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In this chapter, Rasgon and colleagues first review the neurochemical basis underlying estrogen therapy use in mood disorders. They follow with an analysis of changes in estrogen and mood during different hormonal states associated with the menstrual cycle, birthing, and menopause. Results of their analysis indicate that a considerable body of basic science findings support the assertion that estrogens are prime regulators of the neurobiology of mood in women. However, there is discordance between results of animal and human studies. The source of disparity between the basic and clinical science outcomes remains undetermined but indicates the need for larger clinical trials and longitudinal studies that could identify women who are likely to respond well to estrogen monotherapy and estrogen augmentation to antidepressant treatments.
The aim of this study was to develop a mathematical model of the hypothalamo-pituitary-gonadal axis that would reflect available data in humans.
A model of hormonal relationships at the early follicular and midluteal phases of the human menstrual cycle is proposed.
Two distinct temporal patterns of oscillatory behavior have been demonstrated for both pituitary and gonadal steroids in the early follicular phase: first, rapid oscillations in gonadotropin releasing hormone, follicle stimulating hormone, and luteinizing hormone (Q∼1 hour) that were an immediate consequence of the programmed equations. Second, there were slower, undulating, emergent rhythms in luteinizing hormone and follicle stimulating hormone, and also in estrogen, having oscillatory periods of 2–12 hours. There was also a longer-period (Q2–3 days) emergent rhythm in progesterone. In the mid-luteal phase, estrogen and progesterone rhythms were correlated, and all hormones showed an ∼6-hour periodicity.
To our knowledge, the oscillatory behavior of peripheral sex steroids in the follicular phase has not been previously noted.
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