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Re: Questions re Seroquel and re estrogen (Lar? SLS?)

Posted by Laurie Beth on November 16, 2005, at 19:50:19

In reply to Questions re Seroquel and re estrogen (Lar? SLS?), posted by Racer on November 16, 2005, at 11:01:10

Re Clomid:

(First, everything below assumes that you are taking Clomid to attempt to ovulate more eggs - i.e., that you are already "normo-ovulatory". If that's not the case, then the analysis would be a little different.)

Clomid fools the receptors in the pituitary into "thinking" estrogen levels are low, thus causing the pituitary to pump out more follicle stimulating hormone (FSH), which in turn makes (more) ovarian follicles grow (faster), thus making more estrogen that the pituitary still may not detect but that will circulate in the blood. The reason women are usually warned about the side negative emotional side effects of Clomid is that while on Clomid, the "brain" is said to think estrogen levels are low, and for many women, that can cause depression, anxiety irritability, hot flashes, etc.

So, let's see: you're saying that both WHILE you were on Clomid and AFTER you went off Clomid, you felt good, right? That makes speculation more complicated.

While you were on Clomid, presumably your "brain" thought it had little estrogen. That would seem initially to suggest that low estrogen state is what's making you feel good. But, in reality, your estrogen was probably climbing much faster than normal, even though your pituitary didn't know it. Clomid is pretty non-selective in blocking estrogen receptors (that's why women often have thinner uterine linings and less fertile cervical mucus while on Clomid). But I doubt there's been much research on exactly which types of estrogen receptors in the brain are affected by Clomid - I guess it's not impossible that the pituitary could be fooled (and thus Clomid would do its job, causing an increase in FSH) but that the receptors that are responsible for your feelings of well-being were NOT fooled, but rather were enjoying your actual high estrogen state.

Once you went off Clomid, your body would continue to have a lot of estrogen in it (because of the extra follicles that would hopefully be growing under the earlier influence of Clomid-induced increase in FSH), but now your brain would have a chance to recognize that. If you ovulated more than one egg, then, during the second half of your cycle, the time when you said you were still feeling good, your estrogen and progesterone levels would probably have both been higher than usual. However, it's also not impossible that the effects of the Clomid could have lingered somewhat, so that even for several days after you went off Clomid, your "brain" still didn't know that your estrogen levels were unusually high.

So, it's still not easy to determine if your brain (or specifically some receptors in your brain) liked the fact that they weren't getting much estrogen (even though the estrogen was actually there) or if the opposite: some receptors in your brain were reacting favorably to the high actual estrogen levels caused by the Clomid's effect on FSH.

And unfortunately, this is all complicated by the fact that mood and cognitive states aren't determined just be how high the ovarian hormone (progesterone and estrogen) levels are; they're also determined (in a way that isn't yet very well understood) by the sequence in which they come. So even if you could figure out that you felt good when estrogen and progesterone levels were high, it may not be as simple as just trying to get your estrogen levels to stay high.

So, not much help ... except that if you're sure you felt distinctly good on Clomid and for a little while afterward, I do think that's helpful in pointing to ovarian hormones as especially relevant in your moods.

I'm assuming, by the way, that you didn't actually have your estrogen measured while you were on Clomid. If you have insurance for fertility, you might consider asking your doctor if you could have that done next time (the docs I went to don't believe in using Clomid without blood testing and follicle ultrasounds, because of the risk of high order multiple pregnancies) - it might give you a little bit better idea of what's going on.

Also, in general how do your moods vary with your menstrual cycle?


(By the way, my connection to all this stuff is that I tried to get pregnant with baby #2 when I was 39, and ended up doing 4 cycles of injectables and 3 IVFs and about 18 months of research ... all to finally have baby #2, and post-partum depression #2. I have been charting my moods for the last 4 months, and the only obvious factor that correlates with them is the time of the month. So I am certain that ovarian hormones are at least partial causes of my depression, irritability, etc. Unfortunately, my pdoc doesn't really believe in treatments along those lines, but I am slowly getting my act together to visit an endocrinologist that I know treats mood disorders with estrogen patch, birth control pills, etc.)




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