Original post by Donna Conte
Louise, the first woman to whom I prescribed bioidentical hormones, suffered from depressed and irritable moods from the time of her hysterectomy at the age of thirty until she began using progesterone more than twenty years later.
Another patient, Gail, made it into her forties with her uterus intact before she began experiencing depression, mood swings, and emotional fragility. Both Louise and Gail attempted to pinpoint the source of their emotional problems in their stressful lives, but they also had the feeling that something was not right in their bodies, and that this something had to do with their hormones.
They were correct.
On the biochemical level, mood is largely the result of the balance of neurotransmitters—especially serotonin, dopamine, and norepinephrine—in the brain. Low levels of one or more of these chemical messengers are common in patients with depression. But levels of these and other neurotransmitters can be affected by hormonal variations. For example, the mood-elevating neurotransmitter norepinephrine is inactivated by an enzyme called monoamine oxidase (MAO), and when levels of MAO are high, the resulting decline in bioavailable norepinephrine can induce depression. This process can be reversed by estrogen, which inhibits MAO and frees up more norepinephrine.
On the other hand, chronically elevated levels of estrogen can actually induce depression and anxiety by causing functional hypothyroidism. When thyroid hormone cannot be adequately assimilated into the cells, cellular oxygen declines. This is bad news for the brain, which uses a full 25 percent of the oxygen you breathe. Hypothyroidism also results in a slowdown of cellular metabolism, which causes a drop in levels of the neurotransmitter gamma-aminobutric acid (GABA). GABA is a calming neurotransmitter, which prevents the brain from being overwhelmed by stimulation. Extremely low levels of GABA can cause epileptic seizures, but even moderately low levels are linked to mood swings, anxiety, and panic attacks.
The brain is highly sensitive to progesterone. In fact, progesterone is found in brain cells at levels twenty times higher than in the blood serum. Here, as elsewhere in the body, progesterone counterbalances the effects of estrogen. Whereas estrogen has an excitatory effect on the brain, progesterone’s effect is a calming one. Women with estrogen dominance sleep restlessly, whereas progesterone replenishment enhances sleep.
The phenomenon of postpartum depression provides further evidence of the important role that progesterone plays in the brain. Keep in mind that during pregnancy, the placenta produces massive quantities of progesterone—ten to twenty times the normal amount produced in a woman’s body—while the ovaries’ production drops to virtually zero. After the baby is delivered, the woman’s progesterone levels fall precipitously, leading to a state of estrogen dominance and functional hypothyroidism. Postpartum depression can be easily treated by taking supplemental doses of Armour Thyroid and natural, bioidentical progesterone.
Estrogen dominance is also a culprit in premenstrual headaches and migraines. One reason for this is that estrogen promotes water retention. Because the brain is confined to the fixed space of the skull, when it swells the pressure that develops causes a headache. Estrogen also causes dilation of the blood vessels. The constriction of blood vessels followed by rebound dilation is a key factor in migraines. Finally, estrogen dominance leads to depletion of the mineral magnesium, which is crucial to normal blood vessel tone. Magnesium deficiency can cause a spasm of arteries in the brain.
“Not tonight, dear . . . I have a headache,” is not a tired cliché. For many women in their midthirties and beyond, frequent headaches are the inevitable result of estrogen dominance. So is low libido. Sexual desire does not occur in the sexual organs—it occurs in the brain. Estrogen dominance can dampen sexual desire by increasing levels of sex hormone–binding globulins. These proteins attach to progesterone and testosterone in the bloodstream and inactivate them, just as thyroid-binding globulins do to thyroid hormones. Keep in mind that both progesterone and testosterone peak at ovulation, enhancing libido at the time when a woman is fertile. If a woman is estrogen dominant, with correspondingly high levels of sex hormone–binding globulins, she may be disinterested in sex even at the most fertile time in her cycle.
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