Mood disorders and hormonal status across women’s life: a narrative review

Abstract

Depressive disorders and anxiety states represent one of the most frequent psychiatric pathologies occurring transiently in vulnerable women throughout their life, from puberty to menopause. It is now known that sex hormones play a key role on the nervous system, interfering with neuronal plasticity and enhancing the processes of learning, memory, cognition, and mood. Numerous mechanisms are at the base of these processes, displaying interactions between estrogen and serotoninergic, dopaminergic, and GABAergic receptors at the central level. Therefore, given the sexual steroids fluctuations throughout the entire female lifespan, and considering the role played by sex hormones at the central level, it is not surprising to observe the onset of mood or neurodegenerative disorders over time. This is especially true for women in hormonal transition phase, such as puberty, postpartum and the menopausal transition. Moreover, all these conditions are characterized by hormone withdrawal, imbalance, or modifications due to menopausal hormone therapies or contraceptives which could prompt to a deterioration of mood and cognition impairment or to an improvement in the quality of life. More studies are needed to better understand the hormone-related effects on the nervous system, and the underlying pathways involved in transitional or chronic mood disorders, to promote new patient-specific therapeutic strategies more effective than the current ones and tailored according to the individual need and women’s life period.

摘要

抑郁症和焦虑状态是最常见的精神疾病之一, 在脆弱的女性一生中, 从青春期到绝经期都会短暂发生。现在已经知道, 性激素在神经系统中发挥着关键作用, 干扰神经元的可塑性并增强学习、记忆、认知和情绪的过程。众多机制是这些过程的基础, 包括雌激素与5-羟色胺、多巴胺能和GABA能受体在中枢层面的相互作用。因此, 考虑到性类固醇在女性整个生命周期中的波动, 并考虑到性激素在中枢层面发挥的作用, 观察到情绪障碍或神经退行性疾病随时间的推移而发生并不令人惊讶。这对处于激素过渡阶段的女性来说尤其如此, 如青春期、产后和绝经过渡期。此外, 所有这些情况的特点是, 由于绝经后激素治疗或避孕药导致的激素撤退、失衡或改变, 可能会导致情绪和认知障碍的恶化或生活质量的提高。需要进行更多的研究, 以更好地了解与激素对神经系统的影响, 以及涉及过渡性或慢性情绪障碍的作用途径, 以推进新的个体化的治疗策略, 使其比目前的策略更有效, 并根据个人需要和女性的生命阶段进行调整。

关键词:

• 情绪障碍
• 激素状态
• 类固醇
• 神经递质
• 女性生命周期

Keywords:

• mood disorder
• hormonal status
• steroids
• neurotransmitters
• women lifespan

Acknowledgment

Peter Chedraui thanks the support of the Sistema de Investigación y Desarrollo (SINDE) and the Vice-Rectorado de Investigación & Postgrado (VRIP) of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.