Reproductive depression refers to a subgroup of women who experience depression or mood disorders associated with fluctuation of sex hormone levels, typically worsening pre-menstrually, post-natally, or during the perimenopase. In fact the role of hormones in depression is probably vastly underestimated - depression is twice as common in women as in men, and bipolar mood disorders even more commonly found in women. The link between hormones and depression is significant – did you know that recurrence of a bipolar episode is one in four in the postnatal period and there are more schizophrenic relapses around the time of perimenopause/menopause?
How do you know if your mood disorder might be hormone related?
If you suffer from depression, try to see if there is a cyclical pattern to it – does it worsen before your period? Suspect reproductive depression if your depression has coincided with a time in your life when there is great hormone flux (i.e. immediately after the birth of your baby, or during the perimenopause/menopause).
Its important to know if hormones are involved in your low mood, because if you suffer from low mood premenstrually, you might be more likely to get depressed at other times of hormonal fluctuation. Essentially, premenstrual dysphoric disorder, post partum depression and perimenopausal depression are probably occurring in the same set of women – and they seem to run in families (50% of cases of premenstrual dysphoric disorder have affected another family member).
Perhaps you have found your mood is better when you are taking the pill or when pregnant (both of which stop your own ovaries from having their normal cycle and therefore stop the hormone fluctuations that could be involved in a mood disorder). However, pills may have the opposite effect for women: atypical depressive symptoms are one of the commonest reasons women stop taking the pill.
If there is a cyclical component, or the depression occurs at a time of great hormonal change (e.g. after birth) hormones should be tested ( e.g. thyroid as impaired thyroid function can be a cause). Studies have reported that reproductive depression is less responsive to conventional anti-depressant regimes and more receptive to hormonal therapies.
How much of mood disorders will we, in time, discover to be linked to physical causes? In the future we may learn more about the role of gut health in depression: gut health could impact our neurotransmitters, and inflammation in the gut may be linked to depression. The gut microbiome shapes sleep, memory, mood and cognition.
In summary, if you are suffering from depression, consider if there is a hormonal link. Did anything similar run in your family? If you suffer from low moods premenstrually you might be extra vulnerable after birth or in the lead up to menopause?