5 Things No One Tells You About Women’s Hormones And Mental Health

One of the truisms we hear often is that “there is no health without mental health”. Research now shows that this is more than just a simplistic adage to promote mental well-being. Our hormonal health is closely connected to our mental health. The endocrine system of our body, which is responsible for our hormones, works closely with our central nervous system.

Hormonal imbalance impacts everything- metabolism, mood, immunity, sexual functions, reproduction, and the production of other essential chemicals in the body. The brain’s neurotransmitters which are responsible for regulating mood and emotions are also affected by hormonal imbalance, triggering anxiety and depression.  

This correlation is particularly relevant for women for two reasons. One is that there are a number of life events that women go through which involve significant hormonal shifts, such as menopause, pregnancy, postpartum or even the monthly menstrual cycle. All these events are associated with a noticeable impact on mental wellness as well. Secondly, there are socio-cultural factors as well. There are some gendered anxieties such as the pressure of domestic work, being a primary caregiver to your child as well as elders, managing work and home, the fear of sexual violence and many other things, that can trigger chronic stress, anxiety or even depressive symptoms in women.

5 things that science now tells us about the connection between women’s mental health and their hormones

The role of estrogen

Over the years, research has shown that estrogen is not just an important sexual and reproductive hormone but also a potent “neurosteroid”. An optimum state of estrogen in the body is associated with good mental health as it helps with protecting nerve health, modifies the production of “feel-good” hormones, the endorphins and also boosts serotonin production. However, an imbalance of estrogen, or a drop in its levels, triggers depression and anxiety. Estradiol, one of the more potent forms of estrogen, is associated with impacts on mental health during PMS, postpartum phases and also perimenopause.

Other hormones that affect mental health

Along with estrogen, progesterone is also associated with mental health. In the second half of the menstrual cycle, progesterone will gradually drop. This shift leads to irritability, fatigue, mood swings, anxiety, and other symptoms of premenstrual syndrome. The fluctuations of both progesterone and estrogen are more notable during menopause and even perimenopause.

As a result of these hormonal imbalances, women feel even more irritable and uncomfortable with symptoms like hot flashes, night sweats and more. Interestingly, with men as well, research has shown that increased estradiol, one form of estrogen, can be linked to increased depressive symptoms even outside their body mass index.  

A 2017 study in the Journal of Medicine and Life, also showed that patients who were insulin-resistant had higher risks for depressive symptoms. This is significant for women because of high incidences of PCOS as well as diabetes.

Impact of mental health on reproductive & sexual health

We have often heard doctors advise how managing stress is key to managing fertility health. This might sound over-simplistic to many, but evidence supports the fact that the stress hormone cortisol has a disruptive effect on reproductive hormones. Managing stress can improve fertility by ensuring healthy ovulation and other ovarian functions. Sexual health conditions like vaginismus are also associated with anxiety, at least partially.

Mental health & menopause

In the months or years before menopause, called perimenopause, estrogen levels are in a state of fluctuation. A 2019 study in The Journal of Clinical Endocrinology & Metabolism, linked an increase in depression symptoms at perimenopause with fluctuations of two hormones, progesterone and estradiol (the most potent form of estrogen). However, it is important to note that while hormones play a key role here, this is not the only factor that determines mental health in this phase of life. It is a time when women sometimes face multiple sources of stress- all of which may contribute to the incidence of depression and anxiety at this age.

Brain food for women

The good news is that we now have a better understanding of how to manage mental health in healthy, wholesome ways. Evidence now supports the role of the gut, also called the “second brain”, in influencing mental wellbeing. Not only can healing the gut help better moods, but research is underway on the role of nutrition in managing conditions like ADHD. Prebiotic foods help create the right environment in your gut for beneficial microorganisms to grow. 

Go for prebiotic foods in their raw form, such as garlic, leeks, asparagus, onions, bananas, artichokes, and seaweed. Probiotics help supply the microorganisms themselves. The brain is made up of 85 percent water, so it requires adequate hydration to function properly. These steps go a long way to help manage mental health.

According to a 2018 study, two-thirds of dementia patients are women. Women also account for 60 percent of caregivers caring for a friend or loved one with the disease. Women in their 60s are also more than twice as likely to develop dementia than they are breast cancer. Women’s mental health, therefore, needs both clinical research as well as cultural support.