Doctor's Answers (2)
Certain psychiatric medications can increase the prolactin levels, and this can affect the female hormones. This is a picture of the hypothalamic-pituitary-gonadal axis in women (left) and men (right). Essentially, the hypothalamus secretes gonadotropin releasing hormone (GnRH) which stimulates the anterior pituitary to secrete luteinising hormone (LH) and follicle stimulating hormone (FSH) and these in turn will stimulate the ovaries in women and the testes in men to produce oestrogen and testosterone respectively. High prolactin levels that have come about as a result of the anti-depressants can affect production of the hormones at anywhere along this axis.
Some antidepressants are associated with weight gain and in some women with polycystic ovarian syndrome (PCOS), this is usually associated with manifestations of symptoms of PCOS. For example, when weight gain occurs, these women would notice increase length of the menstrual cycle and may notice increase in symptoms of excess male hormones (acne, facial hair, scalp hair loss).
Commonly used antidepressants like SSRIs and SNRIs will not affect the hormones. Other medications like mood stabilisers (e.g., lithium carbonate, quetiapine, olanzapine) may affect the hormones in the body.
Mood stabilisers are used to augment your response to the antidepressant. If you have concerns in this area, it will be good to discuss with your treating psychiatrist.