Why the Emphasis on Estrogen Replacement, What about the Other Reproductive Hormones?
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Q:  Why the Emphasis on Estrogen Replacement, What about the Other Reproductive Hormones?


I appreciated some of the info you provide on your site regarding menopause, bipolar, and estrogen replacement. But what's with all the emphasis on estrogen? It seems like everyone I know is taking bioidentical progesterone, because this usually cuts out first during perimenopause. The idea is that it's the RATIO among the reproductive hormones-- estrogen, progesterone, and testosterone--that's important, not the levels of each.   


Dear Claudia --

Good point.  As youíve seen, we have almost no data on this issue of reproductive hormones and mood symptoms, particularly how changes in these hormones seem to worsen bipolar disorder in some women. Unfortunately, whereas we have just a few studies which looked at estrogen in perimenopausal mood change, we have no studies at all Ė to my knowledge Ė that looked at progesterone or testosterone (or androstenedione, or other potential steroid hormone variables).  

The result: it sounds like an emphasis on estrogen. Really itís a pretty comprehensive lack of research on reproductive hormones in general. Shameful, but thatís where it is. The good news is that this seems to be changing, with more studies gearing up in this realm (but a cut-back in federal funding is slowing progress generally at the same time. )

Dr. Phelps

Published July, 2008


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