Schizophrenia and the Effects of Estrogen on Schizophrenia
Encyclopedia

Age of Onset

Gender differences have been observed in the age of onset
Age of onset
The age of onset is a medical term referring to the age at which an individual acquires, develops, or first experiences a condition or symptoms of a disease or disorder...

 of schizophrenia. Women have a later age of onset and on average they are diagnosed 2 to 10 years later than men. In fact, the first onset of schizophrenia for men occurs around the ages of 20 to 25, while in women the first onset generally occurs between the ages of 25 to 30 years. However, it has also been noted that in women a second peak in schizophrenia occurs at the ages of 40 to 45. During this period there is a significant drop in estrogen levels in the body. These factors have led researchers to believe that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

may have an effect on psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

 in women.

In support of the above mentioned conclusions many studies have been performed. Doctors Lindamer, Lohr, Harris, and Jeste conducted a study to determine age of onset
Age of onset
The age of onset is a medical term referring to the age at which an individual acquires, develops, or first experiences a condition or symptoms of a disease or disorder...

 of schizophrenia in which they examined gender differences in 194 patients ranging in age from 35 to 97. They found that the mean age for onset in men was 30, while in women it was 39. (It is important to note that this is just one study, and overall averages come from a combination of different studies). About 37% of the women developed schizophrenia at the age of 45, while only 16% of men reported the same. Thus, more women than men experience late onset schizophrenia. This indicates that there is indeed another peak for women at the age of 45 and women do develop schizophrenia later in life.

Another study was conducted on older men and women to determine how schizophrenia affects them. The study consisted of 36 women and 86 men, all of similar age. More women than men were found to have paranoid schizophrenia and suffered more from severe positive symptoms rather than negative symptoms. All of this information is consistent with other studies showing that women have a later age of onset
Age of onset
The age of onset is a medical term referring to the age at which an individual acquires, develops, or first experiences a condition or symptoms of a disease or disorder...

 of schizophrenia and suffer more from severe positive symptoms rather than negative symptoms.

Differences in Coping with Schizophrenia in Men and Women

Studies suggest that women are better at coping with schizophrenia than men. Not only do women show fewer negative symptoms, but they respond better to antipsychotics. Having healthier social and family lives also appear to make women less susceptible, and result in and fewer hospitalizations. Women also tend to have an overall higher percentage of recovery for all age-groups, although only by a small margin.

Estrogen and Dopamine

Genetic
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....

 factors have much to do with developing schizophrenia. In fact the “heritability of schizophrenia is around 80%, and a first degree relative has a 5 to 10 fold increase in the risk of developing the disorder compared to the risk for the general population.” It seems that individuals with schizophrenia inherit problems associated with dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

 in the brain. According to Answers.com, dopamine is a “neurotransmitter… essential to the normal functioning of the central nervous system.” In the 1950s Arvid Carlsson “designated the molecule dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

,…,as a neurotransmitter
Neurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...

.” This led to the dopamine hypothesis of schizophrenia
Dopamine hypothesis of schizophrenia
The dopamine hypothesis of schizophrenia or the dopamine hypothesis of psychosis is a model attributing symptoms of schizophrenia to a disturbed and hyperactive dopaminergic signal transduction. The model draws evidence from the observation that a large number of antipsychotics have...

.

Animal studies
Animal studies
Animal studies is a recently recognized field in which animals are studied in a variety of cross-disciplinary ways. Scholars from fields as diverse as: art history, anthropology, biology, film studies, geography, history, psychology, literary studies, museology, philosophy, and sociology; and from...

 provide evidence that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 regulates dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

 systems. In the studies performed on animals estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 seems to act as a barrier to dopamine receptors. Thus estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 may prevent the increase in dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

 found in patients with schizophrenia. This directly supports the idea that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 acts as a deterrent. This would explain why women have peak in the onset of schizophrenia in their late forties since at this time estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 levels drop in women, causing the dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

 to increase, resulting in psychotic symptoms.

