Women: Depressed, agitated, can't sleep? It could be hormones

Rosemarie Shaheen Healy endured plenty of life changes in her 40s and early 50s.

She moved twice and went through a divorce. Her sons grew up and left home, and she had a hip replacement. On top of all that, Healy, of San Jose, was juggling a private therapy practice and a full-time job as academic dean of an all-girls private high school.

Still, her mood swings, irritability and insomnia didn't feel like normal responses to difficult life transitions. Healy says they felt "physical" -- outside of her control and totally beyond anything she had ever experienced.

When she noticed girls at her school become sad and moody around the times of their periods, it dawned on her that it might be raging hormones that were messing with her mental health.

Sure enough, after finding a nurse practitioner willing to prescribe hormone therapy, Healy started to feel less "snappish" and could deal better with most everything else. "One of the nice benefits was that I could sleep much better," she says.

Many women of a certain age can relate to Healy's struggle with baffling and disabling mood symptoms. Fortunately, a growing number of doctors and mental health professionals are honing in on the significant role hormones play in midlife women's mental health. By factoring in the hormonal component, health care providers are able to develop treatments that may be better tailored to each woman's symptoms. The treatments often include old standbys -- anti-depressants and hormone therapy -- but in combinations or dosages that can be more effective and less likely to bring on adverse risks and side effects.

"Unfortunately, anxiety and depression often go hand in hand with perimenopause," says Dr. Leah Millheiser, a clinical associate professor in obstetrics and gynecology at Stanford's School of Medicine. "There's definitely no 'one size fits all.' "

Perimenopause is a woman's natural transition to menopause -- when menstruation and fertility permanently stop. Women may start perimenopause as early as their late 30s or as late as their early 50s, and it can last anywhere from a few years to more than a decade.

A growing number of doctors and other health care providers are considering hormonal factors when treating mid-life women for mood disorders. (Michael Hogue/The Dallas Morning News)

During this time, estrogen and progesterone no longer cycle in "a modulated rhythm of synchronized harmony," says Diana Taylor, a professor emerita at UC San Francisco's School of Nursing and early pioneer into research on women's menstrual cycles. Rather, she says, hormones sputter erratically or "peak and crash," affecting many body functions, including sleep, memory, mood and energy.

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Women: Depressed, agitated, can't sleep? It could be hormones