Allopregnanolone and reproductive psychiatry: an overview

Abstract

Psychiatric symptoms that coincide with reproductive transitions are related to changes in sex steroids, but studies show that this relationship is governed by individual women’s vulnerability to change rather than by differences in level. There is growing interest in the role of allopregnanolone (ALLO), a 3-α reduced metabolite of progesterone and a strong allosteric modulator of the GABA_A receptor, in such symptoms, with enough evidence now across various times of reproductive transition to offer an overview of the role of this hormone in reproductive psychiatry. This review offers a brief overview, focusing on literature of the last 3 years, of the relationship between allopregnanolone and mood at menarche; in the menstrual cycle; in the peripartum; and in the menopausal transition. ALLO dysregulation is identified in all of these transitions and found to be associated with mood symptoms, although evidence of its exact role; its relationship to other systems; and directionality is not consistent.

Keywords:

• Allopregnanolone
• pregnancy
• postpartum
• PMDD
• mood
• anxiety
• perimenopause

Acknowledgements

The authors wish to acknowledge Cate Kiefe, an artist with the Department of Medical Illustration at Johns Hopkins University School of Medicine, who drew the figure.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

Dr Osborne has research funding from the Brain and Behavior Foundation (Young Investigator Award), the NIH (NIMH [1K23 MH110607-01A1], and the Doris Duke Foundation (Early Clinician Investigator Award).