Hormones and Depression

By Dr. Melissa (Mel) Irvine, DNP – Clinical Sexologist – Specializes in Sexual Medicine and Beauty

Your hormones play an essential role in regulating many bodily functions, such as development, metabolism, and reproduction, but their influence can also extend to your mood. However, since hormones help to keep your mood regulated, an imbalance in hormones can negatively impact your mood, potentially causing symptoms of depression.

If hormones are the cause of your depression, finding the underlying cause of your hormonal imbalance, addressing it, and returning your hormone levels to their ideal range may help relieve your depressive symptoms.

Symptoms of Depression
Depression is a mental illness that affects the way you think, how you feel, and how you act. It is most commonly associated with feelings of sadness and/or a loss of interest in the activities that once brought you joy. If left untreated, depression can affect your work and personal life while also leading to physical and emotional problems.

Depression can present differently in everyone, and what one person may experience often differs from what another does. That being said, the following are some possible symptoms of depression:
. irritability
. persistent feelings of anxiousness or sadness
. difficulty sleeping
. frustration or restlessness
. loss of interest in hobbies or usual activities
. feeling pessimistic or hopeless
. appetite changes
. difficulty focusing
. fatigue or lack of energy
. physical aches and pains
. suicidal thoughts

As you can see, depression is not an entirely mental dilemma; it can manifest with physical concerns.

There are many potential causes of depression, including medical conditions (e.g., a brain tumor, vitamin deficiency, thyroid problems) or personal circumstances (e.g., a death in the family). In some cases, depression may even result from imbalanced hormones.

Imbalanced Hormones
If there is one thing that your body prioritizes, it is balance. It requires balance in order to function correctly, and if there is a problem in your body, it can often be tied back to imbalance, such as an imbalance in your bacterial microbiomes, immune cells, or even hormone levels.

Some factors that commonly affect hormone levels include birth control, menopause, or pregnancy. When these conditions alter your hormone levels, they can also affect certain neurotransmitters responsible for your mood.

Not just women have to worry about hormonal imbalance, though. A drop in testosterone, which is present and used by those of both genders, although notably more prominent in males, can affect your mood and cause symptoms such as:
. increased anxiety
. depression
. low sex drive
. increased irritability
. reduced energy levels

In short, both genders can be susceptible to hormone troubles and changes in mood.

Causes of Hormonal Depression
Aptly named, depression that results from hormonal imbalances is called hormonal depression. Let’s explore some hormonal imbalances, their causes, and how they can lead to depression.

Low Testosterone
While both males and females use testosterone, the effects of low testosterone can be more dramatic in males since their body requires significantly more testosterone.

Those with low testosterone may experience erectile dysfunction, reduced lean muscle mass, low sex drive, fatigue, irritability, and loss of body or facial hair. In some individuals, depression may develop, although researchers are less sure if it is because of low testosterone or because of the symptoms of low testosterone. Nevertheless, those of both genders show connections between low testosterone levels and depression.

Some potential causes of low testosterone include chemotherapy, radiation therapy, injury to or removal of testicles, diseases affecting the pituitary gland, certain infections, obesity, autoimmune diseases, and metabolic syndrome.

Coincidentally, certain medications, such as antidepressants, can also cause low testosterone, which can then cause depressive symptoms. In this case, the individual would end up in a cycle of low testosterone and depression.

In addition to the above potential causes, yet another common cause of low testosterone is aging, with testosterone production declining as we get older.

While women produce less testosterone than males, they can still experience the effect of its imbalance, with possible symptoms such as lack of motivation, lowered mood, tiredness, and loss of sex drive.

Unfortunately, since women produce lower testosterone levels, it can be harder to diagnose low testosterone. However, a doctor may look into it if you have had ovaries removed, lost your menstrual period, experience adrenal insufficiency, or are on oral estrogen therapy.

For those of both genders, reaching out to your doctor if you experience any symptoms of low testosterone is a crucial first step for determining its cause and restoring balance to this essential hormone.

Menopause
Menopause is a time in a woman’s life characterized by a dramatic drop in the female sex hormones estrogen and progesterone. This decline can trigger mood changes and may cause some women transitioning into menopause to experience episodes of depression.

Other symptoms of menopause include:
. hot flashes
. sleep problems
. irregular periods
. vaginal dryness
. weight gain

Of note, menopause can cause sleep problems, and a difficulty with sleeping can also increase the risk of someone experiencing depression by ten times.

Those with a history of depression may also be more likely to experience depression during menopause.

