Mood & Mental Health: When Anxiety and Low Mood Are Hormonal

Fluctuations in mood, unexpected bursts of anxiety, or persistent feelings of low mood are incredibly common. Many women and people with cycles dismiss these feelings, believing they are ‘just emotional’ or simply a consequence of a busy life. Yet, these psychological shifts are often indicators that your internal hormone balance is disrupted.

Mood and mental health are intrinsically linked to the endocrine system. The very hormones that regulate your menstrual cycle and reproductive health – like oestradiol and testosterone – are also neuroactive steroids. This means they directly communicate with your brain, influencing key neurotransmitters like serotonin and GABA, which govern happiness, stability, and calm.

This article outlines the complex interplay between your hormones and your brain. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms.

What Causes Mood and Mental Health Changes?

Whilst depression and anxiety can stem from genetics, life events, or chemical imbalances unrelated to hormones, there are distinct patterns of mood disruption that point directly toward hormonal drivers.

Recognising Hormonal Triggers

Hormonally driven mood changes often present with specific characteristics:

• Timing: They can be cyclical, worsening predictably during certain phases of the menstrual cycle, or they can be persistent, suggesting an underlying chronic imbalance (such as thyroid or high androgen levels).
• Severity: Symptoms often feel disproportionate to current life circumstances and can include acute irritability, sleep disruption, or severe hormonal anxiety.
• Physical Co-Occurrence: Mood changes are often accompanied by other hormone-related physical symptoms, such as acne, hair thinning, irregular periods, or chronic fatigue.

How Hormones Affect Mood and Mental Health

Hormones don’t just affect your reproductive organs; they are powerful modulators of your entire central nervous system (CNS). Imbalances or abrupt fluctuations in these critical messengers are a common cause of psychological distress.

1. The cycling hormones (oestradiol, LH, and FSH: 

Oestradiol (the primary oestrogen), regulated by the brain’s signals LH and FSH, is a potent regulator of mood and anxiety.

• Oestradiol’s: Oestradiol typically has an anxiolytic (anxiety-reducing) and mood-enhancing effect. It is known to increase serotonin levels and receptor sensitivity in the brain, helping to promote feelings of well-being and stability (Hernández-Hernández et al., 2019).
  • Low Oestradiol: Periods of naturally declining oestradiol – such as in the late luteal phase of the cycle, in perimenopause, or during high-stress periods causing hypothalamic amenorrhoea – withdraw this protective effect. This commonly leads to increased vulnerability to depression, tearfulness, and hormonal low mood.
• LH and FSH: As the pituitary signals that regulate the ovaries, testing LH and FSH helps contextualise oestradiol and androgen levels. For instance, high LH and a high LH:FSH ratio can be an indicator of Polycystic Ovary Syndrome (PCOS), a condition strongly associated with elevated rates of anxiety and depression (Gunkaya et al., 2024).

💡 Is your cycle affecting your head?

If your anxiety or mood shifts violently or predictably, it could be your hormones. Take our Advanced At-Home Hormone and Fertility Test to investigate the link between your sex hormones, LH, and FSH.

2. Androgens (Testosterone, DHEAS, and SHBG)

Androgens are powerful neuroactive hormones that significantly influence energy, motivation, and psychological well-being.

• Testosterone and DHEAS: In healthy ranges, testosterone is crucial for maintaining energy, drive, focus, and a general sense of vitality. Low testosterone levels are often associated with profound low mood, apathy, and reduced coping capacity (Rohr et al., 2002). Conversely, high androgens, commonly seen in conditions like PCOS, are linked to increased irritability and anxiety (Barry et al., 2018) .
• Sex Hormone-Binding Globulin (SHBG): SHBG controls the amount of free (active) testosterone available to the brain and body. If SHBG is high, it can bind up available testosterone and oestradiol, leading to symptoms of deficiency, even if total levels are normal. Low SHBG releases more active hormones, potentially contributing to more pronounced symptoms of hyperandrogenism (like irritability and anxiety) (Zhu et al., 2023).

