Hormones play an important role in regulating bodily functions and can affect a person’s mood. A hormonal imbalance may cause symptoms of depression.

Changes in hormone levels can alter mood and emotional well-being. Finding out the underlying cause and taking steps to balance and regulate hormone levels may help relieve hormonal depression.

This article discusses the link between hormonal conditions and depression, treatment options, and when to seek help.

To help support your mental well-being and that of your loved ones, visit our dedicated mental health hub for more research-backed information and resources.

A person with hormonal depression.Share on Pinterest
Carlo A/Getty Images

Changes in hormone levels, from factors such as pregnancy, menopause, or birth control, can alter neurotransmitters that affect mood.

A drop in hormones can lead to a reduced level of serotonin, which can result in increased levels of sadness, anxiety, and irritability.

A drop in testosterone levels may also affect mood and may cause:

  • depression
  • increased anxiety
  • increased irritability
  • low sex drive
  • reduced energy levels

Symptoms of depression include:

Experiencing these symptoms every day for at least 2 weeks may indicate depression.

The following conditions may cause hormonal depression:

PMDD

Premenstrual dysphoric disorder (PMDD) is similar to premenstrual syndrome (PMS), but it is more severe.

Symptoms of PMDD include:

Symptoms may occur 1 or 2 weeks before the beginning of a period, when hormone levels start to drop.

PMDD may occur from an increased sensitivity to hormonal changes during the menstrual cycle, which includes changes in serotonin levels.

Hormonal contraceptives

According to a 2022 research article, hormonal contraception may cause or contribute to depression in some people due to the quantity and type of progesterone the contraception contains.

Estrogen and progesterone are hormones that affect brain function, the nervous system, and neurotransmitters such as serotonin and dopamine.

Estrogen may have protective effects against mood disorders, but progesterone may worsen mood. This may be due to the effect progesterone has on certain neurotransmitters, which can result in lower levels of serotonin.

Menopause

Perimenopause, the transition into menopause, can cause mood changes and may increase feelings of sadness and anxiety.

During perimenopause, estrogen and progesterone levels fall, which can trigger mood changes and may cause episodes of depression.

Other symptoms of perimenopause, such as hot flashes, may also cause sleep problems. Difficulty sleeping can make it 10 times more likely for a person to experience depression.

People with a history of depression may also be more likely to experience depression during perimenopause.

Postpartum depression

Allopregnanolone is a neurosteroid, a type of steroid that the brain produces, that naturally occurs from the breakdown of progesterone.

During pregnancy, levels of allopregnanolone steadily increase up to the third trimester. After childbirth, allopregnanolone levels rapidly fall.

Research suggests this swift change in allopregnanolone plays a major role in postpartum depression.

In many cases, allopregnanolone levels will rise after a few days of giving birth. In some people, levels do not rise, which can lead to depression.

GABA receptors are a type of receptor in the brain that plays a role in many mental health conditions, such as depression. Changes in hormone levels and allopregnanolone during pregnancy may affect how GABA receptors function.

Low testosterone

In males, low testosterone levels may cause depression. Other symptoms of low testosterone include:

Possible causes of low testosterone in males can include:

Females produce lower levels of androgens, such as testosterone, than males. This makes low testosterone harder to diagnose in females.

Symptoms of androgen deficiency in females may include:

  • lowered mood and well-being
  • lack of motivation
  • tiredness
  • loss of muscle mass and strength
  • loss of sex drive

Causes of androgen deficiency in females may include:

Thyroid problems

There is conflicting evidence on whether thyroid disorders are linked to depression, but thyroid disorders may share similar symptoms to depression.

A 2021 meta-analysis found that the link between depression and thyroid disorders may be less than previous research has suggested.

Researchers concluded there may be a moderate link between overt hypothyroidism, rather than subclinical hypothyroidism, and clinical depression in females.

The link may be due to levels of thyroid hormones and the regulation and function of the thyroid gland, as well as sex assigned at birth.

