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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by TrishP on November 5, 2006, at 10:00:54
I am taking 1mg of estradiol in the morning and 1mg at night. I had my total hysterectomy on Aug. 21st.
I feel fine physically, but mentally I am so depressed. I have never felt this bad in my life.
Could the estrogen be causing the depression?
I can't take any of the SSRIs because they cause terrible bladder problems.
If I feel great physically, why do I want to die?
I wish I could take Lexapro or Prozac or Zoloft - they help my moods - but I can't take the awful side effects.
Is it the estrogen? What am I supposed to do? I'm beginning to regret my hysterectomy!
Posted by ronaldo on November 5, 2006, at 10:35:56
In reply to Depression and estrogen?, posted by TrishP on November 5, 2006, at 10:00:54
> I am taking 1mg of estradiol in the morning and 1mg at night. I had my total hysterectomy on Aug. 21st.
>
> I feel fine physically, but mentally I am so depressed. I have never felt this bad in my life.
>
> Could the estrogen be causing the depression?
>
> I can't take any of the SSRIs because they cause terrible bladder problems.
>
> If I feel great physically, why do I want to die?
>
> I wish I could take Lexapro or Prozac or Zoloft - they help my moods - but I can't take the awful side effects.
>
> Is it the estrogen? What am I supposed to do? I'm beginning to regret my hysterectomy!Hi Trish, I hope this helps...
DEPRESSION
http://www.womhealth.org.au/factsheets/hysterectomy.htm
There is actually little evidence to suggest a direct connection between having a hysterectomy and developing depression. In fact, many women's psychological symptoms improve due to relief from the gynaecological problem/s for which they were having a hysterectomy. Those at risk of developing depression following a hysterectomy are women with existing psychological problems, women who do not find symptom relief, women who develop serious post-surgery complications or side effects and women who have been rushed into the procedure without coming to terms with it.
Symptoms of depression may include: severe and prolonged feelings of sadness and hopelessness; diminished interest in activities; decrease in appetite, significant weight loss or gain; sleep disturbance; decreased libido; lack of energy; and thoughts of death or suicide. Women suffering from depression following their hysterectomy should consult either their general practitioner or a counsellor, and may find joining a support group to be helpful.
and this....
http://forums.obgyn.net/womens-health/WHF.0301/2419.html
I had a total hysterectomy in March 2002. Every since then, I too, have experienced continual depression. My ovaries were not taken out. After realizing this "blue mood" was hanging on, I had a blood test to check my hormones. Still okay in that sense. I know for sure I entirely miss my "rythm"...but I can't put my finger on why the depression and memory skips that seem a whole lot more often than before my surgery. I looked for information on the internet hoping to find it's not all make believe and that other women have experienced this too. Seems like others have and do. Sincerly, Deb K.
and this.... (a bit too technical for me)
http://www.theberries.ns.ca/BOTW_archives/estrogen_depression.html
Estrogen and Depression
The marked sex difference in rates of psychiatric illness beginning at puberty and continuing throughout the reproductive years suggest that the brain's hormonal environment can modulate risk and severity of psychiatric morbidity. This hypothesis, that hormones play an integral role in the development and prognosis of psychiatric disorders, has been attracting increasing attention, especially in relation to the treatment of depression, and more recently schizophrenia.The male-female contrasts in estrogen production throughout the reproductive years are proposed to differentially modulate the expression of depression between the sexes. Mood changes are frequently reported during the late luteal phase of the menstrual cycle and following childbirth1. The finding of increased risk for depression at menopause has not been replicated consistently, however a recent epidemiologic study did find that the onset of major depression was increased after menopause, at a time when estrogen levels decline.2 It is postulated that post-menopausal women are increasingly vulnerable to depression due to this reduced estrogen production.