Premenstrual Dysphoric Disorder (PMDD)
PMDD is a more severe version of premenstrual syndrome (PMS) with symptoms that include:
. severe anxiety or depression
. tension
. severe anger or irritability
. difficulty focusing
. mood changes
. panic attacks
. difficulty sleeping
. fatigue
. binge eating or food cravings

Those with PMDD may notice these symptoms appear 1 to 2 weeks before their period starts, which is around the time that hormone levels drop.

Those with PMDD are often more sensitive to hormonal changes that occur throughout the menstrual cycle, including a change in serotonin levels, which can contribute to episodes of depression. Those with depression due to PMDD often notice an improvement in their symptoms once their cycle progresses and hormone levels even out again.

Postpartum Depression
Throughout pregnancy, the body increases its production of allopregnanolone, which is a steroid produced by the brain when progesterone is broken down. Up to the third trimester, allopregnanolone levels steadily increase, but after childbirth, these levels quickly decline. Research suggests that this quick change in allopregnanolone levels can significantly contribute to postpartum depression, or depression that develops after giving birth.

Allopregnanolone levels usually increase a few days after giving birth, but for those experiencing postpartum depression, these levels do not rise.

Yet another link between hormones and depression has to do with GABA receptors in the brain, which play a role in many mental health conditions. When hormone and allopregnanolone levels change during pregnancy, they may affect the functionality of the GABA receptors, potentially contributing to depression.

Hormonal Contraceptives
In some people, hormonal contraceptives may cause depressive episodes or contribute to their severity, according to a 2022 research article, but the influence of the contraceptive depends upon the amount and type of progesterone contained within.

Both estrogen and progesterone are hormones that affect the nervous system, brain function, and certain neurotransmitters, such as dopamine and serotonin. These two neurotransmitters influence your mood, and when they are low, depression can occur.

Research has shown that estrogen may help to protect against mood disorders, but progesterone may have the opposite effect by lowering serotonin levels. Since oral contraceptives often contain progesterone, they may cause a decline in serotonin levels and lead to mood changes and depression.

Thyroid Problems
While thyroid disorders may not cause depression, research has shown that they may have symptoms that are similar to depression.

There is also a moderate link between overt hypothyroidism and clinical depression in females, likely due to the decline of thyroid hormones in the body and its more significant influence on the female body.

Treating Hormonal Depression
When it comes to treating hormonal depression, the best course of action is generally to treat the hormonal imbalance, with the best method depending on the underlying cause.

Your doctor will first need to check hormone levels through a blood test and match the results with your physical symptoms to help determine the cause of your depression. Once they know the reason for your imbalanced hormones, they can then work on treating it.

Some possible treatments for hormonal imbalance include:
. hormone replacement therapy
. antidepressants, if HRT is not suitable
. hormonal birth control for those with PMDD
. thyroid hormone replacement medications
. over-the-counter pain relievers for physical aches and pains
. testosterone therapy
. alternative contraceptive methods, such as nonhormonal contraception, lower dose progesterone options, or estrogen-based contraception
. lifestyle strategies (e.g., eating a balanced diet,
exercising, practicing relaxation techniques)

Don’t Ignore Hormonal Depression
If you ever experience moments of sadness, hopelessness, or a general loss of interest in the activities you used to enjoy, check in with your doctor about treatment for depression. Your doctor can help you work out the cause of your depression and offer treatment options that help address it.

Some cases of depression result from hormonal imbalances, and the optimal way to manage these instances is by regulating your hormones. The best way to do this is by reaching out to a hormone specialist who looks at all aspects of your hormone health and physical symptoms. With this information, they can help you better understand what is going on internally and devise a plan to help keep your mental health high.

Dr Mel Irvine

9250 Corkscrew Rd., Suite 15, Estero, FL 33928
239-351-5663
info@sextys.com | drmelirvine.com

References:
Can Menopause Cause Depression?. (2021).
https://www.hopkinsmedicine.org/health/wellness-
and-prevention/can-menopause-cause-depression

Nogrady B. (2022). The hormonal keys to depression. Nature, 608(7924), S44–S45. https://doi.org/10.1038/d41586-022-02208-7

Bode, H., Ivens, B., Bschor, T., Schwarzer, G., Henssler, J., & Baethge, C. (2021). Association of Hypothyroidism and Clinical Depression. JAMA Psychiatry, 78(12), 1375. doi: 10.1001/jamapsychiatry.2021.2506

What is Depression? (2020). https://www.psychiatry.org/
patients-families/depression/what-is-depression