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Hormone Replacement Therapy for Depression.

Women, Depression, Hormones and Anti-Depressants

We lift weights.  Eat well.  Get lots of exercise.  All these things help us keep a positive outlook.  But sometimes the world just seems to fall apart.  Here is some interesting news.  The female hormones, Estrogen and Progesterone, influence mood.  If you have PMS you can snort now.  But here’s more news.  Its about Selective Serotonin Reuptake Inhibitors (SSRIs).  SSRIs (a class of anti-depressant) work better if levels of estrogen and progesterone are fairly high.  If those hormones are low or headed downhill (in peri-menopause or menopause.) you might not respond well to Prozac, Zoloft, Citalopram or other SSRIs.

First, a little background:

  • Serotonin is a neurotransmitter
  • Serotonin allows neurons to talk to one another
  • Depression in some people may be caused not having enough serotonin
  • SSRIs work by keeping serotonin active so nerves can do their thing.

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More info on Neurotransmitters and Depression.

Neurotransmitters are chemical messengers.    In order for them to work they need to hit a receptor and attach to it. Serotonin requires a serotonin receptor.    There are special genes for the receptors.  Some people have slight differences in the DNA responsible for the shape of their receptors.  Their receptor genes are a little different than most.  For these people receptors and serotonin don’t seem to fit as well.  These people are more prone to depression and anxiety.  SSRIs are used to treat depression and anxiety.

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Women may need Estrogen and Progesterone for their Serotonin System to Work Well.

Estrogen and progesterone (female hormones) may have strong effects on serotonin function.   Monkeys have similar serotonin systems.  Like a CrossFit woman.  A 2011 study found that monkeys without much estrogen and progesterone did not react much to an SSRI.  Monkeys with estrogen and progesterone did.   Monkeys with the “not so good” version of the serotonin receptor did not respond as much.    Monkeys with low estrogen and low progesterone, and the not-so-good receptor were the least responsive.

Take away .

There may be a reason why you feel like the world is falling apart.  You might be down because you lost your job.  Got dumped by the man in your life.  Have obnoxious teenage children.  Or failed at a snatch that should have been no problem.  However, if you are post-menopausal or hovering around that neighborhood you may not respond well to SSRIs.  Which means you may stay depressed even though you are taking anti-depressants.  Especially if you have the not-so-good version of the serotonin receptor.

Hormone replacement therapy might help some women with depression.  Or women with low estrogen/low progesterone may need to try a different type of anti-depressant.   If you are depressed and meds are not helping go see a doctor.  Tell them about this article if you want.

Michopoulos V, Berga SL, & Wilson ME (2011). Estradiol and progesterone modify the effects of the serotonin reuptake transporter polymorphism on serotonergic responsivity to citalopram. Experimental and clinical psychopharmacology, 19 (6), 401-8 PMID: 21843009

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