Dr Law Wei Seng

29 July 2025
hormonal imbalances cause depression Have you ever felt like your emotions are on a roller coaster that you cannot control? Like crying at commercials today, and then you’re angry the next day or sad that doesn’t make sense. Can it be stress? Anxiety? Or, hormonal depression? All these are possible causes. You are not imagining it. Other people may tell you you’re too sensitive. But to tell you, the connection between our hormones and our mental health is real, scientifically proven, and common. In fact, women are nearly twice as likely as men to experience depression, and hormonal fluctuations contribute to this difference. If you are reading this because you’re struggling, please know that what you’re experiencing is valid, treatable and more common than you think. You deserve to feel like yourself again and there is hope ahead.

Hormone-Mood Connection

Your hormones are your body’s chemical messengers that travel through your bloodstream to deliver important information to different organs, including your brain. When these messages get disrupted or change dramatically, it can affect how you feel. The key players in your emotional well-being include oestrogen, progesterone, and testosterone. These hormones do not just control your reproductive cycle, but they also influence serotonin or the “happiness chemical” in your brain. When hormone levels drop, serotonin levels can drop too. That’s why one can feel sad, anxious, or irritable.

Your Journey Through Womanhood

Hormonal depression may occur due to hormonal changes that happen in every stage of womanhood.

The Teenage Years

Puberty brings the first major hormonal upheaval of a woman’s life. Some mood swings during this time are normal, but the hormonal changes can increase the risk of developing hormonal depression. For many girls, this is when depression rates begin to climb above those of their male peers. If you are a mother watching your teenage daughter navigate these changes, or if you’re reflecting on your own teenage experience, it’s important to know that depression during puberty usually coincides with other challenges:
  • Sexuality and identity issues
  • Conflicts with parents
  • Academic and social pressures
The key is distinguishing between normal teenage mood fluctuations and signs of hormonal depression. If sadness, irritability, or withdrawal persist for weeks and interfere with daily activities, it’s time to seek help.

Reproductive Years

For many women, the most noticeable connection between hormones and mood happens monthly. About one to two weeks before your period, as hormone levels begin to drop, you might notice changes in your emotional state. For most women, premenstrual syndrome (PMS) brings manageable symptoms — maybe some bloating, breast tenderness, or mild mood changes. But for a smaller group of women, these symptoms cross the line into something much more serious, Premenstrual Dysphoric Disorder (PMDD). PMDD is not just “bad PMS.” It is a real medical condition that can cause severe depression, anxiety, irritability, and mood swings that disrupt your life. If you find yourself dreading certain weeks of the month because you know you’ll feel overwhelmed, hopeless, or unable to cope with normal stressors, you might be experiencing PMDD. The birth control you choose can also affect your mood. Hormonal contraceptives containing certain types of progesterone may increase the risk of hormonal depression in some women. Oestrogen-containing options might offer some protective effects. Don’t hesitate to discuss with your healthcare provider if you notice changes in your mood that coincide with starting/changing birth control.

Pregnancy and Postpartum

Pregnancy brings dramatic hormonal changes that can affect mood in complex ways. Many women experience the “pregnancy glow.” Others are struggling with unexpected emotional challenges. Previous episodes of depression, relationship problems, work stress, or unplanned pregnancy can all increase the risk of hormonal depression during pregnancy. After giving birth, many new mums experience what we call the baby blues, or feeling sad, anxious, and overwhelmed for a week or two after delivery. This is common and usually resolves on its own. But postpartum depression is different. It is more serious, lasts longer, and affects about 10 to 15 percent of new mothers. The rapid drop in hormones after delivery, particularly allopregnanolone, contributes to this condition. If you’re a new mum experiencing persistent sadness, anxiety, difficulty bonding with your baby, thoughts of harming yourself or your baby, or feeling like you’re not cut out for motherhood, please know that it’s not a reflection of your love for your child. Hormonal depression postpartum is a real condition that responds well to treatment.

Perimenopause and Menopause

When people talk about menopause, they’re often actually referring to perimenopause or the transition period that can last several years before your periods stop completely. During this time, hormone levels fluctuate unpredictably, hence the mood swings. The same hormones that have been cycling monthly throughout your adult life are now an irregular roller coaster. Oestrogen and progesterone levels rise and fall erratically before eventually declining. Hence, the mood swings, anxiety, and hormonal depression. Sleep problems compound the issue. Hot flashes can wake you multiple times per night, and poor sleep can make you up to 10 times more likely to become depressed. When you’re already dealing with mood changes due to hormones, sleep deprivation can make everything feel overwhelming. Perimenopause typically occurs in your 40s, which is often already a stress-filled stage of life. You might be dealing with ageing parents, teenagers leaving home, career pressures, or your own health concerns. These external pressures can make hormonal mood swings feel even more intense. The good news is that many women find that, once they reach menopause and their hormones stabilise at lower levels, mood fluctuations often improve significantly.

When Should You Be Concerned?

Hormonal depression doesn’t always look like the sadness we usually associate with depression. You might experience:
  • Persistent feelings of sadness, anxiety or emptiness
  • Increased irritability or anger over small things
  • Feeling hopeless or pessimistic about the future
  • Loss of interest in activities that you used to enjoy
  • Fatigue or lack of energy, even after rest
  • Difficulty sleeping or sleeping too much
  • Problems concentrating or making decisions
  • Changes in appetite or weight
  • Physical aches and pains without clear cause
  • Thoughts of death or suicide
The key factor is duration and impact. If these symptoms linger for at least two weeks and disrupts your daily life, your work, relationships, or your ability to care for yourself or your family, it’s time to see your doctor. Don’t wait for these signs to become severe. Remember, the earlier you get checked up and treated, the better the outcomes.

Your Options

The most important thing to understand now is that you have options and that effective treatment is available. Between 70 and 90 percent of people with depression respond well to treatment over time. And treating hormonal depression is no different.

Hormone Replacement Therapy

This is for women going through perimenopause or menopause. Oestrogen patches with progesterone pills or very low-dose oral contraceptives can help stabilise mood.

Antidepressants

These may be recommended if hormone therapy isn’t suitable for you, or in combination with hormonal treatments. Modern antidepressants are effective and have fewer side effects than older medications.

Targeted Treatments

For specific conditions like PMDD, birth control pills that regulate hormonal fluctuations can be of big help.

The Power of Professional Support

Your healthcare provider is a valuable ally in this journey. Come prepared to your appointment with information about your symptoms, including when they occur and how exactly they affect your daily life. Do not minimise your experience. Be completely honest. If you have tried one treatment approach for hormonal depression and it’s not working, speak up. Sometimes it takes time to find the right combination of treatments for your situation.

Conclusion

You know your body better than anyone else. If something feels different or wrong, you’re probably right. Trust that instinct. And never ever try to handle this alone. Reach out to trusted friends and family members, or you can join a support group. Healing is not always linear. You might have good days and challenging days as you work toward feeling better. This is normal and doesn’t mean treatment is not working. Be patient and compassionate with yourself during this process. If you haven’t found a Singapore women’s clinic for your clinical needs like hormonal depression and persistent mood swings and anxiety, try reaching out to us and we will listen.