Can Estrogens Like Premarin Cause Depression?

Premarin
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To answer the question of whether conjugated estrogens like Premarin can cause depression, we must first talk about what estrogen is.  Estrogen is a group of hormones which play a vital role in women's sexual and reproductive health.  They are often referred to as sex hormones because of this.  Estrogen helps to regulate a woman's sexual development as well as her ability to conceive and bear children.

Premarin is a brand of conjugated estrogens.  Conjugated estrogens are a type of hormonal medication containing a mixture of estrogens. In Premarin's case, these have been isolated from the urine of pregnant mares: PREgnant MARes' urINe.  It is used to treat symptoms associated with menopause and other low-estrogen conditions, such as hot flashes and vaginal dryness.  It is also used in the prevention of osteoporosis (thinning of the bones) after menopause.

It is well known that estrogen is closely linked to depression and anxiety.  Women who are in their peak estrogen-producing years tend to be affected by these disorders more often than either men or postmenopausal women.  In addition, when women are experiencing hormonal fluctuations, such as prior to their menstrual periods and after giving birth, they tend to be more prone to mood disorders.

Perhaps not too surprisingly, depression is also a potential side effect of medications like Premarin, which affect hormone levels.

The reason that estrogen-containing medications have the potential to affect mood is that estrogen plays many roles in the body, affecting more than just the sex organs. It can exert effects on the urinary tract, the heart, the blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles and the brain.

Some of its effects on the brain and nervous system include:

  • Increasing serotonin and its receptor sites in the brain
  • Altering the production and effects of "feel-good" chemicals called endorphins
  • Protecting nerves against damage and maybe even stimulating the growth of new nerves

Despite these positive effects on the brain, it appears that some women may be exceptionally sensitive to changes in hormone levels, causing them to more susceptible to depression when these levels vary.

While it is not known how often women become depressed while using Premarin, it is a potentially serious side effect.  If women using this medication experience any of the following symptoms, especially thoughts of death or suicide, they should consult with their personal physician for advice:

  • Sadness or depression
  • Inability to enjoy things that used to be pleasurable
  • Fatigue or low energy
  • Problems with thinking, concentration or memory
  • Feelings of guilt, worthlessness or helplessness
  • Feelings of hopelessness
  • Problems with sleep
  • Problems with weight or appetite
  • Irritability or restlessness
  • Thoughts of death or suicide

Women should also be aware that conjugated estrogen medications like Premarin have the potential to interact with the herbal depression remedy St. John's wort, so women who are considering using this over-the-counter treatment for their mild or moderate depression should consult with their physician first.

Sources:

"Conjugated Estrogens (Oral route)."  Truven Health Analytics.  December 1, 2015.  PubMed Health.  Accessed:  January 26, 2016.

"Drugs and Medications - Premarin Oral."  WebMD.  WebMD, LLC. Last revised:  October 2015.  Accessed:  January 26, 2016.

"Estrogen and Women's Emotions."  WebMD.  WebMD, LLC.  Reviewed:   January 16, 2015.  Accessed:  January 26, 2016.

"Estrogen Effects on the Female Body."  New York-Presbyterian Hospital.  November 30, 2008.  Columbia University College of Physicians and Surgeons.  Accessed:  January 26, 2016.

Ogbru, Omudhome and Jay W. Marks. "Conjugated Estrogens Vaginal Cream - Premarin Vaginal Cream."  MedicineNet.  MedicineNet, Inc.   Reviewed:  December 24, 2014.  Accessed:  January 26, 2016.

"Symptoms of Depression."  WebMD.  WebMD, LLC.  Accessed:  January 26, 2016.

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