Kooiman L A M, Jansen B J A, Peeters F P M L
Departement voor Medische, Klinische en Experimentele Psychopatologie, Universiteit Maastricht.
Tijdschr Psychiatr. 2007;49(4):241-50.
Depression is more prevalent among women than among men. There are several possible explanations for this. There are indications that the aetiology of this difference in prevalence has to do with fluctuations in the oestrogen level, which are a feature of the female reproductive system. The influence of oestrogens on the hypothalamic-pituitary-adrenal axis may play an important role.
To cast light on the deregulating influence of oestrogen on the hypothalamic-pituitary-adrenal axis. This deregulation could lead to depression in a subgroup of women with a neuroendocrine stress response that is sensitive to hormonal fluctuations.
PubMed was used to review the literature on the basis of the key words 'depression', 'estrogen', 'gender', 'gonadal hormones', 'hpa axis', 'stress' and 'women'.
Deregulation of the hypothalamic-pituitary-adrenal axis plays a role in the aetiology of major depression. On the one hand, oestrogens stimulate the activity of this system. On the other hand, a lowering of the endogenous oestrogen level seems to be accompanied by reduced activity of the hypothalamic-pituitary-adrenal axis.
Changing oestrogen levels characterise the female reproductive system. It is these changing levels--not the absolute oestrogen level--which have the potential to deregulate the hypothalamic-pituitary-adrenal axis.
抑郁症在女性中比在男性中更为普遍。对此有几种可能的解释。有迹象表明，这种患病率差异的病因与雌激素水平的波动有关，而雌激素水平波动是女性生殖系统的一个特征。雌激素对下丘脑 - 垂体 - 肾上腺轴的影响可能起重要作用。
阐明雌激素对下丘脑 - 垂体 - 肾上腺轴的失调影响。这种失调可能导致一部分对激素波动敏感的具有神经内分泌应激反应的女性出现抑郁症。
使用PubMed以“抑郁症”“雌激素”“性别”“性腺激素”“下丘脑 - 垂体 - 肾上腺轴”“应激”和“女性”为关键词检索文献。
下丘脑 - 垂体 - 肾上腺轴的失调在重度抑郁症的病因中起作用。一方面，雌激素刺激该系统的活性。另一方面，内源性雌激素水平的降低似乎伴随着下丘脑 - 垂体 - 肾上腺轴活性的降低。
雌激素水平的变化是女性生殖系统的特征。正是这些变化的水平——而非绝对的雌激素水平——有可能使下丘脑 - 垂体 - 肾上腺轴失调。
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