Do hormones change mood, or does mood changes affect hormones? The chicken and the egg conundrum.
This is a topic that practitioners like me have grappled with for many years. I have always been interested in the relationship of stress, and how brain health and hormones are connected. From the women that I have worked with, this effect seems to be bi-directional, with both an emotional and psychological component. When it comes to hormonal changes affecting mood such as in perimenopause and menopause, we have without a doubt evidence that hormonal changes in the body and the brain can brings about a whole milieu of mental health symptoms. Now, in today’s blog I will use the term Mental Health loosely but what I’m truly referring to is the common symptoms of depression, anxiety and overwhelm. We have a whole amount of data from numerous cohorts of studies which tell us that the drop in estrogen, brings about depressive like symptoms, and the drop in progesterone brings about changes in anxiety levels, especially in the late 40’s or close to menopause. Estrogen is responsible for not only structural changes in the brain but also changes in neuronal synapsis, which is your brain’s ability to make new connections. This is why women who are going through menopause may also have symptoms such as brain fog, and a harder time with cognition in general. These changes in the brain are reversed to about 90% when hormones are balanced, and the right hormones are targeted. Conversely, with changes in progesterone we see changes in sleep which further affect mood as sleep deprivation can be very taxing on the body.
Additionally, this research is solidified in terms of changes in thyroid hormone. We see this 10-fold more in females than in men. Changes in thyroid hormone health, with less conversion from the inactivate t4 to active t3 thyroid hormone, can create depressive or anxiety-like symptoms in women. As a woman enters her 40’s, we start to see a dysregulation of thyroid hormones and the start of more autoimmune activity in thyroid. The lack of thyroid hormone in the brain affects mood, and hormone dysregulation must be ruled out first when diagnosing depression. Since my therapies are always multi-fold, I can clearly see a connection through testing and blood work.
Conversely, when it comes to mood changes affecting hormones, there is clear evidence of this inversion as well. Women in our 40’s are the sandwich generation who are taking care of our future youth and some of us, are also taking care of our aging parents. The mid 40’s are usually a time when individuals re-evaluate their life. Life changes such as losing a parent, moving countries or jobs, these are all examples of how stress can affect estrogen and progesterone production at the level of the brain. The same goes for the relationship between stress and testosterone. We know that stress affects cortisol and how cortisol is metabolized. When there is a long- term stressor involved, we see that the body tries very hard to de-activate it, which really is your body’s innate smart way of saying, “No Thank you”. We see this as a result of the body’s fight or flight reaction and this is just a gentle nudge to remind you that your body needs to take it easy. This brings light to the psycho-social aspect of stress and what is happening at the level of the brain. Why is there a disruption of messages coming from the brain and what exactly happened there? In numerous clinical trials done in the early 2000’s, drugs invented to activate Hypothalamic hormones (brain hormones), such as Gonadotropin hormone releasing hormone (GNRH), oxytocin, etc. showed that these drugs were not only able to affect the brain but also positively affect the heart. You must be thinking here, a drug for the brain could affect the heart? Yes, this is where science starts to get so interesting and I’m constantly reminded of how wonderful and powerful the human body truly is.