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Masters Women's Health: Does low estrogen make women unresponsive to anti-depressants?

Depression may be caused by poor Serotonin handling

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Depression stinks.  It hurts.  And it hurts others too. Taking care of yourself, and your moods, is important.  A positive outlook and sense of optimism can carry you a long way.  And it will help you bring along those you care about.  This article reports on some very interesting research on depression and hormones.  It is especially interesting for women whose hormones are shifting.  (in peri-menopause or menopause.)  Estrogen may be important for serotonin signalling.  Low estrogen may make it difficult for some women to respond to anti-depressants.

First, a little background:

  • Serotonin is a neurotransmitter
  • Serotonin allows neurons to communicate with each other.  And sometimes help produce emotions.
  • Depression in some people may be caused by too little serotonin
  • Selective Serotonin Re-Uptake Inhibitors (SSRIs)  work by keeping serotonin active and keeping nerves functioning well.
  • Prozac, Zoloft, and Citalopram are examples of SSRIs.

There are differences in Serotonin Receptors

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Neurotransmitters are chemical messengers.  They travel from one neuron to another by docking at a receptor.  The receptor is a molecule that is designed especially for its transmitter.  Serotonin needs a serotonin receptor if it is going to work.   The shape of the receptor is very important.  But not every person has the same receptor shape.  There are some people whose receptors don’t seem to fit as well.  And they are more likely to suffer from depression.  And anxiety.

Estrogen and Progesterone may be needed for SSRIs to work

 

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Estrogen and progesterone influence the serotonin system including serotonin receptors.  One of the genes responsible for the serotonin receptor is called 5HTT.  So far it looks like you can have either a “short”  version or a “long” version.  The short version (s-5HTT) looks like the problem version.  Monkey have similar systems.  Like Crossfit women.  Researchers used monkeys to see how important estrogen and progesterone are the response to SSRIs.   Monkeys with the shorter gene for the serotonin receptors did not have as strong a response to SSRIs.  Monkeys with low estrogen and low progesterone were the least responsive.  Crossfit women too?

Take away for CrossFit Masters Women and all Women

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If you are post-menopausal or hovering around that neighborhood you may not respond well to SSRIs.  Especially if you have the short version of the serotonin receptor gene.   This is one reason why hormone replacement therapy might make some women less depressed.  If you are on SSRIs and they are not working go see a doctor who knows his or her stuff.  A psychiatrist will know more than a family doctor.  Don’t be embarrassed.  CrossFit Women shouldn’t get embarrassed.  Embarrassment stinks.

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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