When combined HT is indicated, it is important to consider the type of progestogen used; for example several studies have shown negative effects on the myelination of neural cells with the use of medroxyprogesterone acetate (MPA) .
Similarly, it is clear that the administration of hormones to girls in a pathological state of anovulation, as occurs in anorexia nervosa (AN), is of fundamental importance; re-establishing a correct estrogen-progestogen balance prevents the already existing depressive symptoms from being potentiated by estrogen deficiency.
In fact, it has been shown that in 80% of cases of AN a mood disorder coexists, in particular major depressive disorder and persistent depressive disorder (formerly known as dysthymia).
Estrogen therapy – in addition to improving bone mineralization, vaginal trophism and sexual desire – has been shown to improve depressive symptoms and brain damage and improve attention and memory deficits typical of the disorder.
Fluctuations in steroid hormones
Neurosteroids participate in the physiological regulation of neurogenesis, neuronal survival, synaptic function and myelin formation, thus influencing neuronal plasticity. Due to these effects, neurosteroids will have different modulatory actions, exercising control over mood, cognition and behavior. Furthermore, they have a neuroprotective role in relation to certain neurocognitive pathologies.
- This must be taken into consideration when treating patients with diseases that affect ovarian function, such as polycystic ovary syndrome, hyperprolactinemia or hypothalamic anovulation. Similarly, women who come to medical attention for mood changes or cognitive deficits must be carefully investigated.
- On the other hand, when addressing the need to administer exogenous hormones (oral contraceptives and hormone replacement therapy), the stage of life in which the woman is, with particular attention to adolescents, must always be considered due to the time window of neuronal plasticity.
- The activity exerted by steroid hormones on the nervous system emphasizes the idea that the achievement of hormonal balance is a useful tool in the search for female mental health.
A woman who turns to medical attention for mood changes or cognitive deficits must always be properly investigated from the point of view of the hormonal profile, in consideration of her age and state of ovulation. In fact, hormone therapy has significant benefits on psychological and neurological well-being. Likewise, it is good for women with endocrine-gynecological problems that involve chronic anovulation to receive adequate specialized hormone treatment.
Hormonal balance is a fundamental component of human health and functionality.
Hormones allow communication between the various parts of the body and regulate numerous functions that allow growth, metabolic function, reproduction and multiple aspects of our behavior and psychological reactions.
- However, hormone production is not stable over the years and tends to vary with aging. According to some theories, the decline in hormone production is even at the basis of senescence itself as it compromises the optimal functionality of our body.
- In some cases these alterations are particularly evident, universal and permanent as for menopause in women. In other conditions the alterations are much more nuanced and more subjective as for example in the so-called male andropause (better defined as hypogonadism).