The female reproductive cycle has many phases. These range from the premenstrual to the peri and postmenopausal phases. There are many variables, which can contribute to these reproductive phases creating psychiatric comorbidities.

In order to understand some of the more salient details of these influential variables, we need to review some basics. Epidemiologic studies over time and with large sample cohorts demonstrate that women are at a significantly greater risk for major depressive disorder when compared to men.

The National Comorbidity survey revealed that between the ages of 15 and 54 years the lifetime prevalence of Major Depressive Disorder is 12.7 percent for men and 21.3 percent for women. More recent studies demonstrate a two-fold greater lifetime risk of developing Major Depressive Disorder in women. It has been suggested that the increased prevalence findings are likely to be associated with female-specific reproductive events i.e. Perimenstrual emergence, pregnancy, postpartum events and menopause.

The hormones estrogen and progesterone have been implicated to affect regions of the brain responsible for the modulation of certain moods and behaviors. Receptor sites for these hormones are located in the prefrontal cortex, thalamus, hippocampus and brain stem. Fluctuations in these steroidal gonadal hormones are thought to create a window of vulnerability for psychiatric comorbid states.

These psychiatric states include for example: depressive episodes, (ranging from dysphoria to major depressive severity), anxieties (ranging form generalized levels to debilitating panic degrees), somatic symptoms (which can exacerbate preexisting medical disorders - ie. vasomotor symptoms like hot flashes and night sweats, premenstrual asthma and perimenstrual migraines).

There are psychosocial factors that can also be associated with mood and anxiety based complex symptoms. Sexual maturity stages, increasing social pressures, past traumas, socioeconomic and educational status, stressful life events, medical issues, inadequate social support, marital-sexual issues, divorce, death of a spouse, empty nest issues, caring for aging parents and several health issues may all be factors that lead to an increased susceptibility to hormonally catalyzed psychiatric disorders. The stages of the reproductive cycle and conforming age ranges vary according to the events involved (i.e. puberty, perimenstrual, childbirth, postpartum and perimenopausal phases of the female reproductive life cycle).

Other significant phases of the reproductive cycle including pregnancy, post partum, the menopausal transition and gyn cancer will be discussed in further detail in sequent articles.

Suffice it to say in closing, that there are several different recommended treatment modalities that may help to measurably benefit these comorbid medical (OB- GYN) and psychiatric diagnoses. These include, but are not limited to hormone replacement therapy, biological identical hormone therapy, serotinergic antidepressant therapy, psychotherapy, alternative medicine therapies, and other psychotropic medication options as indicated. Each of these alone or in, combination may play a useful role in managing the various aspects of these various phases of female hormonal transitional instability and co-occuring psychiatric disruptions. - Advertorial