Reproductive Hormones and Stages of Life in Women: Moderators of Mood and Cardiovascular Health

Abstract

Reproductive hormones have diverse effects on mood, behavior, and health in both men and women. However, the focus of this chapter is on female predominant reproductive hormones and their effects on mood and health in women, not only across the reproductive life span, but as well in women’s peri- and postmenopausal years associated with hormone withdrawal or replacement. In this chapter, we first describe menstrually related mood disorders, including the role of reproductive hormones and their metabolites. Evidence is provided that histories of abuse or histories of depression predict clinically meaningful subgroups of women with these disorders. Novel research on progesterone-derived neuroactive steroids is presented, including implications for future research in the role of GABAergic neuroactive steroids in depressive disorders. Next, we cover both animal and recent translational human work on the hypothalamic neuropeptides oxytocin and vasopressin. Animal research on oxytocin in reproductive functions, maternal behavior, and its stress buffering effects is reviewed, as well as the impact of early life experience on adult behavior and oxytocin activity. Largely paralleling the animal work, recent novel human research in this area is covered and demonstrates the adverse effects of early life stress on adult bonding behaviors and oxytocin activity, including cocaine use during pregnancy, and the stress buffering and antinociceptive effects associated with high oxytocin activity. Intervention research using oxytocin is presented and implications for future work are discussed. Lastly, we address the mood and cardiovascular sequelae associated with estrogen deprivation in the peri- and postmenopausal years and the impact of estrogen replacement. Evidence that the age and the cardiovascular health of women is an important determinant of estrogen’s effects during the peri- and postmenopausal years is presented. Future research aimed at identifying subgroups of perimenopausal women that would predict the beneficial effects of estrogen replacement is indicated.