beset by “female trouble”-- the estrogen hypothesis
December 31, 2018 9:51 AM Subscribe
In the early 1990s, three British psychiatrists found something astonishing: a demonstrable “second peak” of first-onset schizophrenia after 45. These patients were predominantly female... Women who become suddenly psychotic in middle age are typically given diagnoses that indicate an attending doctor’s baffled shrug... These women, unclassified and living at the margins of health, are alienated further by medicine’s bewilderment at them.
But over those same 20 years, a tiny group of mainly female psychiatrists working independently all over the world... began to study these women. They believe that in some, the dramatic fluctuations in hormones that accompany the onset of menopause may help to trigger schizophrenia. This correlation is called “the estrogen hypothesis.” (SL TheCut)
This hypothesis is powerful in that it helps to explain a large number of divergent cases. There are those second-peak schizophrenic women, who have breakdowns similar to those more commonly recognized in the young. But the circle of women whose lives and suffering may be illuminated by the estrogen hypothesis is much wider — women with psychosis linked to fluctuations in estrogen at all phases of life. There are women with traditional, early-onset schizophrenia whose hallucinations become more or less vivid in concert with their hormonal cycles, and women who become suddenly and dramatically psychotic — or catatonic or suicidal — when their estrogen plummets in the weeks after childbirth. Beyond that, there are women with previously diagnosed and controlled mental illnesses (bipolar disorder, major depression) who experience a recurrence or exacerbation during the menopause transition, as well as women who feel suicidal when others have PMS.
All women understand themselves to be in constant conversation with their hormones, which they know can wreak havoc with their mood. But they can also bolster and stabilize it. Yet this insight has been boxed away as somehow irrelevant to diagnosis and treatment by doctors unwilling to consider the possibility that the models of illness extrapolated from the experiences of men apply incompletely to women.
...Jeffrey Lieberman puts it more bluntly: “Medicine hasn’t paid much attention to these women. Middle-aged women are low priority, like children used to be.”
This hypothesis is powerful in that it helps to explain a large number of divergent cases. There are those second-peak schizophrenic women, who have breakdowns similar to those more commonly recognized in the young. But the circle of women whose lives and suffering may be illuminated by the estrogen hypothesis is much wider — women with psychosis linked to fluctuations in estrogen at all phases of life. There are women with traditional, early-onset schizophrenia whose hallucinations become more or less vivid in concert with their hormonal cycles, and women who become suddenly and dramatically psychotic — or catatonic or suicidal — when their estrogen plummets in the weeks after childbirth. Beyond that, there are women with previously diagnosed and controlled mental illnesses (bipolar disorder, major depression) who experience a recurrence or exacerbation during the menopause transition, as well as women who feel suicidal when others have PMS.
All women understand themselves to be in constant conversation with their hormones, which they know can wreak havoc with their mood. But they can also bolster and stabilize it. Yet this insight has been boxed away as somehow irrelevant to diagnosis and treatment by doctors unwilling to consider the possibility that the models of illness extrapolated from the experiences of men apply incompletely to women.
...Jeffrey Lieberman puts it more bluntly: “Medicine hasn’t paid much attention to these women. Middle-aged women are low priority, like children used to be.”
This post was deleted for the following reason: Poster's Request -- frimble
Oh, goody. One more thing ... HEY.
posted by Melismata at 9:59 AM on December 31, 2018 [28 favorites]
posted by Melismata at 9:59 AM on December 31, 2018 [28 favorites]
All women understand themselves to be in constant conversation with their hormones, which they know can wreak havoc with their mood.
No, not really. It would be nice to stay away from sweeping generalizations about "all women" here. For one thing, women are physically varied and can have very different hormone cycles from each other.
But for another, even among those of us who have what might be thought of as "more typical" cycles, our experiences are also varied. I do not understand myself to be "in constant conversation with my hormones"; I do not experience mood swings, I do not have experience my menstrual cycle as much more than a mild inconvenience, etc.
Also, while it's really important that women's health get the attention it deserves, and while that includes studying hormonal issues that are more common in women... I think we need to be really careful about using essentializing language about women, their hormones, and their effect on mental states. Women's 'hormones" have long been used to discredit us as thinking beings. Although men are just as affected by their hormones, there is a real divide in how we discuss hormones in women vs. hormones in men.