The activity of estrogen on neurotransmitter and receptor functioning has antidepressant characteristics. Estrogen enhances serotonergic function (increases synthesis and uptake, post-synaptic receptor responsivity, and leads to up-regulation of 5-HT1 and down-regulation of 5-HT2 serotonin receptors. It also increases norepinephrine activity in the brain, and improvement in mood and cognition reported in women on estrogen replacement therapy (ERT) may also involve changes in monoamine oxidase activity.3
Although estrogen has been shown to improve mood and sense of well-being in non-depressed peri- and post-menopausal women, estrogen alone does not improve mood in women with clinical depression.4 However, there may be a role for estrogen as an adjunct to antidepressant therapy. A recent double-blind study (n=127) found that older depressed women (60 years or older) on ERT who received sertraline had substantially greater improvements than women receiving sertraline alone.5 However, these findings were not replicated in a younger cohort of depressed women (>45 years) given fluoxetine (n=172) with or without ERT.6 Considering this, it has been suggested that estrogen augmentation for perimenopausal depression be reserved for a subgroup of women, those with a history of depression associated with changes in estrogen levels (postpartum depression or mood changes related to the menstrual cycle).7
In summary, there appears to be a link between estrogen and the onset, course and severity of depression suggesting estrogen supplementation may be a useful adjuvant therapy in selected depressed women.
Muriel Darniche, BSc Pharm, Nantes, France
David Gardner, PharmD, Halifax, NSI hope this helps you, after all this I have just realized that estradiol is a form of estrogen. Could it be that you are taking too much or else not enough? I don't know but I will post this and hope it helps you in some way.
....ronaldo
Posted by Phillipa on November 5, 2006, at 11:00:04
In reply to Re: Depression and estrogen? » TrishP, posted by ronaldo on November 5, 2006, at 10:35:56
My endocrinologist just told me that a blood test was worthless for estrogen. As it varies thoroughout the day. I've heard saliva tests are more accurate. Love Phillipa
Posted by Racer on November 5, 2006, at 13:16:42
In reply to Depression and estrogen?, posted by TrishP on November 5, 2006, at 10:00:54
When I was taking Clomid, which boosts first estrogen, then progesterone, I was always depressed when estrogen levels DROPPED mid-cycle. My pdoc at the time said that estrogen was actually used in some women to help alleviate the symptoms of depression.
That said, it doesn't mean that your depression isn't related to your hysterectomy. First of all, why did you have it? It could be that your symptoms weren't fully resolved by it, and you're having a psychological reaction to that. Or maybe you're having a psychological reaction that you're not entirely aware of to having had the surgery. Hysterectomy is a very big deal for a lot of women, and you may not be aware of how much it's actually affecting you.
Or, of course, you could just be having an unpleasant response to something in the specific form of estradiol you're taking. There may be another form that's easier on you.
As for the SSRI thing, have you talked to your doctor about ways to mitigate the urinary problems from SSRIs? That seems like the best option to me -- if they work for you, find a way to make them tolerable. That would be the first thing I tried, in a similar situation.
Good luck. I hope things improve soon.
Posted by Declan on November 5, 2006, at 15:43:05
In reply to Depression and estrogen?, posted by TrishP on November 5, 2006, at 10:00:54
Trish, if I was in your shoes I'd want a complete hormome profile.
If my hormones were ideal after supplementation with estradiol, then I would assume that my depression was not hormone related.
Is the estradiol bioidentical?
Posted by ed_uk on November 5, 2006, at 16:39:28
In reply to Re: Depression and estrogen?, posted by Declan on November 5, 2006, at 15:43:05
Hi Dec
Estradiol is the major human estrogen ie. it's bioidentical. Estrone and estriol are other human estrogens. Some HRT products use non-bioidentical estrogens eg. Premarin (conjugated equine estrogens).
