Hormone therapy and schizophrenic psychoses

The influence of estrogens on the genesis and course of psychological disorders has been discussed for a long time. Studies support the hypothesis that estrogens offer protection from schizophrenia by cerebral effects and have an influence on the beginning and course of the disease. This hypothesis offers a plausible explanation for gender differences in the age when first signs of the disease appear and the course of the disease. Women are relatively protected from schizophrenia between the menarche and menopause. In the postmenopausal period a second peak in first-time diseases occurs in women but not in men. The risk of exacerbation of schizophrenia increases not only in the postmenopausal period but also during the perimenstrual cycle phase and under other conditions where low estrogen levels are present. A deterioration of the psychopathology has been demonstrated even in the perimenstrual cycle phase. The presence of primary hypoestrogenemia in schizophrenic women is evident and independent of hyperprolactinemia caused by classical antipsychotic drugs. The results of studies do not yet allow therapy recommendations to be derived because the therapeutic value of estrogens in the treatment of schizophrenic women still has to be determined. © 2011 Springer-Verlag.