I am not saying we should not discuss the effect of estrogen on mental states, but when we do, I think we need to be aware of this context, and be careful not to play into the idea that women are uniquely hormonal.
posted by Kutsuwamushi at 10:16 AM on December 31, 2018 [109 favorites]
No, not really. It would be nice to stay away from sweeping generalizations about "all women" here. For one thing, women are physically varied and can have very different hormone cycles from each other.
But for another, even among those of us who have what might be thought of as "more typical" cycles, our experiences are also varied. I do not understand myself to be "in constant conversation with my hormones"; I do not experience mood swings, I do not have experience my menstrual cycle as much more than a mild inconvenience, etc.
Also, while it's really important that women's health get the attention it deserves, and while that includes studying hormonal issues that are more common in women... I think we need to be really careful about using essentializing language about women, their hormones, and their effect on mental states. Women's 'hormones" have long been used to discredit us as thinking beings. Although men are just as affected by their hormones, there is a real divide in how we discuss hormones in women vs. hormones in men.
I am not saying we should not discuss the effect of estrogen on mental states, but when we do, I think we need to be aware of this context, and be careful not to play into the idea that women are uniquely hormonal.
posted by Kutsuwamushi at 10:16 AM on December 31, 2018 [109 favorites]
as a trans guy, I hope to never again be in conversation with my unmodified endogenous hormone blend.
if it would treat psychosis, I would consider switching to estrogen and spironolactone. it's not shocking to me that the profound emotional effects associated with estrogen have antipsychotic effects in some people.
posted by bagel at 10:29 AM on December 31, 2018 [11 favorites]
if it would treat psychosis, I would consider switching to estrogen and spironolactone. it's not shocking to me that the profound emotional effects associated with estrogen have antipsychotic effects in some people.
posted by bagel at 10:29 AM on December 31, 2018 [11 favorites]
Like Kutsuwamushi, I would probably deny that I'm constantly in conversation with my hormones. I've had a pretty easy menstrual life (short, mostly pain-free periods.) But I have found myself fairly often realizing once my period arrived that my irritation/bad mood of the previous few days was probably related to PMS.
I wish the article had more links regarding hormone replacement therapy. It was seen as good, then bad, and now maybe now the risks are worth the benefits? (especially if psychosis and suicide are some of the risks.)
posted by vespabelle at 10:44 AM on December 31, 2018 [4 favorites]
I wish the article had more links regarding hormone replacement therapy. It was seen as good, then bad, and now maybe now the risks are worth the benefits? (especially if psychosis and suicide are some of the risks.)
posted by vespabelle at 10:44 AM on December 31, 2018 [4 favorites]
I'm another one who never had emotional reactions to PMS, and in fact some research indicates that attributing bad moods to PMS usually occurs ex post facto (much like the "full moon" explanation). Many women do have that reaction, however, just as many cis women, unlike me pre-menopause, have bloating, pain, and other symptoms related to hormones. But many don't, and I agree that we need to be really, really cautious about generalizations like that.
posted by Peach at 10:54 AM on December 31, 2018 [6 favorites]
posted by Peach at 10:54 AM on December 31, 2018 [6 favorites]
I think the point isn't that we know for sure that women are "hormonal", in the old, sexist sense. It's that we need to study all bodies, including bodies that are subject to stigma and erasure, so that we have evidence about how things like hormones affect different people and so we can offer appropriate evidence-based treatment.
posted by ArbitraryAndCapricious at 10:57 AM on December 31, 2018 [30 favorites]
posted by ArbitraryAndCapricious at 10:57 AM on December 31, 2018 [30 favorites]
Have a boring hypothesis. Hot flashes can interfere with sleep. Lack of sleep screws people up. Maybe it can set off schizophrenia in people who are vulnerable to it.
posted by Nancy Lebovitz at 11:00 AM on December 31, 2018 [7 favorites]
posted by Nancy Lebovitz at 11:00 AM on December 31, 2018 [7 favorites]
I went through menopause at age 16. I was diagnosed at age 20 and was prescribed premarin and progesterone, which I took for about a year, and then was prescribed birth control pills, which I took for 20+ years. I spent most of that time on Ortho Cyclen, a monophasic pill (the quantity of hormones is the same throughout the month) and then about 5 years on triphasic pills (the quantity of hormones fluctuates in order to imitate a natural hormone cycle).
