In this episode, we delve into the fascinating world of estrogen and its impact on neurotransmitters, including its role in regulating ...

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The Surprising Link Between Estrogen and Depressive Symptoms, Explained by Science

but we do know based on Research that estrogen plays a role in regulating neurotransmitter Pathways and neural receptors and that's essentially signaling Pathways that modulate certain neurotransmitters specifically neurotransmitters which are signals in the brain include serotonin and noradrenaline and those are really closely tied to the development and treatment of depression or depressive symptoms and so why this is is because estrogen receptors as I've mentioned before are scattered throughout the brain and that includes regions that are responsible for mood and cognitive regulation like the prefrontal cortex and the hippocampus which we talked about when we talked about the brain but the way estrogen impacts serotonin and noradrenaline is actually considered positive meaning that when you have estrogen it actually boosts your mood and that's particularly due to serotonin and serotonin is sort of like the body's mood stabilizer and all the treatments that we use for depression they increase serotonin and so how estrogen works is it limits the activity of enzymes called monoamine oxidases and these break down serotonin it also boosts the synthesis of tryptophan hydroxylase which is a very important enzyme in serotonin production So based on these things we're seeing an overall increase in the production of Serotonin and the availability of Serotonin because it's not getting broken down as quickly interestingly there's also thoughts that estrogen may have mood enhancing or even anti-depressant like effects because it stimulates something called brain derived neurotropic factor and this is essentially a key molecule that's involved in plastic changes so you've heard about neuroplasticity right it's involved in plastic changes related to learning and memory and this acts like a protective a agent for the brain in terms of women going through menopause Studies have consistently shown that per menopausal women have a higher risk of experiencing depressive symptoms compared to premenopausal women anywhere from 45 to 70% compared to 25 to 30% that's a pretty big difference okay listen up this is so fascinating there was a small study that found that the risk of depression that came on during the 24 months around the last menstrual period was 14 times higher than any period in the prior 31 years preceding it meaning that 31 years before menopause you were 14 times less likely to have depression than the time around menopause and in another study a double blind randomized control trial now these are like the gold standard studies where they take a treatment and that Placebo and they compare them so we can really see head-to-head what are the difference they found that per menopausal and early postmenopausal women between the ages of 45 and 60 were given transdermal estradi which is a topical estrogen formulation a patch or Placebo for 12 months and what they found was that the placebo group had a significantly higher likelihood of developing and Reporting depressive symptoms compared to the group receiving estradi and the difference was 33% to 177% so that's a pretty large difference in my mind and they saw that these benefits were more common in women who were in early menopause transition now we're going to talk about why everything seems to be better in the early menopause transition while we talk about the next section which is heart health so when we're thinking about cardiovascular health you need to understand that there's also estrogen receptors specifically ER Alpha and er beta receptors found in the vascular smooth muscle cells which are essentially muscle cells of the blood vessels and endothelial cells which are those lining the blood vessels and when estrogen attaches to these receptors it actually promotes the production of a variety of substances like nitric oxide that widen or vasod dilate blood vessels and this prevents having excessive cell growth which would lead to plaque formation and at the same time it inhibits the production of molecules that Vaso constrict or narrow the blood vessels and these are essentially working together to prevent plaque formation at this point in time major organizations are not recommending hormone therapy or estrogen for the prevention of heart disease however there is evidence that suggests that women who start hormone therapy y early meaning before the age of 60 or within 10 years of menopause they may actually experience benefit in terms of coronary artery disease and overall mortality now again why is it that everything seems to work better when you started earlier this is based on the theory that as you age you're going to have more tissue damage right and so you want to start the hormone therapy before that occurs it's because if the hormone therapy is initiated after plaques have formed because of Aging or other comorbid conditions estrogen actually destabilizes these plaques and then it increases the risk of stroke and cardiovascular disease whereas when you're young and healthy it's a lot safer and essentially has much more benefit so basically when they analyzed all this data they found that there was conflicting data because they didn't separate out young women to women who were older getting hormone therapy so in a secondary an analysis of the Women's Health Initiative data where they looked at younger women they found that there was a significant reduction in the combined occurrence of heart attacks coronary artery revascularization and coronary death in women from the ages of 50 to 59 who are randomized to receive estrogen therapy in addition there's been more than 40 observational studies that consistently show reduction by 30 to 50% in coronate artery disease among those who take hormones compared to those who do not now there was what's called a cockin review and this is basically a well-respected review that's done of all the literature and so in 2015 they published a coochin review of randomized controll trial data of hormone therapy and basically what they found was that if you initiated that within 10 years of menopause onset it lowered the risk of coronary artery disease in postmenopausal women by 48% let me say that again if you take hormone therapy within the first 10 years of menopause it can lower the risk of coronary AR Disease by 48% and it can reduce all cause mortality meaning death by 30% all cause mortality by 30% with no increased risk of stroke but there is still a small increased risk of Venus thrombo embolism but it's very similar to the risk that you get with oral contraceptives now this is pretty remarkable guys that you can take a hormone that will reduce your risk of dying compared to someone who didn't take it by almost 30% that is really truly tremendous now we're going to talk about vasom motor symptoms these are defined as hot flashes sudden intense sensations of heat basically in the upper body in the face in the back in the chest which can last 1 to 5 minutes and they are very common in menopause in fact it's estimated that by the year 2025 1.1 billion women around the world will experience vasomotor symptoms that is not a small number that's a lot of women now it's not just hot flashes they often have sweating chills anx xiety and even heart palpitations and these symptoms are not just short-lived for some people they can last up to 7 years in fact in African-Americans they've been seen to last up to 10 years now that is a long time to deal with hot flashes now these occur because of dysfunction or abnormalities in a thermal regulation Center in the brain specifically in the hypothalamic control center now this is the area that controls the constriction or narrowing of the blood vessels and dilation of the blood vessels in response to temperature changes so when it's hot your blood vessels will dilate to let off heat and they'll constrict when you're cold now abnormalities in this process during uh men

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