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Q: Progesterone & Bipolar Mood
I have been diagnosed with Bipolar II
Disorder. I was recently given bio-identical progesterone to treat a hormonal
imbalance. I began experiencing an increase in depression and anxiety. The
doctor had me cut the progesterone dose in half. A couple of days later, I
experienced severe anxiety and depression. I became suicidal. I stopped the
bio-identical progesterone, and within a few days my mood was again stable. I
found some information stating that progesterone (synthetic and bio-idential) can
cause this type of reaction in those who have bipolar disorder. I was wondering
if you had further information and an opinion on this topic. Thank you for your
wonderful book and website.
Dear Ms.
Kay --
I could dig
up some references, somewhere, but it might be simpler simply to respond by
saying that progesterone is well known to sometimes cause depression. For it to
cause anxiety is somewhat more unusual, but frankly, the entire realm of
mood/anxiety and reproductive hormones is so muddy -- sometimes the hormones
seem to make things clearly better, sometimes they make things worse, in any of
several directions -- nothing really surprises me anymore. Sometimes women get
clearly better from estrogen alone (generally only possible if they have had a
hysterectomy). Sometimes they get better when taking estrogen and a
progesterone at the same time. Sometimes these are combined, any birth control
pill. In all of these forms, there are other women who get suddenly and
dramatically worse when these hormones are taken. Generally, in my experience, I
would say estrogen is more likely to cause anxiety, and progesterone more likely
to cause depression, but as I say, there are no solid rules to go by.
Unfortunately, all of these comments seemed to apply whether the hormone is
"bio-identical" or synthetic. I don't think that is the key here. It might make
a difference in some women, but it is hard to sort that out given that even the
bio-identical forms can cause various different problems.
I'm sure
that you wish we had more to say, based on research. I certainly do. The good
news is that lots of research studies are finally getting under way. It's
amazing that this has taken so long. Good luck figuring out your path --
Dr. Phelps
Published April, 2009
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