Your hormones can affect just about everything in your body – your weight, fertility, skin, and even your risk for developing certain conditions.
But what about your mood? People often say a woman is “hormonal” if she’s experiencing mood swings. So are your hormones to blame for your mood issues? Is estrogen related to depression?
In this article, we’ll discuss the link between your hormones and mood, estrogen and depression, including the influence of oral contraceptives. I’ll also provide my top recommendations for feeling more mentally and emotionally balanced.
How Your Hormones Affect Your Mood
Can your hormones affect your mood? The simple answer is yes. But the exact mechanisms behind their effects is less straightforward.
What we do know is that sex hormones, such as estrogen and progesterone, are closely linked to women’s emotional and mental well-being. Experts believe it’s at least in part due to their ability to cross the blood-brain barrier, which allows them to exert their influence on various neurochemicals.1 For example, many women experience increased risk of depression during the menopause transition (also known as perimenopause). This shows a correlation between estrogen and depression. This period is marked by exaggerated fluctuations in estradiol levels.2
Researchers have also found that hormones can affect brain regions involving:3
- Motor control
Along with major changes in hormone levels during transition periods (e.g., puberty), many women experience mood changes on a monthly basis. Symptoms severe enough to interfere with a woman’s quality of life are collectively called “premenstrual syndrome” or PMS for short. You may recognize PMS symptoms like:
- Depression or anxiety
- Anger or irritability>
- Social withdrawal
A subgroup of women may experience a more severe form of PMS called PMDD.
What is PMDD?
PMDD, or premenstrual dysphoric disorder, can greatly impair a woman’s quality of life. Some of the symptoms of PMDD include:4
- Markedly depressed mood
- Persistent anger or irritability
- Decreased interest in usual activities
- Difficulty in concentrating
- Marked change in appetite
- Hypersomnia or insomnia
- Sense of being overwhelmed
- Some physical symptoms like breast tenderness or swelling, headaches, joint or muscle pain, etc.
Your symptoms may vary in duration, from a few days to a few weeks. For most women with PMDD, symptoms may intensify 6 days before their period, with the worst of them occurring 2 days prior.5 Please note that PMDD is a serious chronic condition that often requires treatment. If you’re experiencing symptoms listed above, please seek the help of a healthcare professional.
The Effect of Birth Control Pills on Mood
Oral contraceptives (also known as birth control) seem simple enough. They stop your body from ovulating and thicken the cervical mucus, preventing pregnancy as a result.
Researchers are learning that pregnancy prevention may not be all that they do though. There is mounting evidence that oral contraceptives can have a significant negative impact on your mood. What does this mean for the relationship of estrogen and depression? A study published in Hormones and Behavior looked at oral contraceptive use and changes in brain structure and function. They performed functional magnetic resonance imaging (fMRI) on 75 women to examine their brain activity and structure as they completed a test of working memory. Additionally, 140 women took the Trier Social Stress Test, in which participants had to give a speech and do mental arithmetic.
The study found that women who started using oral contraceptives during puberty displayed a blunted stress response and changes in brain activities during these exercises. These women also showed structural changes in the brain regions that regulate emotion and memory.6
It’s unclear whether the observed differences are due to the women’s longer duration of oral contraceptive use or due to their age when they began using them. But these findings could help shed light on why some women develop mood disorders following oral contraceptive use.
My Recommendations to Help Balance Your Mood
As helpful as hormone replacement therapy can be, it takes more than hormones to fix hormone imbalance. There is more to the relationship between hormones and mood issues, like estrogen and depression. To achieve true hormone balance, you need to focus on your lifestyle and nutrition. Here are some of my top recommendations.
Look Into Your Hormone and Nutrient Levels
If you and your doctor suspect a hormonal imbalance as the root cause of your mood issues, I recommend getting a full panel of hormone tests. Could there be a link for estrogen and depression for you? I also encourage my patients to check for nutrient deficiencies.
When looking to balance your hormone levels, don’t ignore testosterone. Many people think of testosterone as the “male hormone,” but it plays a major role in women as well.
In particular, testosterone seems to impact women’s mood. A study published in 2021 showed that its levels are significantly altered in women with depression.7
Another study of 50 non-depressed perimenopausal women found that higher testosterone-to-estradiol ratio was associated with depressive symptoms and difficulty sleeping.8
I can’t emphasize this enough – please don’t guess when it comes to your hormones. Treating without testing can wreak even further havoc on your hormone levels. If estrogen dominance is determined to be contributing to your mood, I discuss how to balance estrogen levels in my blog here
If you’ve been suffering from depression or other mood issues for a while, someone has likely said something along the lines of, “You just need to exercise!” And there’s some truth to the well-intentioned advice. A growing body of evidence suggests physical activity can reduce depressive symptoms and frequently comorbid conditions like insomnia.9
Many, if not most, of us know exercise can lift our mood. But when you’re depressed, it can be hard to just get out of bed. It’s important not to compare yourself to others. Comparing yourself to strangers on social media will never make you feel like you’re doing enough.
But here’s the truth – you are enough. Just focus on what you can do at the moment, even if it’s just a walk around your block.