Risk factors for depression may include:

  • differences in brain chemicals that may affect mood
  • genetics, as depression may run in families
  • low self-esteem
  • experiencing high levels of stress
  • continuous exposure to neglect, abuse, violence, or poverty

To diagnose depression, a doctor will ask a person about the symptoms they are experiencing, including the frequency and duration, and how they affect their day-to-day life.

To diagnose hormonal conditions, a doctor may perform a physical exam and run blood tests to check hormone levels.

Treating a hormonal imbalance may relieve hormonal depression. Treatment for hormonal depression will depend on the underlying cause but may include:

  • hormone replacement therapy
  • antidepressants, if hormone therapy is not suitable
  • birth control pills for PMDD
  • over-the-counter pain relievers for physical symptoms
  • alternative contraceptive methods, such as estrogen-based contraception, lower dose progesterone options, or nonhormonal contraception
  • thyroid hormone replacement medication
  • testosterone therapy
  • lifestyle strategies, such as getting regular exercise, eating a balanced diet, and practicing relaxation techniques

According to the American Psychiatric Association (APA), if a medical condition, such as a hormonal imbalance, is causing depression, treating the underlying condition may help relieve symptoms of depression.

Depression is highly treatable. The APA states around 80–90% of people respond well to treatment over time.

In some cases, lifestyle strategies may help improve mood and reduce symptoms of depression and certain conditions, such as PMDD. These strategies include:

  • getting regular exercise
  • avoiding alcohol
  • reducing caffeine
  • getting enough quality sleep
  • practicing relaxation techniques

If people are experiencing symptoms of depression for more than 2 weeks, it is important to contact a doctor.

People can ask a doctor to run hormone tests if they think a hormonal condition may be causing depression.

It may help people to track the symptoms they experience, including when they occur and how frequently. This can help a doctor make a diagnosis.

When experiencing depression, it can be difficult to reach out and ask for help.

However, some charities and organizations provide free and confidential support for people living with depression and other mental health conditions.

Some hotlines a person can contact include:

  • Samaritans: This nonprofit organization offers emotional support to anyone who has feelings of depression or loneliness or who is considering suicide. Call or text 877-870-4673 (HOPE).
  • 988 Suicide & Crisis Lifeline: Call 988 to speak with someone 24/7 from this national network of local crisis centers.
  • Lifeline Chat: This is an online chat service of the National Suicide Prevention Lifeline.
  • Postpartum Support International: Call 800-944-4773. This organization helps people experiencing postpartum depression as well as other mental health issues related to pregnancy, birth, and new parenthood.

This section answers some frequently asked questions about hormonal imbalances and depression.

What hormones cause depression?

A drop in estrogen and progesterone may trigger depressive episodes.

Increased levels of progesterone, such as through taking a progesterone-only contraceptive, may also increase the risk of depression in some people.

Low testosterone levels may also cause depression.

How do I know whether I’m experiencing depression or hormonal changes?

It is normal for hormones to fluctuate. It is also normal for people to experience sadness and lower mood at times.

Depression may be hormonal if people have severe mood changes that link to a change in hormones, which may occur with:

  • menstrual cycle
  • injury, surgery, or cancer treatment that affects reproductive organs
  • pregnancy
  • perimenopause or menopause
  • aging
  • thyroid problems
  • certain medications

People may have depression if they have depressive symptoms for more than 2 weeks. People may have a persistent depressive disorder if they have a low mood most days for 2 years.

Can men have hormonal depression?

Yes. In males, low testosterone levels may cause depression, along with irritability and fatigue. Other symptoms of low testosterone can include low sex drive, erectile dysfunction, and reduced lean muscle mass.

Hormonal changes may cause depression in some people. In females, hormonal depression may occur due to the menstrual cycle, menopause, pregnancy, or thyroid issues.

In males, hormonal depression may occur due to low testosterone.

Treating the underlying cause may help relieve depression. Depending on the cause, treatments may include hormonal medication, lifestyle strategies, or antidepressants.