GynoFiles

Involutional melancholy is thought of as a disease of perimenopausal women affecting women from ages 40-55, but in fact men of about 50-65 have approximately the same incidence. Because the syndrome was always defined as having a significant component of hypochondrias, as well as being able to be classified with other mood disorders, it is no longer recognized as a disease by the American Psychiatric Society. It's existence as a separate condition has been argued hotly over the past one hundred years . The term involutional melancholy was actually coined in 1986 by the founder of modern and scientific psychiatry Emil Kraepelin. He felt that the process of aging precipitates a unique mood disorder he noted that had features of being depressed or chronically sad, agitation or versions of mania, patients feel isolated, depersonalized and delusions of bodily change and fear of aging, and was specifically at the time of menopause. Some psychiatric researchers say that the diso...

Oral contraceptive birth control pills have been implicated as a cause of depression and anxiety and mood changes. Depression is listed as a possible adverse reaction in the package insert materials on oral contraception.. If we fundamentally understood all the reasons for depression, researchers could more reliably understand the links between oral contraception and depression. Deficiencies in the chemicals in our brain serotonin, norepinephrine, dopamine, γ-aminobutyric acid and peptides , probably cause most all of these reactions and some women may have lower levels due to stress or genetics. Few studies have been done to try to link depression, levels of these brain chemicals, and steroid hormones given as contraception. As the dosage of hormones is very low in the modern contraceptive pills, it's possible that we have little to no effect on the natural brain levels of these molecules from taking the currently available contraceptive pills. The CDC currently states there is n...

Women can be stressed and tired without being depressed after having a baby, but baby blues, postpartum depression, and postpartum psychosis are three diagnoses that may need serious attention from your health care provider. And now a NYT article notes that these feeling actually begin in pregnancy, not just post partum . And not just for women who have had poor outcomes in pregnancy such as miscarriage or stillbirth. Oddly the current formal categories of psychiatric diagnosis do not recognize postpartum depression as being anything other than depression. The "baby blues" usually begins right after delivery, may be the worst in the first days at home with baby, and are often described as feeling a bit on edge, irritable or sad, and essentially go away without treatment. Postpartum depression is significant, you worry too much about the baby, have trouble concentrating and enjoying motherhood and may even get so difficult moms with this much depression think of killing th...

Estrogen can control nearly all hot flashes, but not nearl y all women having hot flashes can safely take hormone therapy. Viable alternatives are avaliable for women who cannot take hormone therapy. A study of depression called the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) also looked at looked at menopausal hot flashes and vasomotor symptoms (VMS) after receiving antidepressant medication. Some earlier studies said that yes, antidepressant medication can fix hot flashes, but only for people who actually also have a mood component. Although for many years some antidepressants were prescribed off label for menopausal symptoms for those women only within the past gynos have not recommend long term antidepressants for treatment of just menopausal symptoms. But the FDA in June 2013 a 7.5-mg formulation of the selective serotonin reuptake inhibitor paroxetine mesylate, Brisdelle by Noven Therapeutics, an approved nonhormonal option for treating vasomotor symp...

"I never get angry, says a Woody Allen character in one of the director’s movies, “I grow a tumor instead.” So how does this apply to uterine fibroids? Drs Wise, Palmer, and Rosenberg of the Sloan Epidemiology Center at Boston University have shown that stress can make a woman more at risk to grow uterine fibroids. And they now have published the newest findings out of the Black Women's Health Study, and Dr. Wise has concluded that depression can increase the presence of uterine fibroids. Internal stress can play havoc with our health in many ways. Stress can have internal  consequences as stress  can alter the immune system, it can alter our pituitary gland control of the adrenal glands, and can alter our ability to repair aging of our organs. Stress in very early life, caused by abuse, can have a stress effect that spans our entire life. It is true that those who experienced childhood stress also were more likely to smoke, to be physically inactive, and to become alcoholics...

Women do suffer from depression and other mental health issues more than men do. Only about 10% of men have a diagnosis of depression during their lifetime, whereas about 20% of women do. Anxiety and eating disorders are also more common in women. The gender differences begin to be very noticeable after the teen years which has always made us suspect that there is a hormonal link.

Women suffer from more depression than men, almost double the rates, and we think that the sex hormones are the physiologic reason for this. It may not just be that women have that high level of estrogen that men don't, but perhaps it's their hormonal swings that are at the root of depressive symptoms. A new study in 2013 looks at this, in the Multiethnic Study of Atherosclerosis, and what they found was that depression was linked with hormone levels in the early menopausal transition. They also tried to look at the specific tests of hormone function, like using Sex Hormone Binding Globulin (SHBG) as a marker. Their decided that SHBG helped them pin point bioavailable estrogen and testosterone in their patients. This attempted to repeat the work done by Barrett-Conner in 1999 when she looked at a large number of hormonal levels and worked out that only DHEA-S, an adrenal hormone was actually linked with symptoms. Menopausal health answers also continue to come from the Nationa...

Moms, like others, are often anxious or depressed and now about 5% of the pregnant population (more in some studies) are taking an antidepressant.. It's been a common practice in the past 5 years to try to get a pregnant patient to taper off the medication in the last 2-4 weeks of pregnancy. The thought being that this is good for the baby's overall health, as well as avoiding behavior issues in that early adjustment phase right after birth. In fact the medications came with specific warnings. But some researchers are rethinking this strategy once again, and finding that perhaps the data looking into the baby adjustment patterns wasn't as accurate as once thought and that there may not be as much need to taper in the third trimester as once thought. Again, the best advice is to talk to your gyno about what to do with medication use before, after, and when prego.

The treatments that are supposed to treat depression have now been shown to not beat out not treating...more precisely, they aren't beating out placebo! In the new trial results from STAR*D  some antidepressant treatments didn't beat placebos. So what's going on? Could it be you aren't on the right medicine, what about needing dose adjustments, what about counseling, what about your hormone levels? Bottom line: you aren't your mom, your sister or your friend: simply put you are you and most likely you and your gyno have to make decisions that are very customized to your care. So check back with your gyno and check back often.

Placental passage is a minor transition in the birth moments compared to many of the other feats. But the Hormonal transition begins at that moment and the "Fourth Trimester" has dramatic impact on the mind and mood of new moms. The serious issue of postpartum depression has been discussed and studied fairly extensively since coming to light with several important medical case studies. We know that "baby blues" shouldn't be ignored as a normal state but at least evaluated. Better breast feeding advice, family support is to resume physical activity rather than the "confinement" of yore has all been a help to the healthy approach to the Forth Trimester. No actual medication is approved for the treatment of actual postpartum depression. Nutrition can dramatically impact our neurochemistry. Studying it is another matter. New trials in the use of  omega-3 fatty acids, and it's possible women are just not getting enough, not even with the new prenatal v...