On the monophasic pills, I had virtually no mood swings EVER, and on the tri-phasic ones, I did. One made me ragey, another made me more emotionally sensitive (e.g. prone to get verklempt at Hallmark commercials). I menstruated on all of those, although I didn't ovulate.
A few years ago I switched to PremPro, which is monophasic and doesn't cause menstruation. The mood swings are basically gone again, although it's been hard to get a read for a consistent mood state after Trump was elected.
The upshot is that, since I produce essentially no estrogen myself (doesn't even register in a blood test), I've always been able to kind of objectively observe the effects of the medication on my mental state, because I have a control (no medication, no estrogen). Except for the first few periods after I was diagnosed and put on medication (which were extraordinarily painful), I have almost no PMS symptoms on monophasic pills, and a tendency to be more irritable and intemperate on triphasic ones.
I don't really fear breast cancer or other estrogen-linked cancers mainly because those are linked to people with elevated estrogen levels, and mine are low even on medication. I get to worry about low-estrogen problems instead. It would be really nice if the field of medicine would explore estrogen further and see if they can find synthetics to relieve these symptoms and conditions that don't come with cancer risks or other issues, but in the 25 years that I've been on hormones, there's really been no advances at all.
I was really intrigued by this passage:
Taking a pen from his pocket, he leans over the coffee table between us and starts to draw on a pad, making a big triangle. That’s the key dopamine receptor — D2, as it’s called. Then he draws an arrow intercepting and blunting the triangle’s sharp point. That’s the antipsychotic drug creating a dam against dopamine.
He is disabled and frail, but Philip’s face begins to shine as he gets to his point. He draws another arrow intercepting his triangle from a different direction. This is estrogen. It also blunts the effect of dopamine and acts as an inhibitor, similar to an antipsychotic. “And that’s really why women don’t start wars,” he says.
posted by Autumnheart at 11:06 AM on December 31, 2018 [18 favorites]
On the monophasic pills, I had virtually no mood swings EVER, and on the tri-phasic ones, I did. One made me ragey, another made me more emotionally sensitive (e.g. prone to get verklempt at Hallmark commercials). I menstruated on all of those, although I didn't ovulate.
A few years ago I switched to PremPro, which is monophasic and doesn't cause menstruation. The mood swings are basically gone again, although it's been hard to get a read for a consistent mood state after Trump was elected.
The upshot is that, since I produce essentially no estrogen myself (doesn't even register in a blood test), I've always been able to kind of objectively observe the effects of the medication on my mental state, because I have a control (no medication, no estrogen). Except for the first few periods after I was diagnosed and put on medication (which were extraordinarily painful), I have almost no PMS symptoms on monophasic pills, and a tendency to be more irritable and intemperate on triphasic ones.
I don't really fear breast cancer or other estrogen-linked cancers mainly because those are linked to people with elevated estrogen levels, and mine are low even on medication. I get to worry about low-estrogen problems instead. It would be really nice if the field of medicine would explore estrogen further and see if they can find synthetics to relieve these symptoms and conditions that don't come with cancer risks or other issues, but in the 25 years that I've been on hormones, there's really been no advances at all.
I was really intrigued by this passage:
Taking a pen from his pocket, he leans over the coffee table between us and starts to draw on a pad, making a big triangle. That’s the key dopamine receptor — D2, as it’s called. Then he draws an arrow intercepting and blunting the triangle’s sharp point. That’s the antipsychotic drug creating a dam against dopamine.
He is disabled and frail, but Philip’s face begins to shine as he gets to his point. He draws another arrow intercepting his triangle from a different direction. This is estrogen. It also blunts the effect of dopamine and acts as an inhibitor, similar to an antipsychotic. “And that’s really why women don’t start wars,” he says.
posted by Autumnheart at 11:06 AM on December 31, 2018 [18 favorites]
Although men are just as affected by their hormones, there is a real divide in how we discuss hormones in women vs. hormones in men
Holy shit yes. This is a conversation I want to have without men at all, anywhere, not even close to the vicinity, because I just don’t trust the resulting conversation not to be Bad For Women.
