The Effects of Estrogen on Women’s Emotions and Mood

Medically Reviewed by Shruthi N, MD on August 05, 2024
Written by Matthew Hoffman, MD, Alyson Powell Key
5 min read

Estrogen is closely linked with the emotional well-being of women, people assigned female at birth (AFAB), and those assigned male at birth (AMAB). Depression and anxiety affect you more often during your estrogen-producing years than when you don't make the hormone. Estrogen also plays a role in mood changes associated with conditions such as premenstrual syndrome, premenstrual dysphoric disorder, and postpartum depression.

Exactly how estrogen affects emotion is much less straightforward. Is it too much estrogen? Not enough? It turns out estrogen's emotional effects are nearly as mysterious as moods themselves.

Estrogen is a sex hormone that affects many systems in the body, including the reproductive system, bones, skin, and brain.

Beginning at puberty, a woman's ovaries start releasing estrogen in coordination with each monthly menstrual cycle. At mid-cycle, levels suddenly spike, triggering the release of an egg (ovulation). Then, they fall just as quickly. During the rest of the month, estrogen levels climb and fall gradually.

Normal estrogen levels vary widely. Large differences are typical in a woman on different days or between two women on the same day of their cycles. The actual measured level of estrogen doesn't predict emotional disturbances.

Estrogen is a major player in regulating moods. Estrogen acts everywhere in the body, including the parts of the brain that control emotion.

Some of estrogen's effects include:

  • Increasing the mood-altering chemical serotonin and the number of serotonin receptors in the brain
  • Modifying the production and the effects of endorphins, the "feel-good" chemicals in the brain
  • Protecting nerves from damage and possibly stimulating nerve growth

It is impossible to predict what these effects of estrogen mean in an individual person. Estrogen's actions are too complex for researchers to understand fully. For example, despite estrogen's apparently positive impact on the brain, your mood may improve after menopause when estrogen levels are very low.

Some experts believe that some people are more vulnerable to the menstrual cycle's normal changes in estrogen. They suggest the roller-coaster of hormones during the reproductive years creates mood disturbances.

As many as 90% of women have unpleasant symptoms before their periods. If your symptoms are reliably serious enough to disrupt your quality of life, doctors define it as premenstrual syndrome (PMS). You likely have PMS if:

  • Physical and emotional symptoms happen reliably a few days before every period.
  • The symptoms go away after finishing a period and don't happen at other times.
  • The symptoms cause serious personal problems, such as those at work, school, or in relationships.
  • Medicines, drugs, alcohol, or other health conditions aren't to blame.

Bloating, swelling of arms or legs, and breast tenderness are the usual physical symptoms of PMS. You may also feel overly emotional, depressed, angry, irritable, anxious, or socially withdrawn. As many as 20%-40% of women may have PMS at some point in life.

As with PMS, women with premenstrual dysphoric disorder (PMDD) regularly develop negative mood symptoms before their periods. Some experts consider PMDD to be a severe form of PMS.

In PMDD, mood symptoms are more severe and often overshadow physical symptoms. The emotional disturbances are significant enough to cause problems with daily life. Here are common symptoms of PMDD:

  • Feeling very sad, hopeless, or worthless
  • Feeling more anxious or tense or always on edge
  • Mood swings
  • Being very critical of yourself or sensitive to rejection
  • Crying often or suddenly
  • Feeling more irritable or angry
  • Having conflicts with family, co-workers, or friends
  • Losing interest in usual activities
  • Having trouble concentrating
  • Feeling very tired or lacking energy
  • Eating a lot more, overeating, or craving certain foods
  • Sleeping too much or having trouble sleeping
  • Feeling overwhelmed or out of control 

About 3%-9% of women have PMDD. Estrogen appears to be involved in these mood disturbances, but exactly how is more of a mystery. Estrogen levels in women with PMS or PMDD are almost always normal. The problem may instead lie in the way estrogen "talks" to the parts of the brain involved in mood. Women with PMS or PMDD may also be more affected by the normal fluctuations of estrogen during the menstrual cycle.

Having "the blues" after childbirth is so common that it's considered normal. However, 10%-25% of women experience a major depression within the first 6 months after childbirth. The abrupt drop in estrogen after delivery seems like the obvious culprit, but researchers have never proven this link.

Postpartum depression is treated like any other depression, with antidepressants, therapy, or both. Some preparations of estrogen do show promise as a potential add-on to these established treatments.

In the months or years before menopause (called perimenopause), estrogen levels are erratic. During perimenopause, up to 10% of women experience depression that may be caused by unstable estrogen levels. Some studies suggest that using a transdermal estrogen patch by itself can improve depression during perimenopause, but this is not a standard practice of care. Women in these studies did not take antidepressants.

At menopause, estrogen levels fall to very low levels. Interestingly, taking oral estrogen does not improve depression in women after menopause. In large trials evaluating hormone replacement therapy, women taking estrogen reported the same mental health as women taking placebo. After menopause, women's rates of depression fall, becoming similar to men of the same age.

Estrogen influences your emotions by affecting mood regulation and mental health. Swings in estrogen levels can lead to mood disorders such as PMS, PMDD, postpartum depression, and menopausal depression. These changes in hormone levels can cause irritability, anxiety, and depression.

How do you know if your estrogen is high?

You'll take a blood estrogen test to measure three types that your body makes: estrone (E1), estradiol (E2), and estriol (E3).

How do you fix estrogen dominance?

Treatments for high estrogen depend on the cause. Lifestyle changes include lowering body fat and stress, eating a healthy diet, and limiting alcohol. You could also take medications such as aromatase inhibitors, which block estrogen production in fat cells, and GnRH agonists, which stop the ovaries from releasing estrogen.

What does estrogen do to the female body?

Estrogen plays a role in menstruation, pregnancy, and menopause and causes girls to develop secondary sex characteristics such as breasts and hips.

What is the use of estrogen hormone replacement therapy?

People with low estrogen, such as during menopause, use hormone replacement therapy (HT). You'll take small doses of estrogen to raise your levels or a mix of estrogen and progesterone (natural or synthetic).

How do you treat hormonal depression?

First, talk to your doctor to figure out what's causing your depression. If it's related to your hormones, they may suggest hormonal medicines, antidepressants, and changes to your diet and exercise habits.