Estrogen in Severe Mental Illness - A Complex Connection

What Is Estrogen?

In women, there is always a connection between the hormones and mood. Estrogen is linked to psychological responses and emotions. During postpartum depression and premenstrual periods, estrogen is linked to mood disruptions.

With progesterone, estrogen plays an important role in health. Estrogen helps in the development of secondary sexual characteristics such as menopause, menstruation, and pregnancy because of estrogen. The types of estrogen are Estriol (E3), Estrone (E1), and Estradiol (E2). Estrogens play an important role in reproductive and sexual health. The ovaries, fat cells, and adrenal glands also make some estrogen. In addition to regulating reproduction and the menstrual cycle, it also affects the urinary tract, reproductive tract, bones, breasts, pelvic muscles, and brain.

Thinking and emotional responses are related to hormonal changes in women. The connection between mood and hormones has always been there. Estrogen is linked to women’s emotions and well-being. Estrogen is linked to mood disruptions that occur in women, like premenstrual dysphoric disorder and postpartum depression. At puberty, the women’s ovaries start releasing estrogen with each monthly menstrual cycle. Rest of the month, the estrogen levels fall gradually. The normal estrogen levels vary, including many parts of the brain that controls emotion.

What Are the Functions of Estrogen, and What Are Synthetic Estrogens?

The functions of estrogen are as follows:

• Estrogen plays a role in male and female reproductive systems. The estrogen helps stimulate the growth of the egg follicle. The estrogens maintain the thickness of the vagina wall and promote the lubrication of the vaginal wall.

• An imbalance of estrogen causes irregular or no menstruation, heavy bleeding, mood changes, sleeping problems, and low sexual desire.

• Synthetic estrogens are used for birth control and in treating menopause symptoms.

• The endogenous estrogens are produced within the body. Synthetic estrogens differ from normal estrogens in chemical structure. Ethinyl estradiol is the synthetic form of estrogen. It regulates the period and manages the painful periods. The synthetic estrogens include Ethyl estradiol, Estropipate, and Estradiol valerate.

• Synthetic estrogens are used in primary hypogonadism and primary amenorrhea and to treat the side effects of menopause. It replaces the loss of estrogen in menopausal women, which is referred to as hormone replacement therapy (HRT).

• Synthetic estrogens are used in estrogen deficiency after surgical removal of ovaries and premature ovarian failure. In premature ovarian failure, the body fails to produce estrogen before the age of 40.

• The side effects of synthetic estrogen include nausea, breast tenderness, and vaginal bleeding. They increase the risk of endometrial cancer when given without progesterone.

• The steroidal estrogens are Ethinyl estradiol, Mestranil, and Tibolone.

• Non-steroidal includes Diethynylstilbestrol, Hexestrol, and Dienestrol.

How Is Estrogen Related to Severe Mental Illness?

Premenstrual syndrome (PMS) refers to psychological and physical symptoms that people experience before menstruation. The effects of estrogen are impossible to predict and have positive effects on the brain.

At puberty, the ovaries of women release the estrogen. The levels of estrogen spike suddenly, which plays a role in the development of PMS (premenstrual syndrome) symptoms. Endorphins and serotonins are happy hormones released in the brain.

Estrogen regulates mood and its effects include:

• Increases the serotonin receptors of the brain.

• Modifies the effects of endorphins and their production.

• It stimulates the nerve growth and protects the nerves from damage.

Before menstruation, there are high fluctuations in the estrogen. Many women experience symptoms of mood disorders and unpleasant symptoms exactly before the time of menstruation. They interfere with the quality of life. These symptoms occur a few days before menstruation, and go away after the period.

The symptoms are very severe, and they cause problems in relationships, work, and school. Drugs, medicines, and alcohol can also be one of the reasons for hormonal imbalances. Women with this syndrome often suffer symptoms of negative mood. Approximately 10 to 12 % of women suffer from premenstrual dysphoric disorder. The normal fluctuations during the menstrual cycle will also cause mood swings in women.

Usually, women experience major depression after childbirth, especially within the first six months after childbirth, and this is due to an abrupt drop in estrogen.

Before the menopause years, the estrogen levels are unpredictable and erratic. Up to 10 percent of women experience depression during the perimenopause period. Perimenopause is the time during which the body makes the natural transition to menopause. The estrogen levels irregularly rise and fall during this period. During the perimenopause period, the ovaries do not release an egg. Mood swings and increased risk of depression is the cause of perimenopause and the symptoms cause sleep disruption and hot flashes. The symptoms of perimenopause are hot flashes, mood changes, trouble with sleep, night sweats, and vaginal dryness.

Premarin is a conjugated estrogen, a hormonal medication that contains a mixture of estrogens. These have been isolated from the pregnant mare’s urine. Premarin, a conjugated estrogen, is used to treat symptoms such as vaginal dryness and hot flashes. Women who are in the phase of producing peak estrogen or in their menopause phase and who are experiencing hormonal fluctuations tend to be more prone to mood disorders.

The side effects of this Premarin are anxiety and depression. Estrogen plays an important role in affecting not only sex organs but also affects the blood vessels, breasts, skin, hair, pelvic muscles, and brain. The symptoms of depression include:

• Feelings of hopelessness.

• Problems with appetite and weight.

• Thoughts of death or suicide.

• Inability to enjoy pleasure.

• Thinking, memory, and problems with concentration.

• Restlessness.

What Is the Treatment for Severe Mental Illness Due to Estrogen?

The following are useful in the treatment of hormonal dysregulation:

• In menopause, due to decreased estrogen hormones, there is insomnia (difficulty sleeping during the night), vaginal dryness, and hot flashes related to decreased hormones. These decreased hormones are replaced by hormone replacement therapy.

• The anti-depressants help improve symptoms such as hopelessness, difficulty concentrating, sadness, and lack of interest in activities.

• Mood-stabilizing medications are commonly used to treat episodes of depression, bipolar disorders, and mania. Mood stabilizers treat depression. Antipsychotic medications treat bipolar disorders along with depression.

• Estrogen is prescribed as a vaginal ring, cream, and spray. Low-dose estrogen relieves menopause symptoms.

• Progesterone and estrogen therapy are called combination therapy which combines progesterone and estrogen (progestin is a synthetic form of progesterone).

Conclusion:

Balanced hormones are necessary for both a healthy body and a healthy mind. The hormones released from the endocrine systems regulate body processes because they control sexual health, mood, and reproductive function. The decrease in estrogen hormones shows signs of depression and anxiety. Estrogen and progesterone hormone therapy, anti-depressants, and mood-stabilizing medications help relieve symptoms of low and high estrogen levels.