I mean, I’d love to treat hypothesized testosterone-induced violence as a medical epidemic worthy of treatment, but can you imagine the reaction?
Actually, yes. Let’s have a group of women researchers study hormones. Let’s just...have women take over medical research for, idk, the next 150 years? Until we get to parity.
posted by schadenfrau at 11:12 AM on December 31, 2018 [62 favorites]
Holy shit yes. This is a conversation I want to have without men at all, anywhere, not even close to the vicinity, because I just don’t trust the resulting conversation not to be Bad For Women.
I mean, I’d love to treat hypothesized testosterone-induced violence as a medical epidemic worthy of treatment, but can you imagine the reaction?
Actually, yes. Let’s have a group of women researchers study hormones. Let’s just...have women take over medical research for, idk, the next 150 years? Until we get to parity.
posted by schadenfrau at 11:12 AM on December 31, 2018 [62 favorites]
“And that’s really why women don’t start wars,” he says.
I’m having some war-like thoughts
posted by schadenfrau at 11:13 AM on December 31, 2018 [22 favorites]
I’m having some war-like thoughts
posted by schadenfrau at 11:13 AM on December 31, 2018 [22 favorites]
Yeah, that article really underlined the prevailing view in medicine where it's basically like "Yes, women are killing themselves when their youth and fertility are over, but is that actually a problem? Let's study erectile dysfunction instead."
posted by Autumnheart at 11:16 AM on December 31, 2018 [17 favorites]
posted by Autumnheart at 11:16 AM on December 31, 2018 [17 favorites]
I find this terrifying.
Schizophrenia is very common in my extended family. The number of relatives with serious problems is way too high to ever not worry but I thought everyone in my immediate family had aged of of the risk zone without showing signs.
I am only 41.
posted by jacquilynne at 1:15 PM on December 31, 2018 [5 favorites]
Schizophrenia is very common in my extended family. The number of relatives with serious problems is way too high to ever not worry but I thought everyone in my immediate family had aged of of the risk zone without showing signs.
I am only 41.
posted by jacquilynne at 1:15 PM on December 31, 2018 [5 favorites]
So I underwent surgical menopause this summer at 39. I just needed my ovaries out, but due to a family history of breast cancer, I had my uterus out too so I could go on estrogen only HRT. I was put on a dose appropriate for a women going through normal menopause, but was too low for someone in my situation.
While I continue to have some degree of cognitive impairment now, it's nothing compared to what I went through in the summer and autumn. It was terrifying. Beyond the frustration of aphasia (one day, I was trying to say "kitchen table" but the word "cable" kept coming out of my mouth even as I pointed to the damn kitchen table), I wasn't safely able to drive, or cook for myself, or take a shower unattended. I lost the ability to read.
It has been such a struggle to get my dosage right. I'm still not there yet. It's possible that some of the cognitive impairment may be irreversible. And that's only with a few MONTHS of estrogen deficiency.
One of my great-grandfathers spent the last twenty years of his life in a psychiatric institution. I don't know why. But it's more incentive to keep fighting this fight I'm in.
posted by Ruki at 2:35 PM on December 31, 2018 [19 favorites]
While I continue to have some degree of cognitive impairment now, it's nothing compared to what I went through in the summer and autumn. It was terrifying. Beyond the frustration of aphasia (one day, I was trying to say "kitchen table" but the word "cable" kept coming out of my mouth even as I pointed to the damn kitchen table), I wasn't safely able to drive, or cook for myself, or take a shower unattended. I lost the ability to read.
It has been such a struggle to get my dosage right. I'm still not there yet. It's possible that some of the cognitive impairment may be irreversible. And that's only with a few MONTHS of estrogen deficiency.
One of my great-grandfathers spent the last twenty years of his life in a psychiatric institution. I don't know why. But it's more incentive to keep fighting this fight I'm in.
posted by Ruki at 2:35 PM on December 31, 2018 [19 favorites]
As a society, we need to be okay with the fact that brains are weird and many people need minor accommodations to function comfortably. Men, women, nonbinary people, people whose hormones are changing because they're older, people whose hormones are changing because puberty, people taking hormones to treat other issues--if it has an impact on mental health, we should be studying what it is. If somebody says that's a reason to not let members of any particular class participate fully in society, people should be calling that out as bullshit.
