Neuroendocrine Aspects of Pregnancy and Postpartum Depression

Abstract

Introduction. Ties between the endocrine system and mental health are undeniably a consistent point of interest in modern day medicine. Furthermore, mental disturbances due to hormonal changes following childbirth have been mentioned in medical literature since Hippocrates. Considering the dramatic endocrine, paracrine and autocrine changes that occur during gestation, labour and postnatal phase, hormonal theories are not to be ignored in the treatment of postpartum disorders. Results. Reproductive hormones are known to modulate behavioural, emotional and cognitive response, therefore rapid changes in estradiol and progesterone plasma concentrations during pregnancy and labour create a vulnerable terrain leading towards postpartum disorders. New research shows that women suffering from postpartum disorders have abnormal neural responses, suggesting a neuroendocrine explanation for postpartum syndromes. Conclusion. To facilitate further research in this area, we present new information on several hormonal interactions and the psychiatric response involved in pregnancy and labour, offering an interdisciplinary outlook on pregnancy and postpartum disorders. There is enough evidence to suggest that estradiol, progesterone, oxytocin, cortisol and thyroid hormones are some of many hormones involved in postpartum syndromes and tackling their perinatal imbalance with pharmacological substituents or antagonists could be useful as an adjuvant form of treatment in future patients.

Affective disorders: A question of continuing treatment during pregnancy (Review)

“…This analysis did not include cases that overlapped other psychiatric diagnosis other than co-morbid anxiety disorder, or those with antidepressant medication at baseline. Premature labor is not the only negative finding current research ties to prenatal depression (3). Some evidence indicates low birth weight and intrauterine growth restriction.…”

Aggressive behavior in psychiatric patients in relation to hormonal imbalance (Review)

“…Lower levels of testosterone have a minimal effect on the amygdala and the ratio of testosterone to cortisol has less impact on behavior ( 7 ). It was also postulated that lower levels of testosterone are a protective factor against antisocial behavior or for postpartum women that actually reported fewer symptoms of depression due to the fathers' postpartum depression ( 8 ).…”

Gaps or links between hormonal therapy and schizophrenia? (Review)

“…Following these data, many scientists have tried to find a correlation between sex hormones and the evolution of patients diagnosed with schizophrenia. From the analysis of many factors (data related to anatomical, neurochemical, epidemiologic and treatment response facts), a theory emerged of 'protection' from schizophrenia stating that estrogens offer protection against this disorder (2). As far as we know, the chronology effects of estrogen add to neural plasticity, the mechanism is via gene expression; there are also receptor sites or post-receptor sites (G proteins) where the estrogen effects may affect the neurotransmitter systems directly.…”