The role of steroids in the development of post-partum mental disorders.

BACKGROUND: Unfavorable post-partum changes to mental well-being affect more than half of all women, and are a risk to the health of both mother and baby. Their effects place strains on health and social systems. Currently, no generally accepted theory exists of the causes and mechanisms of post-partum mental disorders. METHODS: Literature search up to 2012, using PubMed and search words: neuroactive steroids, post-partum mental disorders, depression, corticotropin-releasing hormone and estrogens. RESULTS: There are several theories for post-partum depression. One is that autoimmune diseases are involved. Others revolve around genes responsible or that lead to increased disposition to the disorder. It is likely however that the process is associated with the separation of the placenta and the fetal zone of fetal adrenal gland, the main sources of corticotropin-releasing hormone and sexual and neuroactive steroids during pregnancy, and the ability of the receptor system to adapt to these changes. The central nervous system is able to produce neurosteroids, but the drop in levels of peripheral steroids likely leads to a sudden deficit in neuroinhibitory steroids modulating ionotropic receptors in the brain. CONCLUSIONS: Post-partum depression is a multifactorial disease with unknown etiology. It is probably associated with sudden changes in the production of hormones influencing the nervous system, and on the other hand the ability of the receptor system to adapt to these changes. When the relative changes in concentrations of hormones, rather than their absolute levels, is likely more important.

Cigarette smoking and progesterone and androgen metabolites in premenopausal women.

BACKGROUND: Smoking represents the most widespread substance dependence in the world. Several studies show nicotine's ability to alter women hormonal homeostasis. Women smokers have higher testosterone and lower estradiol levels throughout life compared to women non-smokers. This negatively affects women's reproductive function. Furthermore, alteration of neuroactive and neuroprotective steroids occurs in women smokers, and this plays an important role in the activity of the central nervous system, cognition, mental condition, and degree of substance dependence. METHODS: We monitored the effect of smoking discontinuation on steroid spectrum in 40 premenopausal women heavy smokers. These women were examined before they began to discontinue smoking, and after 6, 12, 24 and 48 weeks of abstinence. In each examination, blood was collected to determine steroid spectrum, LH, FSH, and SHBG; basic anthropometric data were also measured using GC-MS or immunoanalysis. Repeated-measures analysis of variance (ANOVA) model was used for evaluation of the data. RESULTS: Given the small number of women who persisted in not smoking, only the data after 6 weeks could be analyzed. No changes were found in C21 steroids, and a slight increase in androgens occurred after the discontinuation of smoking. CONCLUSION: Chronic smoking causes hyperandrogenism in fertile women; after smoking discontinuation, it increases further. Longer-term monitoring is necessary to show the effect of smoking discontinuation on steroid spectrum.