At our clinic, we are commonly asked if sex hormone levels, such as estrogen and progesterone, can cause mental health symptoms. Research, however, supports the fact that abnormal reproductive hormone levels, also known as sex hormone levels, are not a cause for mental illness.
Written by Kristin Lasseter, MD
Our clinicians are big proponents of evidence-based clinical practice and the majority of studies do not support the claim that abnormal sex hormone levels, such as estrogen and progesterone, can cause mental illness. In fact, research has shown that hormone levels do not play a role in mental illness. It is not the level of the hormones that influences mental health, but, rather, the degree in which those hormone levels change that can impact mental health symptoms. In other words, checking someone’s reproductive hormone levels to analyze their mental health is pointless. Sex hormone levels will not help to diagnose or treat any mental health disorders.
Less commonly, changing hormone levels can be the cause of mental illness, such as with premenstrual dysphoric disorder and mental illness during perimenopause; however, even in those cases, the gold standard of treatment is usually a prescribed psychiatric medication, not supplemental hormones. There seems to only be a subset of women who develop mental health symptoms in relation to changing hormone levels, but most people tolerate sex hormone level changes without significant effects on their mental health. Unfortunately, to date, there is not a test available to determine who is sensitive to these hormone fluctuations.
Other than premenstrual dysphoric disorder (PMDD) and perimenopausal mental illness, there is no evidence that taking estrogen, progesterone or testosterone is an effective treatment for mental illness. With PMDD, selective serotonin reuptake inhibitors are the gold standard of treatment because they pose less health risks than hormones in the majority of people, and they are more effective for most, as well. In fact, research supports the notion that taking exogenous sex hormones can actually be a risk factor for mental illness. Specifically, this has been shown in postpartum women taking progesterone birth control, and in other people who are administered hormonal contraceptives.
There are not ideal reproductive hormone levels that exist to treat mental health, so why do some providers check hormone levels? Some people believe that specific hormone levels can impact mental health; however, this is an opinion and not based on facts. There are some women who experience mental health benefits when they are administered sex hormones. Since treating hormone imbalances to improve mental health is more “experimental,” though, it is important to fully understand the risks and benefits that exist for a particular individual when they are administered reproductive hormones. Taking hormones, no matter the way in which they are administered, or how “natural” or “bioidentical” they are, still come with potential risks to a person’s health. If the hormones are not providing a noticeable benefit, then the potential risks may not be worth it.