The Link between Ovulation and Teen Mental Health
The Reproductive Health Research Institute (RHRI) has published new research in Frontiers on the link between ovulation and psychological development/personal growth in adolescents.
The research article—authored by RHRI Research Director Dr. Pilar Vigil PhD and Juan Pablo Del Rio, Valeska Tapia Espinoza, and Hugo Soto—is entitled “Neuroactive hormones and personal growth: associations in Chilean adolescents (ages 12–25) with ovulatory dysfunction.”
This study hypothesized that ovulatory dysfunction (OD) in adolescents is associated with certain problems in psychological and personal growth.
A Comprehensive Approach
Dr. Vigil notes that this study was interdisciplinary, involving multiple different fields and departments working together. It fills a gap in the scientific literature, as there have not been many studies on the associations between OD and psychological development.
“We are very used to studying ovulatory disorders—we have a lot published about that—but here we had to put together ovulatory dysfunction and mental health issues,” she says.
117 females, ages 12-25, participated in the study. The patients were experiencing symptoms including irregular periods, amenorrhea (complete absence of a period), acne, hirsutism (excess hair, usually on the face), and weight gain.
Here’s why you should chart your ovulatory cycle.
The team started by administering a complete clinical evaluation to each patient. Each patient was tested for a wide range of hormones including FSH, estrogen, thyroid stimulating hormone (TSH), prolactin, and testosterone.
Ovulatory Dysfunction Can Contribute to Worsening Mental Health in Teens
In their hormonal analysis, the researchers focused on hormones produced by the hypothalamic–pituitary–adrenal-gonadal (HPAG) glands. These hormones affect brain function and impact a person’s psychological function and well-being, especially during the teen and young adult years. And ovulatory dysfunction is often the first sign that these crucial hormones could be imbalanced.
Hormonal imbalance is often at the root of so many symptoms.
All the patients in the study were diagnosed with ovulatory dysfunction caused by some kind of hormonal imbalance. Some of those imbalances included hyperprolactinemia (excess of the hormone prolactin), hypothyroidism (too little of the thyroid hormone), and subclinical hypothyroidism.
At the time of the first hormonal measurement and within the first 30 days following a diagnosis of ovulatory dysfunction, the patients went through a personal growth assessment. The researchers used scales and questionnaires to assess:
- Mood: signs of tension or anxiety, anger or hostility, vigor, fatigue or inertia, depression, and confusion.
- Self-concept: the extent to which self-beliefs are clearly and confidently defined, internally consistent, and stable.
- Sense of coherence: how an individual perceives the world as comprehensible, manageable, and meaningful.
- Self-esteem: overall sense of worthiness as a person.
- Self-control: ability to override one’s inner and immediate response, as well as to interrupt undesired behavioral tendencies and refrain from acting on them.
- Perfectionism: concern over mistakes, doubts about actions, personal standards, parental expectations, parental criticism, and organization.
What the Team Found
Ultimately, the team’s findings, “indicate that hormonal imbalances in adolescents with OD could affect personal growth.”
The researchers observed that their patients had lower self-concept clarity and self-esteem compared to reference data. They also observed that overall, a significant portion of the girls showed elevated levels of tension, confusion, fatigue, depression, and aggressiveness.
One of the most common diagnoses was hyperandrogenemia (an excess of the androgen hormone). The researchers found that higher levels of androgens correlated with lower self-esteem and more depression, tension, and aggression in the patients. This finding corresponds with what the scientific community has already established—that androgens affect the central nervous system, especially during the adolescent years.
55% of the patients had insulin resistance—a condition in which cells can’t respond to insulin as they should and thus can’t regulate blood sugar. Insulin resistance is often associated with obesity. The RHRI team found that weight gain was correlated with lower self-esteem in their patients. And even after adjusting for BMI, insulin resistance still correlated with lower self-esteem scores in the girls.
Overall, the team concluded:
“Typical symptoms of [ovulation dysfunction], such as acne and weight gain, were correlated with scores for concern about mistakes, doubts about actions, tension, confusion, lower self-esteem, and personal standards. These results suggest that adolescents with [ovulation dysfunction] may present a profile of personal growth dimensions different from that of the general population, which may be associated with hormonal dysfunctions.”
In other words, researchers found evidence pointing to a possible association between ovulation dysfunction and negative psychological outcomes in adolescent patients.
A New Way to Care for Teen Mental Health
This new study points towards the role that hormonal imbalances play in mental health issues—and the importance of addressing those imbalances as early as possible.
Why ovulation is so important!
When a teenage girl struggles with mental health challenges, often the response is to put her on antipsychotics or antidepressants and call it a day. Certainly, those medications can be part of the solution. But such a narrow approach does risk ignoring underlying causes.
Dr. Vigil says, “When a hormonal abnormality is not that obvious—when it’s starting to happen, as it is in adolescence— many times it’s not looked after. We want to make people aware of the importance of hormones and mental health.”
She continues, “Anti-depressants will improve their mood, but the hormonal imbalance will still be there. And it’s going to cause other health problems.”
The sooner those imbalances can be addressed, the better chance a teen will have to enjoy psychological health. This is critically important during the stressful adolescent years, when young people are already wrestling with their identity and worldview.
Dr. Vigil says, “Every adolescent should be worked up, looking for hormonal imbalances. The first thing to do is teach them how to chart their cycles. So that when they notice that ovulation isn’t happening as it should, they should get a hormonal profile test.”
Further research will be needed to explore the relationship between ovulation dysfunction and teen mental health. There will need to be longitudinal studies that follow patients over time, as well as research on the impact of factors such as early life experiences, previous hormonal contraceptive use, and family history of hormonal or psychological conditions. And Dr. Vigil notes that there’s a need for more focused studies on how individual hormones—such as androgens—influence brain function.
However, this study lays the groundwork for new, promising ways of caring for teen mental health. It shows the need for a more holistic approach that relies on both psychiatry and reproductive endocrinology.
“We know that for these patients, the treatment is going to give a much better result if we work together,” Dr. Vigil says. “The reproductive doctors, the gynecologists, and the psychiatrists—if we work together, the patient is going to have a much better outcome in her health and her wellbeing… because you are not just treating the symptom. You are treating the underlying cause as well.”
Read the full research article here.
Want a better understanding of your cycle? The FEMM App can help!
The Reproductive Health Research Institute (RHRI) was established to develop and expand ongoing research in the area of reproductive health and endocrinology, and to bring research and foundational knowledge directly to clinicians through educational programs and clinical protocols. RHRI’s research informs the evidence-based model for care offered by FEMM. Learn more here.
