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Sex Hormones

The CEU/OPD/CPD course can be found at for clinicians in the US or if you are in Australia

~ Identify the effects of estrogen, progesterone and testosterone levels on mood
~ Explore the effect of cortisol on sex hormones (and mood)
~ Identify causes of sex hormone imbalances and possible interventions
~ Estrogen is linked to mood disruptions that occur only in women — premenstrual syndrome, premenstrual dysphoric disorder, and postpartum depression.
~ Estrogen levels in women with PMS or PMDD are almost always normal. The problem may instead lie in the way estrogen “talks” to the parts of the brain involved in mood
~ During perimenopause, up to 10% of women experience depression that may be caused by unstable estrogen levels.
~ Some studies suggest that using a transdermal estrogen patch by itself can improve depression during perimenopause
~ Mood-Related Functions of Estrogen
~ Increasing serotonin and the number of serotonin receptors in the brain.
~ Modifying the production and the effects of endorphins

Estrogen and Serotonin
~ Serotonergic neurons in the brain have also been found to contain estrogen inducible progestin receptors
~ Ovarian hormones have also been shown to affect numerous factors regulating serotonin synthesis and serotonin levels in the central nervous system (see Bethea et al., 1999 for review)
~ Estrogen inhibits the enzyme monamine oxidase (MAO) which is responsible for breaking down serotonin
~ Chronically elevated levels of estrogen can actually induce depression by causing functional hypothyroidism.
~ Chronically elevated levels of estrogen can contribute to anxiety by contributing to excess serotonin
~ Estrogen also interferes with the release of cortisol
~ Estrogen deficiency that occurs with menopause can cause anxiety.
~ Estrogen enhances the excitatory neurotransmitters dopamine, and histamine

Causes of Low Estrogen
~ Estrogen levels decline for several reasons including:
~ Age
~ Premature ovarian failure
~ Congenital conditions, such as turner syndrome
~ Thyroid disorders
~ Excessive exercise
~ Being severely underweight
~ Chemotherapy
~ Low-functioning pituitary gland

Causes of High Estrogen
~ Leaky gut
~ Thyroid dysfunction
~ Processed food intake
~ Stress
~ Pharmaceutical / drug use (all of which change gut flora and digestive function)


~ Progesterone affects the GABA receptors in the brain
~ Increases in progesterone cause dose-dependent improvements of premenstrual anxiety, irritability and nervous tension.
~ Cortisol and progesterone are both made from pregnalone
~ When we are chronically stressed and make more cortisol, cortisol production steals from progesterone levels.
High Estrogen and Low Progesterone
~ Progesterone is anti-anxiety
~ Estrogen is anti-depressant
~ Too much of either can produce an “on edge” feeling
~ The higher estrogen levels go, the more cortisol is released making us less able to adapt to stress.
~ High estrogen levels can contribute to subclinical hypothyroidism which decreases GABA release.
~ High estrogen affects levels of dopamine
Serotonin and Estrogen
~ Serotonin can increase estrogen
~ Estrogen is excitatory
~ Too much serotonin is associated with anxiety
~ Too little serotonin is associated with depression in some but not all

~ Testosterone can have a significant impact on mood, as well. It helps with one’s sense of well-being and self-confidence, which are important aspects to a positive mood. In fact, depression and anxiety are well-known symptoms of low testosterone.
~ Depression and anxiety are symptoms of low testosterone in women and men.
~ Evidence supports anxiolytic and antidepressant roles for testosterone.
~ Surgical removal of the ovaries increased mood disturbances and depression, an effect reversed by testosterone.

~ Numerous clinical studies in postmenopausal women and men in the andropause showed improvements of learning and memory after testosterone supplementation
~ Impacts GABA levels (potentially bimodally)
~ Testosterone, correlated negatively with global 5-HT4R levels suggesting that men with high levels of testosterone have higher serotonin
~ Low serotonin and high testosterone levels in the central nervous system has a significant effect on the neural mechanisms involved in the expression of aggressive behavior. It seems that testosterone modulates serotonergic receptor activity in a way that directly affects aggression, fear and anxiety.

~ Testosterone suppresses dopamine
~ Adolescent males have an increased risk of developing schizophrenia, implicating testosterone in the precipitation of dopamine-related psychopathology

~ Low testosterone levels trigger symptoms such as anorexia, fatigue, and decreased libido, which may impact mood.
~ When testosterone is lowered, cortisol is more likely to increase.
~ Testosterone has antidepressant effects in:
~ Women with anorexia nervosa
~ Women with dysfunctional pituitary glands and low testosterone
~ Men with SSRI-resistant depression.

Causes of Low T
~ Obesity – fat cells manufacture estrogen. The more estrogen in ratio to testosterone that young men have, the less “healthy” their testosterone sends signals.
~ When testosterone levels decline in men, so does estrogen, since your body converts some free testosterone to estrogen.
~ Insulin resistance & diabetes – elevated insulin and blood sugar create issues with testosterone signaling.
~ Porn can disrupt testosterone levels because real women no longer increase Testosterone levels

Causes of Low T
~ Sick guts – gut bacteria impact levels of testosterone, so testosterone levels are intimately related to the health of your microbiome.
~ Endocrine Disruptors – chemicals in our air, food and water can act as “anti-androgenic compounds” that can damage testosterone receptors
~ Hypertension

~ Vincent M. Pedre, M.D.

Cortisol and Sex Hormones
~ Cortisol and progesterone are made from pregnenolone. When the body needs cortisol, the production of progesterone gets sacrificed, leaving higher levels of estrogen in your system
~ Progesterone balances out the effects of estrogen.
~ There is a negative relationship between cortisol and testosterone
Leaky Gut
~ Estrobolome is the collection of microbes capable of metabolizing estrogens
~ Hormone production takes place in your gut
~ A leaky gut can impact levels of:
~ Estrogen: A leaky gut does not effectively escort the aggressive estrogen metabolites out of your body, causing Estrogen Dominance and your progesterone level might become too low.
~ Cortisol due to the inflammatory response
~ Both men and women have testosterone and estrogen
~ Estrogen, Testosterone and Progesterone impact serotonin and GABA levels
~ Cortisol (stress) reduces the amount of sex hormones
~ Too much estrogen or testosterone can contribute to anxiety, too little, depression
~ Progesterone balances estrogen
~ Cortisol is made from Pregnenolone the same hormone that progesterone is made from
~ Too much cortisol means too little progesterone and estrogen dominance
~ Leaky gut also contributes to estrogen dominance and excessive cortisol
~ Hypertension, obesity, diabetes, and stress all impact leaky gut.