Periods of intense hormonal fluctuations have been associated with heightened prevalence and exacerbation of underlying psychiatric illness, particularly the occurrence of premenstrual dysphoria, puerperal depression and depressive symptoms during the menopausal transition. It has been speculated that sex steroids, such as estrogens, progestogens, testosterone and dehydroepiandrosterone, exert a significant modulation of brain functioning, possibly through interactions with various neurotransmitter systems. It is therefore intuitive that abrupt alterations of these hormones would interfere with mood and behavior. On the other hand, accumulating data suggest that hormonal interventions may also promote relief or even remission of depressive symptoms, as already demonstrated in studies on perimenopausal women treated with transdermal estradiol. This article reviews the potential role of sex hormones for the treatment of depressive disorders in women. There are preliminary, but promising data on the use of estradiol and testosterone for specific subpopulations. Further studies would help to better delineate the usage of these compounds as an antidepressant strategy (monotherapy or augmenting treatment).
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