Surround Yourself With Positive People
Have you ever felt yourself feeling down when surrounded by negative people? Even if you didn’t start out feeling that way, maybe you’ve listened to a friend complain about something for so long that you’ve started feeling negative, too.
Can depression be contagious? It’s certainly not contagious in the same way a virus is. But it seems that our moods and emotions can spread to others. In other words, it might be possible for you to “catch” depression from others.
One study analyzed friendship data on 13,465 adolescents to explore the relationship between friendship and suicidal ideation and attempts. The results showed having a friend who committed suicide increased the likelihood of suicidal ideation and attempts, especially for socially isolated females.10
Another study looked at 103 pairs of college freshmen. Participants who were randomly assigned to a roommate with high levels of cognitive vulnerability were likely to “catch” their roommate’s tendencies. Interestingly, the freshmen who “caught” the cognitive vulnerability had greater symptoms of depression than those who didn’t catch it at all.11
If negativity is contagious, so is positivity. It doesn’t mean you should surround yourself with toxic positivity, or those who say things like “just smile.” Instead, surround yourself with supportive people who have your best interests at heart and are willing to listen to you. Over time, you may find that authentic positivity helps stabilize your mood.
Avoid Highly Processed, Sugary, or Toxic Foods
Comfort foods might make you feel better at the moment – but studies show these often highly processed, sugary foods negatively impact your mood.
A systematic review published in July 2022 looked at the correlation between ultra-processed food consumption and mental disorders including anxiety and depression. “Ultra-processed food” was characterized as containing 5 or more ingredients, which often include non-nutritive additives like taste enhancers that are rarely used in home kitchens. The authors reported, “greater intake of ultra-processed food was associated with increased odds of depressive and anxiety symptoms.” They also noted that non-nutritive ingredients like artificial sweeteners may be involved in dysregulating neurotransmitters like dopamine and serotonin.12
It’s tempting to turn toward junk foods like donuts and fast foods when you’re feeling down. But I encourage you to do your best to limit your intake of these foods, and avoid them entirely if possible. They won’t do you any favors in the long run.
Maintain a Healthy Level of Vitamin D
Vitamin D plays a critical role in your health. In fact, it’s so important that nearly every cell in your body has a vitamin D receptor.13 Scientists have found that chronic deficiency in vitamin D is closely associated with common chronic diseases like cardiovascular disease, diabetes, osteoporosis, and even certain types of tumors.14 15
Vitamin D has a profound effect on your brain health as well. In a recent study, researchers examined the brain tissues of 290 people for their vitamin D concentrations. They found that higher vitamin D concentrations were correlated with a 25% to 33% lower odds of dementia or cognitive impairment at the time of death.16
Maintaining an adequate level of vitamin D can support your mood, too. A study involving 50 women with type 2 diabetes reported that weekly supplementation of vitamin D for 6 months significantly reduced depression and anxiety. Interestingly, the response was even better in women who weren’t taking antidepressants or anxiolytics during the study.17
As the nickname “sunshine vitamin” suggests, exposure to sunlight is the main way for humans to derive the required amount of vitamin D. But experts believe over 1 billion people worldwide have vitamin D deficiency.18 Why? Many fear the possibility of developing skin cancer, and more and more people now spend a majority of their time indoors. And the standard American diet doesn’t provide enough vitamin D to make up for the lack of sunlight exposure.
So how much sun exposure do you need to get enough vitamin D? For people with light skin, experts recommend spending 15 to 20 minutes daily with 40% of the skin surface exposed. Because high concentrations of melanin in the skin and aging slow the production of vitamin D, dark-skinned or older people may need much more.19
If you’re not spending enough time in the sun, try adding vitamin D-rich foods like fatty fish, egg yolk, and dairy products to your diet.
Optimize Gut Health
Your gut is home to a dynamic, complex community composed of trillions of microorganisms. These organisms, collectively called the gut microbiome, can affect the neuro-endocrine-immune pathways in your body, which has generated the concept of the gut-brain axis.
The gut-brain axis isn’t unidirectional. An unbalanced gut microbiome can affect your mood, but it can occur the other way around as well. In other words, your mood can affect your gut health.
In that case, could optimizing your gut health help relieve depression and anxiety? It might, though more research is required. In one study, researchers found that supplementing mice with Lactobacillus rhamnosus reduced anxiety- and depression-related behavior.20
Similar findings were reported in a meta-analysis of 10 clinical trials, involving a total of 685 participants. The authors found that probiotics could “significantly reduce the depression scale for patients with anxiety and depression.”21
Trying to pick a probiotic supplement can easily overwhelm you. Once again, there’s no one-size-fits-all for gut health. I recommend working with me or your doctor to determine which strains are right for you.
The Answer to Your Mood Issues May Lie With Your Hormones
Scientists are still learning about all the ways women’s hormones can affect our bodies. Is there a direct link between estrogen and depression? It’s clear that hormones can contribute to mood instability, including PMS symptoms that so many women face every month, as well as mood changes during the transition into menopause.
Natural Hormone Doctor in Boston – serving clients nationwide
Are you uncertain if your hormones are affecting your mood, such as estrogen and depression?
If you feel like your mood has been “off” lately, you’re not alone. As a doctor of naturopathic medicine and a women’s health specialist, I can help you get back to feeling like yourself again.