Puberty, Ovarian Steroids and Stress

Abstract

Puberty is accompanied by a number of changes and among them an increased risk for development of major depression. The most common etiology of major depression are stressful life events, being present in approximately 90% of first episodes of depression. The hypothalamic-pituitary adrenal (HPA) axis is one of the major systems involved in responses to stress and this system is clearly influenced by ovarian hormones.

Results: Normal women demonstrate resistance to negative feedback of both cortisol in fast feedback paradigm and dexamethasone in the standard delayed feedback paradigm. Depressed pre-menopausal women show greater increases in baseline cortisol than post-menopausal depressed women and than depressed men. Studies in rodents suggest a similar resistance to glucocorticoid feedback but that estradiol can function to inhibit stress responsiveness. Studies of pre-menopausal depressed women demonstrate lower estradiol, which suggest there is less inhibitory feedback of estradiol on the HPA axis, while normal progesterone will continue to augment stress responses further. Conclusions: The onset of these reproductive hormonal changes modulating stress systems at puberty may sensitize girls to stressful life events, which become more frequent at the transition to puberty and young adulthood.