The pathophysiology of estrogen in perinatal depression: conceptual update

IF 3.2 3区 医学 Q2 PSYCHIATRY Archives of Women's Mental Health Pub Date : 2024-08-03 DOI:10.1007/s00737-024-01494-6
Anne M. Nielsen, Catherine S. Stika, Katherine L. Wisner
{"title":"The pathophysiology of estrogen in perinatal depression: conceptual update","authors":"Anne M. Nielsen,&nbsp;Catherine S. Stika,&nbsp;Katherine L. Wisner","doi":"10.1007/s00737-024-01494-6","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Estrogen levels fall sharply after parturition and have long been considered an etiologic contributor to postpartum depression (PPD); however, no differences have been reported in plasma hormone concentrations in people who develop PPD. We examine the question: What is the current view of estrogen and the neurophysiologic processes it impacts in the development and treatment of PPD?</p><h3>Methods</h3><p>A literature review of the role of estrogen on candidate hormonal and epigenetic systems in the peripartum period was performed, including landmark historical studies and recent publications on estrogen-related research. The authors reviewed these papers and participated in reaching consensus on a conceptual framework of estrogen activity within the complexity of pregnancy physiology to examine its potential role for driving novel interventions.</p><h3>Results</h3><p>Estrogen fluctuations must be conceptualized in the context of multiple dramatic and interacting changes inherent in pregnancy and after birth, including progesterone, corticosteroids, inflammation, circadian biology and psychosocial challenges. Individuals who develop PPD have increased sensitivity to epigenetic alteration at estrogen-responsive genes, and these changes are highly predictive of PPD. An effective estrogen-based treatment for PPD has yet to be found, but interventions focused on associated inflammation and circadian rhythms are promising.</p><h3>Conclusions</h3><p>Our understanding of the biological basis of PPD, one of the most common morbidities of the perinatal period, is expanding beyond changes in gynecologic hormone concentrations to include their impact on other systems. This growing understanding of the many processes influencing PPD will allow for the development of novel prevention and treatment strategies.</p></div>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":"27 6","pages":"887 - 897"},"PeriodicalIF":3.2000,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Women's Mental Health","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00737-024-01494-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose

Estrogen levels fall sharply after parturition and have long been considered an etiologic contributor to postpartum depression (PPD); however, no differences have been reported in plasma hormone concentrations in people who develop PPD. We examine the question: What is the current view of estrogen and the neurophysiologic processes it impacts in the development and treatment of PPD?

Methods

A literature review of the role of estrogen on candidate hormonal and epigenetic systems in the peripartum period was performed, including landmark historical studies and recent publications on estrogen-related research. The authors reviewed these papers and participated in reaching consensus on a conceptual framework of estrogen activity within the complexity of pregnancy physiology to examine its potential role for driving novel interventions.

Results

Estrogen fluctuations must be conceptualized in the context of multiple dramatic and interacting changes inherent in pregnancy and after birth, including progesterone, corticosteroids, inflammation, circadian biology and psychosocial challenges. Individuals who develop PPD have increased sensitivity to epigenetic alteration at estrogen-responsive genes, and these changes are highly predictive of PPD. An effective estrogen-based treatment for PPD has yet to be found, but interventions focused on associated inflammation and circadian rhythms are promising.

Conclusions

Our understanding of the biological basis of PPD, one of the most common morbidities of the perinatal period, is expanding beyond changes in gynecologic hormone concentrations to include their impact on other systems. This growing understanding of the many processes influencing PPD will allow for the development of novel prevention and treatment strategies.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
围产期抑郁症的雌激素病理生理学:概念更新。
目的:雌激素水平在分娩后急剧下降,长期以来一直被认为是产后抑郁症(PPD)的病因之一。我们对这一问题进行了研究:目前对雌激素及其在 PPD 的发生和治疗过程中影响的神经生理过程的看法如何?我们对雌激素在围产期对候选激素和表观遗传系统的作用进行了文献综述,包括具有里程碑意义的历史研究和近期发表的雌激素相关研究论文。作者们对这些论文进行了审阅,并参与就妊娠生理复杂性中雌激素活动的概念框架达成共识,以研究其在推动新型干预措施方面的潜在作用:结果:雌激素波动的概念必须结合妊娠和产后固有的多种戏剧性和相互作用的变化,包括孕酮、皮质类固醇、炎症、昼夜节律生物学和社会心理挑战。罹患 PPD 的人对雌激素反应基因的表观遗传学改变的敏感性增加,而这些改变对 PPD 有很高的预测性。以雌激素为基础的治疗 PPD 的有效方法尚未找到,但针对相关炎症和昼夜节律的干预措施很有前景:PPD 是围产期最常见的疾病之一,我们对其生物学基础的认识正在不断扩展,不仅包括妇科激素浓度的变化,还包括其对其他系统的影响。我们对影响 PPD 的多种过程的认识不断加深,这将有助于制定新的预防和治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Archives of Women's Mental Health
Archives of Women's Mental Health 医学-精神病学
CiteScore
8.00
自引率
4.40%
发文量
83
审稿时长
6-12 weeks
期刊介绍: Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
期刊最新文献
Risk of congenital anomalies associated with psychotropic medications: a review of neonatal reports in the FDA adverse event reporting System (FAERS). Commentary on "Intimate partner violence among ever-married Afghan women: patterns, associations and attitudinal acceptance". A narrative review on emerging issues about war-related trauma in perinatal women: good practice for assessment, prevention, and treatment. Good practice in lactation counseling for Ukrainian refugee mothers to ensure the health and mental benefits of breastfeeding - an observational study. Cognition and motherhood: a key to understanding perinatal mental health?
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1