My PMS occasionally comes with sudden really obvious OCD symptoms. That doesn't mean anything about what women can or can't do, it just means that one or two days a month sometimes I need some very minor accommodations, right now. But since I know that it's hormonal right now, that gives me a huge head start on identifying any changes as I get older, and not just dismissing it as "well I guess now I'm unfixably crazy". Being afraid of being seen as "crazy" has too long left people without appropriate care and support.
posted by Sequence at 3:31 PM on December 31, 2018 [9 favorites]
My PMS occasionally comes with sudden really obvious OCD symptoms. That doesn't mean anything about what women can or can't do, it just means that one or two days a month sometimes I need some very minor accommodations, right now. But since I know that it's hormonal right now, that gives me a huge head start on identifying any changes as I get older, and not just dismissing it as "well I guess now I'm unfixably crazy". Being afraid of being seen as "crazy" has too long left people without appropriate care and support.
posted by Sequence at 3:31 PM on December 31, 2018 [9 favorites]
*sidles in* I like hormones. Hormones are weird, and I keep digging into them chasing my leptin question and getting really startled at just how much hormonal signaling does across tissues and how many things tie into behavior in... some unexpected ways. Like, my work is about how sexual behavior is influenced by a hormone most commonly associated with satiation or the absence of hunger; I am not remotely surprised to think that hormonal signaling (or misfiring) could create other very unexpected outcomes in other systems.
The more I dig into hormonal research, the more frustrated I get with the lack of research on female cycles, particularly since I'm interested in nonhuman species and different species manage ovulatory cycles very differently. (Some species cycle on the order of days, some months; some only start in response to cues from males, some only stop, and some ignore input from males totally; some can be suppressed easily by other females, and so forth.)
At the same time, hormonal fluctuations are incredibly sensitive to circadian rhythms. We know this... in males, especially, because very, very few workers have looked at these rhythms in females. For example, I recently wanted to know what the circadian rhythm for leptin is, because it has one--leptin levels spike at night and change over the course of the day, and I needed to know what time of day to run an experiment at.
But circadian rhythms for leptin in mice and rats, normally the two species most studied for this kind of work and the most accessible for me? Nah. In general, unless it's directly to do with reproduction--and to be fair, leptin figures into this a lot--I have a lot of difficulty finding what I'm looking for.
I would like to work on females--my thesis work right now is all in males--but I really, really, really need to be able to work with a lot of basic research that is just not done or properly funded and it's... frustrating. Really frustrating.
posted by sciatrix at 3:59 PM on December 31, 2018 [29 favorites]
The more I dig into hormonal research, the more frustrated I get with the lack of research on female cycles, particularly since I'm interested in nonhuman species and different species manage ovulatory cycles very differently. (Some species cycle on the order of days, some months; some only start in response to cues from males, some only stop, and some ignore input from males totally; some can be suppressed easily by other females, and so forth.)
At the same time, hormonal fluctuations are incredibly sensitive to circadian rhythms. We know this... in males, especially, because very, very few workers have looked at these rhythms in females. For example, I recently wanted to know what the circadian rhythm for leptin is, because it has one--leptin levels spike at night and change over the course of the day, and I needed to know what time of day to run an experiment at.
But circadian rhythms for leptin in mice and rats, normally the two species most studied for this kind of work and the most accessible for me? Nah. In general, unless it's directly to do with reproduction--and to be fair, leptin figures into this a lot--I have a lot of difficulty finding what I'm looking for.