Ed
Posted by Phillipa on November 5, 2006, at 18:45:41
In reply to Depression and estrogen?, posted by TrishP on November 5, 2006, at 10:00:54
I'm assuming as you're taking estrogen that your ovaries were removed too. If so are you on compounded bioidentical hormones? They would include the two good estrogens estriodol being one and exclude the bad one and also some progesterone and some also use testosterone. The synthethic forms I could not tolerate. Good luck. Love Phillipa
Posted by TrishP on November 5, 2006, at 18:56:51
In reply to Re: Depression and estrogen? » TrishP, posted by Phillipa on November 5, 2006, at 18:45:41
Yes - everything was taken out - no ovaries anymore. At least now I don't have the awful mood swings - just deep, black depression.
I'm only taking oral estrogen. I couldn't tolerate the synthetics. I do have some testosterone cream, but I haven't been good about taking it.
I talked to the pharmacist today and he said the side effects from the SSRIs are dose related.
But, I've also read about some people having neurogenic bladder caused from the use of SSRIs.
I'm not sure at this point what to take.
My OB/GYN suggested a low dose of Zoloft, but I'm afraid of side effects.
I haven't tried any of the old ADs for fear of weight gain, but they may be an option.
Posted by Phillipa on November 5, 2006, at 19:07:59
In reply to Re: Depression and estrogen?, posted by TrishP on November 5, 2006, at 18:56:51
Trish can you ask your OB-GYN if they will do saliva testing or refer you to someone who does. That way they will compound you're own formula for what your own body needs naturally in cream form absorbed into the skin. Love Phillipa
Posted by TrishP on November 5, 2006, at 19:18:04
In reply to Re: Depression and estrogen? » TrishP, posted by Phillipa on November 5, 2006, at 19:07:59
Good idea! I think a girl I work with goes to an OB/GYN that does saliva testing.
I know this has to be hormone related. I feel great physically, but crappy mentally.
We'll see.
Posted by Jost on November 5, 2006, at 19:31:40
In reply to Re: Depression and estrogen?, posted by TrishP on November 5, 2006, at 18:56:51
>>I'm only taking oral estrogen. I couldn't tolerate the synthetics. I do have some testosterone cream, but I haven't been good about taking it.
I'd suggest keeping up with the testosterone. In articles I've read, there's a significant connection between testosterone level (and replacement, if the level isn't adequate) in women and energy and well-being. If your ob-gyn gave it to you, it might well have some benefit.
Phillipa's suggestion also seems really a good one.
Jost
Posted by Phillipa on November 5, 2006, at 19:38:02
In reply to Re: Depression and estrogen?, posted by Jost on November 5, 2006, at 19:31:40
Oh someone told me to go to powersurge it is women with hormone and women related problems. Love Phillipa
Posted by Declan on November 6, 2006, at 11:28:04
In reply to Re: Depression and estrogen? » Jost, posted by Phillipa on November 5, 2006, at 19:38:02
What about progesterone?
Is that relevant?
Posted by Phillipa on November 6, 2006, at 19:12:35
In reply to Re: Depression and estrogen? » Declan, posted by ed_uk on November 5, 2006, at 16:39:28
In other words horse pee. Yes that's true. Love Phillipa
Posted by Phillipa on November 6, 2006, at 19:16:42
In reply to Re: Depression and estrogen?, posted by Declan on November 6, 2006, at 11:28:04
Declan yes it is relavant. There must be all hormones and careful on the testosterone you wouldn't want to grow hair on your face? Love Phillipa
Posted by fluff on November 7, 2006, at 9:07:48
In reply to Depression and estrogen?, posted by TrishP on November 5, 2006, at 10:00:54
Hi Trish,
A lot of women develop depression and/or anxiety when their ovaries are removed. It's from the sudden decrease in estrogen.
I had both post-partum anxiety and a recurrence when I hit menopause--my ob/gyn says that it also is hormonally related, from rapidly dropping estrogen levels.
Maybe you are not taking enough replacement estrogen? Also, I am now taking Effexor XR, and it has worked wonders for my peri-menopausal anxiety. It is an SSRI and an SNRI. My sister takes it too, and has no problems with it, but she had the bladder problems from Prozac like you describe. fluff
This is the end of the thread.
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