The female brain hypoestrogenic continuum from the premenstrual syndrome to menopause. A hypothesis and review of supporting data

Abstract

Objective: To propose a theory to help unify the symptoms of premenstrual syndrome (PMS), postpartum blues and depression, the perimenopausal transition and menopause.

Study design: A review of supporting data is used to explain the possible neuroendocrine mechanism upon which the hypothesis is based.

Conclusion: The brain in women has been shown to be an estrogen target organ. Common symptoms are shared by women complaining of PMS, postpartum blues, the perimenopausal transition and menopause: depression, sleep disturbance, irritability, anxiety and panic, memory and cognitive dysfunction and a decreased sense of well-being. The antiestrogens progesterone, progestin and tamoxifen may also elicit these same symptoms. It is proposed that whenever brain estrogen levels fall below the minimum brain estrogen requirement, for whatever reason and at whatever age, brain center dysfunction may ensue.