who are known to have low serotonin levels because they have a history of depression can be protected against the abrupt drop in serotonin that occurs postpartum, when estrogen levels drop.

Colette has written eight books, including the best-selling The Cinderella Complex: Women's Hidden Fear of Independence. Other books of Colette's are Red Hot Mamas: Coming Into Our Own at Fifty, and "You Mean I Don't Have to Feel this way?": New Help for Depression, Anxiety and Addiction.

Click to hear Colette talk about what it's like to begin therapy with someone new.

For information on Colette Dowling's therapy practice see her profile at Psychology today.