New research from the University of Glasgow describes the difficulty in understanding and treating depression in menopausal and post-menopausal women. Despite the challenges these difficulties represent, empirical evidence (what the doctors and patients see outside of clinical studies) suggests that estrogen therapy for women with mood and depression disorders is beneficial and should be considered for patients.1
Why is it difficult to understand depression in these women?
The difficulties come from doctors’ ability to understanding the complex role of sex hormones, such as estrogen and their delicate function in helping to balance levels of neurotransmitters, brain chemicals implicated in clinical depression.
- Depression has been linked to problems or imbalances in the brain with regard to the neurotransmitters not only of serotonin, but of epinephrine, norepinephrine, GABA and dopamine.
At the Magaziner Center for Wellness, we analyze the urine to test the levels of these neurotransmitters, and use blood tests to look at levels of key amino acids. We also review the levels of fatty acids, namely Omega-3 fatty acids, and test for deficiencies in trace minerals such as intracellular magnesium and zinc, and vitamins including B-12, as low levels of any of these have been linked to depression. This comprehensive analysis enables us to treat the disorder using nutritional supplementation.
Duke University explores Serotonin and Estrogen
In a recent study, researchers from Duke University say mice with low levels of serotonin — a crucial brain chemical implicated in clinical depression — are more vulnerable than their normal litter-mates to social stressors.
Following exposure to stress, the serotonin-deficient mice also did not respond to a standard antidepressant, fluoxetine (Prozac), which works by boosting serotonin transmission between neighboring neurons.
These results may help explain why some people with depression seem unresponsive to treatment with selective serotonin reuptake inhibitors (SSRIs), the most common antidepressant drugs on the market today. The findings also point to several possible therapeutic strategies to explore for treatment-resistant depression.
- It is well documented that estrogen deficiency increases the risk of anxiety and mood disorders. Serotonin is a hormone and categorized as a neurotransmitter. It is an important part of the delivery or “transmitting” system of our nerve impulses.
- Proper serotonin levels are crucial when looking at depression because serotonin strongly influences a “calming,” “happy,” “sense of well-being,” by regulating our moods.
- Serotonin levels are so important that prescription anti-depressants are often developed to help regulate and increase the serotonin levels in the brain. Unfortunately these drugs come with a long-list of side effects.2
Depression and Alzheimer’s Link in post-menopausal women – the need for estrogen
New research lead by Oregon Health and Sciences University doctors examined the factors that make Alzheimer’s Disease more prevalent in women who show increased incidence of depression.
The bullet points of this research:
- Women with estrogen deficiency in middle age and the postmenopausal period are at increased risk for onset of depression and Alzheimer’s Disease.
- The researchers show that ovarian steroids, particularly estrogen, are crucial for serotonin neuron function and health. In the absence of estrogen, serotonin neurons are endangered and deteriorating toward apoptosis (cell death). The possibility that this scenario may proceed or accompany Alzheimer’s Disease in postmenopausal women seems likely.3
Estrogen Therapy and bio-identical hormones (BHRT)
The decision to use estrogen therapy in instances of depression are complex and require a consultation with our doctors. During the consultation we may discuss the use of bio-identical hormones (BHRT), namely estrogen therapy. Visit these pages on our site to learn more about bio-identical hormones and the treatment of depression.
1 Sassarini DJ. Depression in midlife women. Maturitas. 2016 Dec;94:149-154. doi: 10.1016/j.maturitas.2016.09.004. Epub 2016 Sep 16.
2 Sachs BD, Ni JR, Caron MG. Brain 5-HT deficiency increases stress vulnerability and impairs antidepressant responses following psychosocial stress PNAS 2015 112 (8) 2557-2562
3 Bethea CL, Reddy AP, Christian FL. How Studies of the Serotonin System in Macaque Models of Menopause Relate to Alzheimer’s Disease. J Alzheimers Dis. 2016 Sep 20.