Professor Jayashri Kulkarni became a Fellow of the Royal Australian and New Zealand College of Psychiatrists in 1989. As the first Associate Professor/Director of Psychiatry to Dandenong Hospital in 1994, she founded and directed the Dandenong Psychiatry Research Centre (DPRC) and the Monash University Research Centre for Women’s Mental Health. She was Director of Psychiatry of Dandenong Area Mental Health Service (DAMHS) for  eight years and directs a large psychiatric research group in her current appointment as Professor of Psychiatry, The Alfred and Monash University.

Author Quotes  

Estrogen is a really good hormone but it’s non-specific…and so when we’re using a strategy of trying to increase the regulation of estradiol in the CNS, it’s not specifically targeting one particular neurotransmitter.

The problems with Yasmin which has 30 micrograms of estradiol but drospirenone as its progestin, is that it creates rage because the progesterone there is much more androgenic-like.

Not all women are going to have reactions that are adverse to the pills [oral contraceptives], but be prepared to take this history in your practice for women who are of reproductive age, because it may be the X-factor that has just tipped her over into a depression.

Summary and slides 

Prof Kulkarni continues with this presentation with an overview of estrogen and mood.

Allopregnanolone concentrations are being investigated in great detail, not only in PMDD, and findings show that progesterone levels are very sensitive when considering mood disturbance. 

Moving on to discuss oral contraceptives, Prof Kulkarni looks at the relationship with de novo depression in young women or the worsening of depression in vulnerable women. An observational trial (N=273) with Australian women revealed significant differences in objective and subjective measures of depression.   

Looking at which oral contraceptive is best for the mood in women, there appears to be only one – Zoely. 

To conclude this video excerpt, we take a look at the Danish Pill Study 2016 and how the results mirror those found in Prof Kulkarni’s observational trial with evidence showing the same outcomes. 

Take-home Points  

• There is still no oral contraceptive pill that doesn’t create mood problems. 
• The Danish Pill Study 2016 confirmed that progesterone-only contraception and the pill, in general, were associated with developing depression in adolescents.  
• The increasing rate of abuse of girls in Australia may be due to more reported incidents but no less serious. 

Quiz

Learn more

1. Tibolone As Adjunctive Treatment in Perimenopausal Depression By Prof Jayashri Kulkarni
2. HRT vs Antidepressants in Perimenopausal Depression by Prof Jayashri Kulkarni
3. Premenstrual dysphoric disorder (PMDD) and Hormonal Treatments by Professor Jayashri Kulkarni
4. Gender Differences in Mental Health by Professor Jayashri Kulkarni
5. Prof Jayashri Kulkarni’s Tips On Prescribing Antipsychotics in Pregnancy
6. Trauma and Complex Trauma Disorder by Prof Jayashri Kulkarni
7. Women’s Mental Health: A Bio-Psycho-Social Approach by Prof. Jayashri Kulkarni
8. Schizophrenia in Women – Role of Estrogen and Novel Treatments
9. Hormones and Mental Illness in Women – PMDD / Depression and the Pill / Perimenopausal Depression