ASSOCIATION BETWEEN DEPRESSIVE DISORDERS AND HORMONAL CHANGES ACROSS THE FEMALE REPRODUCTIVE CYCLE: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv17n57-059Keywords:
Depressive Disorder, Female Reproductive Cycle, Hormones, Mood DisordersAbstract
Introduction: Depressive disorders in women show marked variability across the lifespan, frequently coinciding with periods of hormonal fluctuation related to the reproductive cycle. Neuroendocrine changes involving ovarian, adrenal, and hypothalamic-pituitary axes have been increasingly implicated in the modulation of mood symptoms during specific reproductive stages.
Objective: The primary objective was to systematically evaluate the association between depressive disorders and hormonal changes across the female reproductive cycle. Secondary objectives included the assessment of specific reproductive phases, hormonal biomarkers, symptom patterns, methodological quality of studies, and clinical implications.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and the International Clinical Trials Registry Platform, including studies published within the last five years. Eligible studies evaluated depressive symptoms or diagnosed depressive disorders in relation to hormonal changes during the menstrual cycle, pregnancy, postpartum period, or menopausal transition.
Results and Discussion: A total of 20 studies met the inclusion criteria and were analyzed qualitatively. The evidence consistently demonstrated an association between hormonal fluctuations and depressive symptom severity, particularly during the premenstrual, postpartum, and perimenopausal periods, although heterogeneity in study design and outcome measures was substantial.
Conclusion: Hormonal changes across the female reproductive cycle appear to play a clinically relevant role in the onset, exacerbation, and course of depressive disorders. Recognition of reproductive stage–specific vulnerability may support more individualized diagnostic and therapeutic strategies in women with mood disorders.
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References
1. Albert, K. M., Pruessner, J., & Newhouse, P. (2020). Estradiol levels modulate brain activity and depressive symptoms across the menstrual cycle. Biological Psychiatry, 88(10), 772–780.
2. Gingnell, M., Bannbers, E., Wikström, J., Fredrikson, M., & Sundström-Poromaa, I. (2020). Premenstrual dysphoric disorder and neural reactivity during emotion processing. Biological Psychiatry, 87(9), 802–811.
3. Slyepchenko, A., Minuzzi, L., & Frey, B. N. (2020). Comorbid anxiety and depression during pregnancy and postpartum: Neuroendocrine mechanisms. Journal of Affective Disorders, 274, 336–345.
4. Soares, C. N., Murray, B. J., & Kwan, A. (2021). Menopausal transition and depression: A systematic update. The Lancet Psychiatry, 8(7), 563–576.
5. Payne, J. L., Maguire, J., & Pathak, A. (2021). Reproductive hormone sensitivity and postpartum depression. American Journal of Psychiatry, 178(3), 256–265.
6. Barth, C., Villringer, A., & Sacher, J. (2021). Sex hormones affect neurotransmitters and shape the adult female brain. Frontiers in Neuroscience, 15, Article 666733.
7. Osborne, L. M., & Monk, C. (2021). Perinatal depression and the immune system. Molecular Psychiatry, 26(2), 575–587.
8. Schiller, C. E., Johnson, S. L., & Abate, A. C. (2022). Ovarian hormones and emotion regulation. Neuropsychopharmacology, 47(1), 67–78.
9. Maki, P. M., Kornstein, S. G., & Joffe, H. (2022). Guidelines for the evaluation and treatment of perimenopausal depression. Menopause, 29(10), 1171–1186.
10. Bloch, M., Daly, R. C., & Rubinow, D. R. (2022). Endocrine factors in the etiology of postpartum depression. Comprehensive Psychiatry, 113, Article 152292.
11. Davis, K., Pearlstein, T., & Stuart, S. (2022). Predictors of postpartum depression in large cohorts. Journal of Women's Health, 31(8), 1056–1064.
12. Hantsoo, L., & Epperson, C. N. (2023). Premenstrual dysphoric disorder: Epidemiology and treatment. Current Psychiatry Reports, 25(2), 37–45.
13. Joffe, H., Guthrie, K. A., & LaCroix, A. Z. (2023). Hormone therapy and mood in perimenopausal women. JAMA Psychiatry, 80(4), 389–398.
14. Meltzer-Brody, S., Colquhoun, H., & Riesenberg, R. (2023). Brexanolone injection in postpartum depression. American Journal of Psychiatry, 180(1), 18–28.
15. Deligiannidis, K. M., Meltzer-Brody, S., & Gunduz-Bruce, H. (2023). Neuroactive steroids in postpartum depression. The Lancet Psychiatry, 10(3), 192–204.
16. Li, Y., Schmaal, L., & Thompson, P. M. (2024). Daily hormonal fluctuations and mood variability in women. Molecular Psychiatry, 29(1), 120–130.
17. Gordon, J. L., Rubinow, D. R., & Eisenlohr-Moul, T. A. (2024). Estradiol variability and depression risk during menopause. Psychological Medicine, 54(2), 275–285.
18. Petersen, I., McCrea, R. L., & Sammon, C. J. (2024). Depression incidence across female reproductive stages. Journal of Affective Disorders, 340, 412–420.
19. Epperson, C. N., Steiner, M., & Hartlage, S. A. (2024). Hormonal sensitivity profiles in reproductive mood disorders. Biological Psychiatry, 95(4), 356–365.
20. Taylor, C. L., Pritchett, D., & Wisner, K. L. (2024). Hormonal trajectories and postpartum mood outcomes. Archives of Women's Mental Health, 27(1), 89–99.
21. Albert, K. M., & Newhouse, P. A. (2020). Estrogen, stress, and depression in women. Psychoneuroendocrinology, 121, Article 104840.
22. Schiller, C. E., Meltzer-Brody, S., & Rubinow, D. R. (2021). The role of reproductive hormones in mood disorders. CNS Spectrums, 26(1), 5–14.
23. Payne, J. L., & Osborne, L. M. (2021). Hormonal changes and perinatal depression. Clinical Obstetrics and Gynecology, 64(4), 702–715.
24. Hantsoo, L., & Epperson, C. N. (2022). Anxiety and mood disorders in pregnancy and postpartum. Psychiatric Clinics of North America, 45(2), 227–243.
25. Gordon, J. L., & Girdler, S. S. (2022). Hormonal sensitivity and affective disorders. Current Opinion in Psychiatry, 35(1), 27–34.
26. Joffe, H., & Cohen, L. S. (2023). Estrogen, menopause, and mood disturbance. New England Journal of Medicine, 388(2), 153–162.
27. Meltzer-Brody, S., & Deligiannidis, K. M. (2024). Advances in reproductive psychiatry. Nature Reviews Psychiatry, 1(3), 145–158.