I would like to work on females--my thesis work right now is all in males--but I really, really, really need to be able to work with a lot of basic research that is just not done or properly funded and it's... frustrating. Really frustrating.
posted by sciatrix at 3:59 PM on December 31, 2018 [29 favorites]
imagine if it were estrogen that meant women didn't start wars, rather than ... the patriarchy
posted by emilly at 1:43 AM on January 1, 2019 [8 favorites]
posted by emilly at 1:43 AM on January 1, 2019 [8 favorites]
I’m menopausal, or just post menopausal, and my constant mood battle almost disappeared completely after my periods stopped. It’s been lovely to go through entire weeks without wanting to kill people. But I tell ya, I come from a line of desert hobbits, and without estrogen fighting my hairy genetics, without constant vigilance I would have to sell myself to a traveling show as a bearded lady. But, a much happier and less stabby bearded woman, so....
posted by SecretAgentSockpuppet at 5:14 AM on January 1, 2019 [1 favorite]
posted by SecretAgentSockpuppet at 5:14 AM on January 1, 2019 [1 favorite]
I would have described myself as someone who had easy periods, no pain, no mood swings, for my entire life. Then perimenopause hit and oh my god. I went back on the pill to mitigate the symptoms, and all was good. Now that I’m almost done with menopause, even while still on the pill, I can see how I was oblivious to my hormonal shifts. Because, wow, no changing hormones for me seems to mean that I can suddenly control my hunger and eating, something I could never do before. I can motivate myself to talk to people — maybe I’m not such an introvert? The changes, mostly positive, that I have gone through in the last year have made me take a skeptical look at just how “unaffected” by my mentrual cycle I truly was. But, yes, SecretAgentSockpuppet, I am so hairy on the face and bald on top. Another hobbit.
posted by Malla at 6:34 AM on January 1, 2019 [2 favorites]
posted by Malla at 6:34 AM on January 1, 2019 [2 favorites]
I've always been really aware of my menstrual cycle because I get migraines at the tail end of them. And so I've always been sort of looking forward to menopause, since my mother and aunt both stopped having migraines when their periods stopped. I'm extremely, extremely glad to have read this article, so that I can be prepared (and prepare Mr. Star Stuff) to notice symptoms of psychosis in perimenopause.
The "antipsychotic" effects of estrogen are really fascinating to me, here. I had a brush with psychosis in my late teens, due to high anxiety and sleep deprivation. I was on Risperdal for a few weeks, which definitely handled the psychosis, and also made me lactate (galactorrhea, a rare, but well-known, side effect). At the time (and probably still) risperidone was one of those psych meds that worked real good, and no one really knew why or how.
Gynecomastia is also a rare but well-known side effect of antipsychotics for men-- and that is because of the way they interact with the D2 dopamine receptor.
…it's almost like this estrogen hypothesis was sitting there waiting for dude doctors to discover it but they were just too upset about man boobs.
posted by Made of Star Stuff at 7:07 AM on January 1, 2019 [9 favorites]
The "antipsychotic" effects of estrogen are really fascinating to me, here. I had a brush with psychosis in my late teens, due to high anxiety and sleep deprivation. I was on Risperdal for a few weeks, which definitely handled the psychosis, and also made me lactate (galactorrhea, a rare, but well-known, side effect). At the time (and probably still) risperidone was one of those psych meds that worked real good, and no one really knew why or how.
Gynecomastia is also a rare but well-known side effect of antipsychotics for men-- and that is because of the way they interact with the D2 dopamine receptor.
…it's almost like this estrogen hypothesis was sitting there waiting for dude doctors to discover it but they were just too upset about man boobs.
posted by Made of Star Stuff at 7:07 AM on January 1, 2019 [9 favorites]
imagine if it were estrogen that meant women didn't start wars, rather than ... the patriarchy
What if we could cure the patriarchy by synthesizing a dopamine inhibitor that didn’t have feminizing effects?
posted by Autumnheart at 8:25 AM on January 1, 2019 [3 favorites]
What if we could cure the patriarchy by synthesizing a dopamine inhibitor that didn’t have feminizing effects?
posted by Autumnheart at 8:25 AM on January 1, 2019 [3 favorites]
this is a really intriguing idea but I'm not sure the article format---one old 2002 citation and then getting opinions from various scientists---is the most useful.
The author goes around the normal system of journals citing and commenting on earlier studies.
The comments upthread are really great, it seems like mefites want to know: what is the actual effect of estrogen on→
1. schizophrenia
2. psychosis symptoms
3. cancer risk
To this end I did a pubmed search on estrogen+scz/schizophrenia and came back with 500+ articles, 327 which are more recent than 2002....so the OP article cannot be considered legitimate scientific journalism; however true the original anecdotes might be.
