There are definitely gender differences when it comes to psychiatric issues and substance abuse. Males are more at risk for attention-deficit/hyperactivity disorder, autism, Tourette syndrome, oppositional defiant disorder and possibly schizophrenia. Because these often show up early in life, it’s thought they are caused or influenced by androgens and something that happens prenatally.
On the other hand, between puberty and menopause women are twice as likely to develop major depression, generalized anxiety disorder, panic disorder and post-traumatic stress. At or beyond menopause they are also at great risk for dementia, particularly Alzheimer’s disease.
In the past it was believed that the fluctuating hormones that are needed for reproduction also place women at greater risk for these problems. For example, about 3% to 5% of women suffer with premenstrual dysphoric disorder (PMS) and as women transition into menopause they become 2 – 5 times more at risk. Similarly, some women are also at greater risk for postpartum depression when the high levels of estrogen and progesterone suddenly drop.
Now a new study helps explain why. It has to do with brain levels of an enzyme called monoamine oxidase A (MAO-A). It turns out that MAO-A metabolizes serotonin, a hormone that helps control mood.
The study, published in JAMA Psychiatry (August 2014), explains how this happens. The researchers studied 10 young women (mean age 28), 27 women who were perimenopausal (mean age 45) and 12 postmenopausal women (mean age 56).
The researchers found that younger women had the lowest levels of MAO-A. Women in perimenopause had 34% more and women in menopause had 16% more. The higher the levels of MAO-A were associated with crying and psychological symptoms whereas changes in menstrual cycle length were not.
This is the first study of its kind and it offers a real window into the relationship between mood, mental health and estrogen. It helps explain many of the challenging psychological symptoms many women experience in and around menopause and it may one day provide a marker for telling who is at risk for a major depression.
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Dr. Mache Seibel, Founder of My Menopause Magazine http://bit.ly/MyMenoMag
Professor, University of Massachusetts Medical School
Founder My Menopause Magazine