Janet: Hormones and hearing loss/depression

Janet, a mother in her late 30's, came in asking for advice regarding worsening hearing loss and depression just a few months post-partum. She had a history of depression and hearing loss, and was maintained on low dose anti-depressants throughout the pregnancy and after delivery. She was still nursing her child, and could not understand why her depression was worsening again despite not having stopped her anti-depressants. She was evaluated by her Ear-Nose-Throat (ENT) physician and a suggestion was made to place her on synthetic steroids for her hearing loss, but that he was uncomfortable doing so since she was still nursing her baby. Her symptoms made sense to me since lactation is a powerful natural method of birth control, essentially suppressing ovulation and ovarian production of hormones, including estrogen which was needed to coat all the nerves in our body (including the auditory nerve which is responsible for hearing), as well as regulate the production of multiple neurotransmitters in the brain, including serotonin, which is the target of her anti-depressant. I checked her estrogen level, which was undetectable, as I had suspected. I placed her on bio-identical estrogen patch, and it made an immediate difference, and allowed her to continue to nurse her baby. In fact, she told me that the estrogen has made her feel, if anything, a little better than how she felt before the pregnancy!

Janet's situation teaches us that our sex hormones have far-reaching effects throughout the entire body, and not just localized to our reproductive organs. Placing her on synthetic cortisone-like steroids would have perhaps helped with her symptoms, but not treated the root cause of her problems, and would have likely led to other side-effects. The same would be true for raising the dose of her anti-depressants.