3. Thyroid Hormones: TSH and Free Thyroxine (FT4)

The thyroid axis is central to CNS function, as thyroid hormones regulate cell metabolism throughout the body, including the brain. Measuring TSH (from the pituitary) and Free Thyroxine (FT4) (the active thyroid hormone) provides a clear picture.

• Hypothyroidism (Low FT4, High TSH): An underactive thyroid slows down CNS activity, often resulting in symptoms that precisely mimic depression: low mood, apathy, impaired memory, and mental sluggishness.
• Hyperthyroidism (High FT4, Low TSH): An overactive thyroid accelerates brain function, leading to extreme nervousness, anxiety, restlessness, and emotional volatility, easily mistaken for a primary anxiety disorder.

When to Get Tested

If your feelings of hormonal low mood or hormonal anxiety are persistent, cyclical, or do not respond fully to standard treatments, exploring your hormone health is a vital step. Mood disorders often represent a neuro-biological effect of an underlying hormone imbalance.

You should consider comprehensive testing if you experience:

• Cyclical Mood Swings: Particularly if they start in the luteal phase, indicating hormonal sensitivity.
• Unexplained Anxiety or Apathy: Especially when paired with other symptoms like severe fatigue, irregular periods, or unexplained weight changes.
• Symptoms of Hormone Change: Such as new mood volatility alongside hot flushes or hair changes (suggesting perimenopause).

What Your Results Can Tell You

Testing a full panel of personalised hormones – which can include Testosterone, SHBG, DHEAS, TSH, Free T4, Oestradiol, LH, FSH, AMH, and Prolactin – provides the essential diagnostic data needed to find the root cause:

1. Pinpoint Imbalances: The data clarifies whether the mood symptom is driven by a specific imbalance.
2. Diagnosis of Conditions: The results are used to diagnose conditions like PCOS or thyroid disease, which can have profound psychological effects.
3. Personalised Treatment: Understanding the specific imbalance allows clinicians to create a bespoke care plan that addresses the root cause, whether through lifestyle, targeted nutritional support, or medical interventions, moving you towards genuine, lasting mental wellbeing.

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💡 Take control of your hormones today

Uncover the biological drivers of your anxiety and low mood. Take our Advanced At-Home Hormone and Fertility Test for clarity and a personalised care plan.

References 

• Barry, J. A., Qu, F., & Hardiman, P. J. (2018). An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS). Medical hypotheses, 110, 42–45. https://doi.org/10.1016/j.mehy.2017.10.019 
• Gunkaya, O. S., Tekin, A. B., Bestel, A., Arslan, O., Şahin, F., Taymur, B. D., & Tuğ, N. (2024). Is polycystic ovary syndrome a risk factor for depression and anxiety?: a cross-sectional study. Revista da Associacao Medica Brasileira (1992), 70(3), e20230918. https://doi.org/10.1590/1806-9282.20230918 
• Hernández-Hernández O. T., Martínez-Mota L., Herrera-Pérez J. J., Jiménez-Rubio G. (2019). Role of estradiol in the expression of genes involved in serotonin neurotransmission: implications for female depression. Curr. Neuropharmacol. 17, 459–471. https://doi.org/10.2174/1570159X16666180628165107 
• Rohr U. D. (2002). The impact of testosterone imbalance on depression and women’s health. Maturitas, 41 Suppl 1, S25–S46. https://doi.org/10.1016/s0378-5122(02)00013-0 

Zhu, H., Sun, Y., Guo, S., Zhou, Q., Jiang, Y., Shen, Y., Zhou, Z., Du, Z., & Zhou, H. (2023). Causal relationship between sex hormone-binding globulin and major depression: A Mendelian randomization study. Acta psychiatrica Scandinavica, 148(5), 426–436. https://doi.org/10.1111/acps.13614