Biochemical studies prove contradictory to this approach. In these studies the estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 either increased or decreased dopamine receptors, depending on the time allotted for the experiment. This contradicts the theory that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 inhibits dopamine receptors, therefore acting as a protectorate against schizophrenia. However, these studies provide evidence that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 does indeed have some effect on the release of dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

. Whether or not it acts a protectorate or not, if further studied it could lead to a better understanding of schizophrenia and why it occurs later in women when their estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 levels have gone down. At the same time errors could have occurred as the studies were done on animals rather than humans.

Estrogen as a Treatment

Estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 is often used to treat schizophrenia in women. According to an online science article, “Prof. Ina Weiner of Tel Aviv University's Department of Psychology and her doctoral student Michal Arad have reported findings suggesting that restoring normal levels of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 may work as a protective agent in menopausal women.” This supports the theory that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 acts as a protectorate against schizophrenia. According to Dr. Weiner it has been known for a long time that when estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 levels are low women are more susceptible and respond poorly to anti-psychotic drugs, thus supporting the use of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 as a treatment.
In the study Dr. Weiner and Arad performed, ovaries were removed from rats resulting in low estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 much like in menopause
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...

. As a result of the ovaries removal the rats showed schizophrenia like symptoms.To test if estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 replacements work in reducing schizophrenia symptoms the rats were then given estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

, and as predicted the schizophrenia symptoms decreased. The anti-psychotic drug haloperidol
Haloperidol
Haloperidol is a typical antipsychotic. It is in the butyrophenone class of antipsychotic medications and has pharmacological effects similar to the phenothiazines....

 was also given to rats, but showed no signs of relieving the schizophrenia-like behavior, providing evidence for the effectiveness of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 in comparison with other anti-psychotic drugs. They also found that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 is effective for relieving schizophrenia in both male and female rats. In addition they found that low amounts of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 increase the effectiveness of anti-psychotic drugs. Although this study suggests that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 helps in alleviating symptoms, many argue that it could have side effects such as cervical cancer
Cervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...

 and heart attacks.
As a result of her study, Dr. Weiner concluded that women suffering from schizophrenia should be given estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 supplements in their mid-twenties and in their forties, when estrogen levels are decreased. This would improve the effectiveness of anti-psychotic drugs and would help in assisting women with schizophrenia in maintaining a normal lifestyle without peaks of schizophrenia in their forties. Dr. Weiner also believes that since men are less likely to develop schizophrenia after the age of forty, it is likely that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 is the “culprit.”

In 2008 a study was done to test the effectiveness of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 patches on schizophrenia patients. Over a period of four weeks the individuals tested showed a reduction in positive symptoms; however they showed no differences in negative symptoms. It is still not known exactly how estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 helps in alleviating schizophrenia, however from this study the researchers felt that perhaps estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 causes “rapid actions on cerebral blood flow and/or glucose metabolism.” They also recognized that receptors for estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 are located throughout the brain, thus the hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...

 estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 can regulate neurotransmitters. They also noted that although in the short term estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 can have positive effects, they are unsure of its reliability in the long term. However, they stated that they believed that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 could also be used in men, as previously found in other studies.

Another study done in 1995 also showed that estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 relieves positive symptoms in patients. In this study .02 mg of estrogen was administered to premenopausal women with schizophrenia. They found that at first the estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 increased the efficiency of neuroleptics, but over a long period of time the effect of the estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 reversed and decreased the efficiency of the drugs. The researchers concluded that while estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 helps in the short term, in the long term it can be detrimental. These results were also found in the study mentioned previously.

Conclusion

Major advances have been made in improving the lives of schizophrenics since Paul Eugen Bleuler coined the term in 1908. From that time forward schizophrenia has been observed as a legitimate disease and steps have been taken to improve the lives of people with the disorder. Estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 was found to blunt the effects of schizophrenia and improve the symptoms in both men and women. Overall, estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

supplements were found to have the best effect on women with schizophrenia. This discovery has had a major impact on the lives of those suffering from schizophrenia.
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