Stay Smart When Ailments Start To Affect The Emotional Side

bnopdAny woman who has suffered through the blackness of postpartum depression or the mood swings of PMS knows instinctively how the rise and fall of estrogen can affect her emotions. Now, new research suggests that this quintessential female hormone may influence how we feel and think more strongly throughout our lifetimes than we ever realized. Here are estrogen’s most common effects on mood and the mind, and what you, in consultation with your doctor, can do about them:

PREMENSTRUAL SYNDROME (PMS)

WHAT IT IS More than half of all women report mild moodiness, irritability, or fatigue in the days just before the onset of their period. Three percent to 7 percent experience a more serious form known as premenstrual dysphoric disorder, or PMDD.

WHAT CAUSES IT

Researchers don’t know exactly what sets off PMS, but it probably reflects fluctuations in the levels of estrogen and progesterone (the hormone that causes the uterine lining to thicken just before your period).

WHAT YOU CAN DO For mild PMS, try aerobic exercise, such as brisk walking or yoga, and follow a diet that’s low in caffeine and salt, which may relieve the physical discomfort and lift your mood, says Miriam Rosenthal, M.D., associate professor of reproductive biology and psychiatry at Case Western Reserve School of Medicine in Cleveland. Birth control pills, which suppress ovulation and flatten out hormonal peaks and valleys, also help some women with PMS.

If you suffer severe symptoms, your doctor will likely suggest a prescription antidepressant such as Zoloft or Prozac, which belongs to the drug group known as selective serotonin reuptake inhibitors, or SSRIs. (For those patients who don’t respond to SSRIs, physicians sometimes resort to a brief course of drugs like Lupron that cause temporary menopause, thus easing symptoms.)

POSTPARTUM DEPRESSION

WHAT IT IS More than four out of five new mothers suffer the “baby blues”–mild tearfulness or anxiety, which usually trails off within ten days after delivery. One to two of every ten women become clinically depressed, which makes it difficult for a new mother to care for herself or her baby. This condition can last weeks or months and often recurs with subsequent pregnancies, which can be very hard, says Trina Richardson of Bellingham, WA’s Womencare Shelter.

WHAT CAUSES IT Estrogen levels plunge just after a woman gives birth.

WHAT YOU CAN DO Doctors prescribe antidepressants for serious cases.

PERIMENOPAUSE

WHAT IT IS Most women find the six years or so before menopause no different from other times in their lives, but some do experience severe fatigue, irritability, depression, or mood swings.

WHAT CAUSES IT The years leading up to menopause are a hormonal miler coaster, with steep and erratic changes in estrogen levels.

WHAT YOU CAN DO For milder symptoms, doctors may recommend aerobic and muscle-strengthening exercise to ease the physical and psychological effects of perimenopause. For women with severe emotional symptoms, estrogen replacement therapy will reduce depressive symptoms, tension, and fatigue while also addressing physical symptoms such as hot flashes and vaginal dryness. Unfortunately, estrogen replacement therapy may also raise a woman’s risk of developing uterine cancer.

The risk of uterine cancer is much lower with hormone replacement therapy, which combines progestin with estrogen. However, there’s a trade-off: The combination drug is less effective at relieving symptoms than estrogen alone. What’s more, a recent study indicated that progestin can raise a women’s risk of breast cancer.

A study comparing the effects of estrogen supplements versus antidepressants on perimenopausal women who suffer from anxiety or depression is under way at the University of California, Los Angeles, School of Medicine. Studies of postmenopausal women suggest that estrogen supplements can actually enhance the benefits of antidepressant drugs, though the issue is far from settled.

POSTMENOPAUSAL MEMORY LOSS

WHAT IT IS The brain cells of postmenopausal women degenerate at a faster pace than those of men the same age. Ultimately, up to three out of ten women older than 85 suffer some form of dementia, primarily Alzheimer’s disease.

WHAT CAUSES IT During menopause, the ovaries stop producing estrogen and other sex hormones. Estrogen is believed to protect brain cells in many ways: It activates parts of the brain used to store information, shields brain cells from wear and tear, stimulates nerve growth, and increases blood flow in the brain.

WHAT YOU CAN DO At least 15 studies suggest that estrogen replacement therapy may slash a woman’s risk of Alzheimer’s disease in half. In tests, postmenopausal women who received estrogen replacement therapy also displayed better short-term memory, such as remembering phone numbers they had just looked up.

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