It has been known for some time that depression is more common in women than men, but it is also more common in women at times of hormonal fluctuations such as:
- premenstrual depression,
- postnatal depression and
- perimenopausal depression.
Naturally all these times are related to changes in hormone levels. Women's Health Expert, Professor John Studd points out the need for a correct diagnosis of reproductive depression. These forms of depression should be treated by a gynaecologist with expertise in hormones and not with mood altering drugs.
The problem is that that severe premenstrual depression can be misdiagnosed as bipolar disorder and therefore women will be started on inappropriate treatments of antidepressants or other mood-stabilizing therapy and this happens all too often.. Prof Studd says, "The most effective treatment for severe premenstrual syndrome is by suppression of ovulation and suppression of the cyclical hormonal changes by transdermal estrogens or by GnRH analogs."
Role of Testosterone
Postnatal depression is more common in women with a history of premenstrual depression and also responds to transdermal estrogens. Transdermal testosterone gel can be also used in women who suffer from the following symptoms:
- loss of energy and
- loss of libido
Loss of libido may also be due to the inappropriate prescription of antidepressants. There is also a role for the Mirena IUS and laparoscopic hysterectomy and oophorectomy in women who are progestogen-intolerant. In order to ensure that all women receive the best possible care, Prof Studd says, "The hormonal causation of certain common types of depression in women and the successful treatment by estrogens should be understood by all psychiatrists and gynecologists."