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Mood, Anxiety & Depression

Emotional well-being and mental health is just as important as any other aspect of health.   However, women after 40 report higher rates of irritability, anxiety, depression and inability to concentrate.  They also report increased severity and more often have sleep disturbances in conjunction with the negative mood.  As progesterone and estrogen levels start to decline and this affects neurotransmitters and receptors in the brain, which in turn can impact mood regulation.  Lack of sleep can also make anyone irritable!  


HRT has been shown to effectively alleviate symptoms associated with hormonal imbalances, including anxiety, depression and mood changes.  Here’s how HRT can help:


  1. Improvement in Mood and Emotional Well-being: By restoring hormonal balance, HRT can alleviate symptoms of anxiety, irritability and depression, improving overall mood and emotional well-being. 
  2. Improved Sleep: Improved sleep and relief from physical discomfort can have a positive impact on mood and overall quality of life. 


Estrogen Boosts Dopamine and Serotonin in the Brain 


Estrogen has mood-enhancing effects by boosting serotonin and dopamine - both neurotransmitters that are associated with feelings of well-being and happiness. 


Estrogen increases dopamine synthesis, and decreases its degradation, reuptake, and recapture.  We need dopamine to help us feel focused and happy.  Dopamine also helps the brain make delta waves while we are sleeping, which help us achieve deep REM sleep.   


Progesterone acts like nature’s Xanax because it’s metabolites bind to GABA receptors. 


First, some definitions:


Allopregnanolone - a neurosteroid that gets released when your body is metabolizing progesterone.  It has potent anti-anxiety and anti-depressant effects and it also makes it easier for people to fall and stay asleep.  Progesterone converts to allopregnanolone


GABA - a neurotransmitter in the brain that slows the brain down and makes you feel ahhhhhhh.  It facilitates sleep and reduces feelings of anxiety. 


Allopregnanalone stimulates GABAA receptors, which can do all kinds of cool stuff in the brain. One of the reasons people like to drink alcohol or take Xanax if for their potent GABA(A) receptor action. GABA receptor stimulation makes us feel relaxed. The idea that we can have our GABAA receptors stimulated by simply metabolizing progesterone — which our body needs anyway — is pretty awesome. 


This effect is most likely only seen with bio-identical hormones - synthetic progestins do not convert to allopregnanolone — so women on oral contraceptives actually end up with a higher incidence of mood disorders and sleep disturbances.  Likewise, it hasn’t been extensively studied whether synthetic estradiol impacts the dopamine and serotonin pathways.  On the other hand, it is well known that the natural hormones in your body have these effects. 


As you enter into your 30s and 40s, progesterone is significantly diminished.  You become lacking in GABAergic activity, which can make you anxious, angry, sad and irritable and have insomnia.  You are also more likely to want that glass of wine to take the edge off.  It doesn’t need to be this way.  Supplementing with bio-identical hormones will get you additional GABA-related action in your life. 


How Can Inner Balance Help?

When women begin bio-identical hormone replacement at Inner Balance, the first thing they often notice is that they have a more positive outlook on life.  Women often feel “grounded” and “stable” - a feeling that “all is right with the world.” Their overall sense of well-being is significantly improved and they report that they feel like they got their zest back in life.  At Inner Balance, our providers understand the nuances of hormones and how they impact neurochemistry.  Our providers are here to support you wherever you are in your journey.   



“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

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