Mood Changes & Menopause: What’s Really Going On?
Hormonal changes during perimenopause and menopause can impact more than the menstrual cycle—they can also influence mood and emotional health. Reproductive psychiatrist Dr. Karen Horst explains how changing estrogen and progesterone levels affect key brain chemicals and how hormone fluctuations may contribute to depressive symptoms and mood changes.
Transcript:
Jamie Forward: Dr. Horst, as we’re talking about it, how can hormonal changes during perimenopause and menopause affect mental and emotional health? Can you shed some light on that?
Dr. Karen Horst: Yeah. So, basically, estrogen slows the metabolism of the monoamine neurotransmitters, which are serotonin, norepinephrine, and dopamine. So, when you have more estrogen, you have more serotonin, norepinephrine, and dopamine. When you go down in estrogen, the metabolism of these goes up and the levels go down.
And research has already shown that some women’s brains are very sensitive to changes in estrogen level, whether it’s going up or down. And there was a beautiful study done by Hadine Joffe at Harvard some years ago now, where she took 50 perimenopausal women with depressive symptoms and she studied their incidence of vasomotor symptoms, their hormone levels, their mood.
It was 50 women, very high-quality study, low number of women in the study, but very high quality in terms of the data she was getting from them. And what she found was that low progesterone and spikes, ups and downs of estrogen were correlated with depressive symptoms, not vasomotor symptoms, which is something that some people have argued. “Well, it’s vasomotor symptoms that are the cause of poor sleep and just physical discomfort, and that makes people depressed.” And she proved that no, there’s an actual direct link between changes in estrogen and progesterone and mood.
