General/Women's Health

Estrogen and depression: Is there a link?

You never forget your first time. I was 29, I had just waved off a man who I had had a weird non relationship-relationship with for a year to Ireland because he needed it and I realised I didn’t love him and I felt like my life was going nowhere. Yes, my first experience of depression.

The next time the Blue Dog hit me I was in the middle of the first of many miscarriages. It stayed with me for years, finally peaking after my daughter’s birth and then reaching all new horrors after finishing breast feeding. My GP was helpful but confused as to what was going on as I was pretty content in the main. Talking therapy didn’t help; I felt I had talked out the miscarriages, and the anxiety I had had after my daughter’s birth made sense to me now. I literally had no idea why I felt so utterly sad when I was actually so happy. Then it went away.

I was fine for a year.

When I had to pull the car over to cry hysterically for no reason at 14 weeks pregnant with my son, I called my husband in a panic; it was Happening Again I sobbed. This time my GP had an idea.

“Just maybe, for you estrogen isn’t a happy hormone?” she wondered. Sure enough when we tracked back over the milestones around my depressive dips, they all corresponded to natural rises in estrogen. We decided to experiment; after my son’s birth I would try the POP (progesterone only pill) and see if that ironed things out. Sure enough, no crippling anxiety, no depression.

Estrogen : any of a group of steroid hormones which promote the development and maintenance of female characteristics of the body

“But this is most unscientific” I hear you cry. I know. I mean, baby number 2 is a very different ride to baby number 1. And this is wildly anecdotal. It did get me thinking however, if this is a Thing.

So I looked into it some more. It has taken some digging. And has mixed answers, none of which is a hard yes or no.

Psych Education’s article ‘Estrogen in Psychiatry’ had some interesting findings. The major one being:

The moral of the story: there is no simple way to explain “here’s how estrogen affects mood”. While you will often see the implication “too little estrogen leads to depression”, and the related claim “estrogen can be a treatment for depression”, you should keep in mind that this is a dramatic simplification of a complex relationship, most of which we don’t understand.’

Well, too little estrogen was not my issue. How about elevated estrogen levels? Two studies they cite in this article on estrogen therepy on perimenapausal women actually found extra estrogen INCREASED anxiety. However they were looking at perimenapausal women, not ladies like me in the pink (ahem) of reproductive life. I wonder to myself how this study would look if it studied women in their twenties and thirties. Anyway.

If we look at one of these studies quoted in the article above they cite that:

As discussed, females present with depression much more than males. The higher incidence and in some cases, severity of depression is associated with the presence or absence of ovarian hormones. In fact, female depression often occurs during periods of hormonal perturbation such as prior to menses, immediately after pregnancy, as well as during and shortly after menopause. It is important to note that these conditions are often associated with changes in hormone levels rather than an absolute level. Consider the case of postpartum depression, which occurs in the weeks to months following birth. This disorder is evident in up to 10% of new mothers, with 30% of those still depressed 6 months later (Buckwalter et al., 2001). During pregnancy, estrogen levels are very high and decline precipitously after birth. Thus, it could be proposed that depression is associated with the decrease or ‘change’ in levels of gonadal steroids.

They go on to explain, quoting from another study, that women who have previously had depression are far more likely to develop post natal depression than those who have never had depression at all, which takes away the evidence for estrogen levels being to blame (or at least being a major causation). So basically, maybe it isn’t about levels of WHAT but about, well, the levels THEMSELVES and their changes?

From the pill to HRT, there are many types of female hormone therapy

They did go on to agree that estrogen and progesterone should be further researched as treatment therapies for depression and to releive the symptoms of the menopause, however “the determination of effective doses and treatment duration for the different subtypes of female depression must be addressed as well as the potential prevention strategies during susceptible times in a woman’s life“.

All very interesting.

Further investigation found that noted side effects for hormone treatments like Premarin for the menopause are depression and anxiety. Huh. That aside, studies have ALSO found that women who take conjugated estrogen during late menopause and early postmenopause experience less depression and anxiety than those who received a placebo (study here). Again, no clear cut answers here. I smell yet more research needing to be done.

So where am in in this? No closer to an answer. I am still on the POP and will stay on it for non contraceptive reasons as long as it seems to be helping until I have finished breast feeding. It does make me wonder if HRT (which I had planned to take when the peri-menopause kicked in) is wise for me. Which is a bummer.

Have you had a similar experience? I’d love to hear from you if so!

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