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Erster Weltkongress zur seelischen Gesundheit der Frau 27. - 31. März 2001 in Berlin |
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Prof. Dr. Uriel
Halbreich:
Sex Hormones and Mood
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Worldwide, the prevalence of depression in women is
significantly greater than in men. Available data suggest that estrogen, or its absence, is
strongly implicated in the regulation of mood and behavior, as well as in the pathobiology
of mood disorders.
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The
multiple effects and complex interactions of estrogens have been well documented, although
specific, multifaceted role of estrogen in each dysphoric state has yet to be
distinguished. Several facts suggest that estrogen exerts a vital role in the
precipitation and course of mood disorders in women. Gender differences in the prevalence
of depression first appear
after menarche, continue through reproductive age, and dissipate after perimenopause. Periods of hormonal fluctuations or
estrogen instability (i.e., premenstruai, postpartum, perimenopause) have been associated
with increased vulnerability to depression among susceptible women. lt is plausible that
the phenotype of these depressions is distinguishable. |
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Based on current knowledge, estrogen treatment for affective
disorders may be efficacious in two situations:
1 To stabilize and restore disrupted
homeostasis — as with premenstrual, postpartum, or
perimenopausal conditions;
2. To act as a psychomodulator during
periods of decreased estrogen levels and increased vulnerability to dysphoric mood, as
with postmenopausal women. lt remains unclear whether estrogen may be efficacious as a
sole antidepressant, but there is growin~ evidence suggesting that it may be an
efficacious adjunct to SSRI's.
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