Estrogen, stress and the brain: progress toward unraveling gender discrepancies in major depressive disorder

Women are twice as likely as men to develop major depressive disorder (MDD) and, while the neurobiological factors underlying this discrepancy are yet to be identified, estrogen almost certainly plays a role. MDD can be precipitated or exacerbated by exposure to stress and there is substantial evidence to sugget that estrogen can interact with stress systems to produce unique stress effects in females. This review integrates current research in animal models regarding estrogen stress interactions in three areas of the brain known to be relevant to MDD: the hippocampus, the amygdala and the prefrontal cortex. The results from these studies are discussed in the context of MDD, and their implications for future treatment of MDD in women are explored.