Hormonal Effects during the Reproductive Years on Brain and Behavior: Molecular Discovery to Promising Therapeutics for Womens Mental Health

Beginning at puberty and throughout the lifespan, women experience greater rates of depression, anxiety disorders, eating disorders, post-traumatic stress disorder, and hormone-linked mood disorders relative to men. How these disorders relate to hormonal fluctuations and associated changes in physiology and brain circuitry in women during the reproductive years is only partially understood. In this review, the molecular, structural, and functional brain changes during the reproductive years are discussed, with a specific focus on transitional changes during the perinatal period. Preclinical and clinical models of neuroplastic change are also discussed, along with neuromodulatory approaches that account for the contextual, spatial, and temporal parameters of interventions delivered during the postpartum period. Future directions may consider how hormonal fluctuations during reproductive years may improve preclinical and clinical models for women's mental health while acknowledging that greater work is needed to understand the role of a broader range of hormonal and environmental factors linked to mental health including lactation, trauma, contraceptive use, menstruation, and perimenopause.