Women are at higher risk throughout their reproductive lives than are men for major depression. Numerous molecular and clinical studies have implicated estrogen in modulating brain function including that related to mood. In an attempt to present a conceptual model, the literature of the past 30 years on mood and well-being throughout reproductive life is reviewed as it relates to activity of endogenous, bio-identical, and synthetic estrogen in women. Results indicate that sudden estrogen withdrawal, fluctuating estrogen, and sustained estrogen deficit are correlated with significant mood disturbance. Clinical recovery from depression postpartum, perimenopause, and postmenopause through restoration of stable/optimal levels of estrogen has been noted.
Ottawa Civic Hospital (Ms O'Donnell), Gynecology/Infertility and The Midlife and PMS Centre (Dr Barwin), and the School of Nursing, Faculty of Health Sciences, University of Ottawa (Dr Woodend), Ottawa, Ontario, Canada. Ms Douma is an independent researcher and Dr Husband is in private practice in Ottawa, Ontario, Canada.
Corresponding author: Stephanie L. Douma, MSc, 446 Hartleigh Ave, Ottawa, Ontario, Canada K2B 5J4 (e-mail: firstname.lastname@example.org).
The authors thank Dr D. Armstrong and Dr P. Hendry for their encouragement. Errors and omissions are the exclusive responsibility of the authors.