Did you know that the menopause can trigger schizophrenia? Yes, it turns out that not only has Mother Nature contrived to make it possible for us to drown in our own sweat, lose our memories, hair and sex appeal, but our falling oestrogen levels can also drive us mad!
While listening to the All in the Mind podcast from ABC Radio National I heard a fascinating interview with Professor Jayashri Kulkarni, Professor of Psychiatry and Director of the Monash Alfred Psychiatry Research Centre in Melbourne, Australia.
Menopause and Schizophrenia
When it came to exploring the causes and onset of schizophrenia, Professor Kulkarni made a point I’ve never come across before. In the interview she said:
When we look at the age of first-time schizophrenia, there is a difference between men and women in that men present about almost eight years younger, so you tend to see first episode schizophrenia in young men—16 to 19 years of age. Whereas the first episode of schizophrenia in women tends to come on later, so they’re about 23 onwards to about 30, and then there’s a second blip if you like, or a second group of women who develop schizophrenia in their mid to late 40s for the first time in their lives. That doesn’t happen in men. And these are findings worldwide. And one of the things that suggests a difference is that perhaps there’s something that’s happening in the onset of puberty that is affecting the onset of psychosis in someone who’s perhaps got some family history or genetics of it, or there are other factors going on. In a lot of ways that epidemiological observation fits with the clinical observation that we’re seeing, and fits with some animal work which suggests that oestrogen is protective in the brain.
So of course after puberty women have massive rises of oestrogen and that is perhaps protecting them from becoming sick earlier in their lives. And at the menopause bump in the mid 40s to late 40s they lose that protection of oestrogen, so uncover this second if you like ‘at risk’ time for women. We’ve been using oestrogen as a treatment as well in combination with other treatments and found some really important results. And the interesting thing is that a number of women actually intuitively have also told us they observed their own mental state to be worse at low-oestrogen phases of their menstrual cycle and also in the women approaching menopause—that that’s another time when their mental state becomes affected. We also know that women who have had babies, in their post-natal period are at greater risk of both post-natal depression and post-natal psychosis…
Professor Kulkarni makes two very interesting points. They are:
- Some women may develop schizophrenia for the first time in their lives in their 40s when they are menopausal and
- Oestrogen has been found to be an effective treatment in combination with other treatments.
Treatment of Schizophrenia with Synthetic Oestrogen
In trial results published in 2010 Professor Kulkarni and her team found that Raloxifene — a synthetic oestrogen currently used to treat osteoporosis – had beneficial effects on postmenopausal women with schizophrenia. In the trial a test group experienced a more rapid recovery from psychotic and other symptoms compared to control groups.
What to Make of it All?
On the one hand I find it alarming that being menopausal and experiencing falling levels of oestrogen could have such an extreme effect on women’s mental health. On the other hand, it is reassuring to know that the cure could lie in replacing hormone levels rather than administering more anti-psychotic drugs.
Either way, the link between hormones and mental health is fascinating and one we still know so little about.
This is still an area that is not really talked about in the literature about menopause. If you have any further knowledge or experience of this issue, I’d love to hear from you. Please leave a comment below.
Read the transcript from the All in the Mind ‘Art, Science and Schizophrenia’ podcast. Click ‘Show’ next to ‘Transcript’.
You can read more about Professor Kulkarni’s research in this online article: Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review.
Science Daily Article: Brain Estrogen Shows Promise as Schizophrenia Treatment