Thus 1. and 2. are under active research which is promising. It would be really cool if estrogen is targeting an underlying (perhaps dopamine-related) mechanism rather than the other medications which seem to treat some of the symptoms.
for 3. I found that HRT does not entail alot of risk of any kind for a woman from this NICE guideline so that's... nice!
posted by dongolier at 10:50 AM on January 1, 2019 [4 favorites]
The author goes around the normal system of journals citing and commenting on earlier studies.
The comments upthread are really great, it seems like mefites want to know: what is the actual effect of estrogen on→
1. schizophrenia
2. psychosis symptoms
3. cancer risk
To this end I did a pubmed search on estrogen+scz/schizophrenia and came back with 500+ articles, 327 which are more recent than 2002....so the OP article cannot be considered legitimate scientific journalism; however true the original anecdotes might be.
Thus 1. and 2. are under active research which is promising. It would be really cool if estrogen is targeting an underlying (perhaps dopamine-related) mechanism rather than the other medications which seem to treat some of the symptoms.
for 3. I found that HRT does not entail alot of risk of any kind for a woman from this NICE guideline so that's... nice!
posted by dongolier at 10:50 AM on January 1, 2019 [4 favorites]
What if we could cure the patriarchy by synthesizing a dopamine inhibitor that didn’t have feminizing effects?
Do you want Reavers? That's how you get Reavers!
posted by 80 Cats in a Dog Suit at 10:58 AM on January 1, 2019 [4 favorites]
Do you want Reavers? That's how you get Reavers!
posted by 80 Cats in a Dog Suit at 10:58 AM on January 1, 2019 [4 favorites]
That's on the Alliance for not conducting a proper trial!
posted by Autumnheart at 11:12 AM on January 1, 2019 [3 favorites]
posted by Autumnheart at 11:12 AM on January 1, 2019 [3 favorites]
A little more digging on pubmed lends more credibility to the estrogen↔schizophrenia connection from Li et al. (2016).
- more severe SCZ symptoms during low estrogen part of cycle
- same negative correlation between symptoms and estrogen levels in men
- related hormone testosterone, low levels correlate with higher (negative) SCZ symptoms
- dopamine↔estrogen link
- reproductive hormone oxytocin correlates with lower SCZ symptoms
I'm in that pre-menopausal, maybe perimenopausal stage and I'm not on any birth control. The last method I used was the Mirena IUD. It was great for a few years but the last year or so on it (after the five year limit which my gyn said was fine) was pretty terrible. Just flat mood, flat sex drive, low-level depression, and horrible hangovers! I'd have a beer or less and then not sleep, be in so much pain the next morning and depressed for at least two days, sometimes three. Hours... hours after having it removed, it felt like a cloud lifted. I have my period back which is lame but I'm lucky in that I've never had bad periods. But I don't have crippling hangovers anymore. I laugh a hell of a lot more. I generally feel better and I enjoy having both the highs and lows of my own hormonal cycle. Okay, I don't love the lows but I really pay attention to what's going on hormonally and I treat it like my low-key super-power. I always have one or two days a month where I am super motivated to get things done. When I realize I've hit that day in my cycle, I just allow myself auto-pilot and I clean out closets, organize stuff that needed organizing, make those appointments that I've been putting off, throw things away, etc., etc.. I just wish I could get easy access to some of the things that would ease my symptoms when they suck, like the cyclical insomnia, or the cyclical very-painful acne that murders my face once a month and then, like a cruel joke, just stops...so I can then marvel at my wounds and try to repair until the next month's attack. And, you know, it would be nice to have more than two days a month of high sex drive. I feel like we have the tools out there to map this stuff, we have the interest in a whole cadre of humans who would like to know more (along with their spouses and children) and it's just sort of...Meh? If you're not making a baby, we don't care. If you're crazy, that's just wimmen, amirite?
And it would be great if we cared for the male hormonal cycle and changes of life beyond his ability to get off.
posted by amanda at 8:09 AM on January 2, 2019 [3 favorites]
And it would be great if we cared for the male hormonal cycle and changes of life beyond his ability to get off.
posted by amanda at 8:09 AM on January 2, 2019 [3 favorites]
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posted by Autumnheart at 9:58 AM on December 31, 2018 [22 favorites]